Overview of Breast Self-Examination
Breast cancer is the most common type of cancer among women and is the second leading cause of cancer-related deaths in American women. Because detecting breast cancer early can help slow the disease, many different screening programs have been created.
One suggested method for early detection was breast self-examinations. This is a process where women physically check their own breasts for lumps or changes. The idea behind it is simple and appealing: it’s free, it’s non-invasive (doesn’t involve any medical procedures), and women can do it at home.
However, research has shown that self-exams might not be as effective as we thought at detecting early-stage breast cancer. Most medical organizations, like doctor’s associations and health academies, do not recommend breast self-exams as a standard way to look for breast cancer.
Some international groups have suggested that in countries where medical resources are limited, self-exams could be helpful. The idea now is under review. Despite this lack of support from the research, some breast cancer awareness groups still promote breast self-exams and provide education on how to do them correctly.
Anatomy and Physiology of Breast Self-Examination
When examining your own breasts, it’s important to understand that each individual’s breast structure can vary, and it can change with age, hormonal shifts, and during different stages of the menstrual and pregnancy cycles.
The breast tissue stretches out from the region covered by the second and third ribs and extends downward and across the chest. Sometimes, you might notice a small extension of breast tissue in the armpit region, known as the tail of Spence. The breast is made up of two main parts: The functional portion contains thousands of tiny, milk-producing sacs, while the larger part consists mostly of fatty tissue.
The milk-producing sacs in the breasts develop into ducts and pockets that end at the nipple. When a baby sucks on the nipple, it triggers certain nerves which cause the nipple to become erect and milk to be released. On the surface of the areolas (the darker areas around your nipples), you might notice small bumps. These are Montgomery’s glands, which produce an oil that protects the nipple.
The breast tissue is secured to the skin by connective tissue bands known as Cooper’s ligaments, providing support and allowing free movement. It also contains a network of lymph nodes, which unfortunately can serve as pathways for the spread of breast cancer.
During puberty, girls’ breasts grow due to the production of hormones. The breasts continue to change during pregnancy, preparing for milk production by expanding and darkening the nipple and areola. Once breastfeeding stops, the breasts generally return to their previous size. As women age and go through menopause, the breasts can lose volume and firmness due to reduced hormone levels and weakened Cooper’s ligaments.
Why do People Need Breast Self-Examination
Whether one should do monthly breast self-examinations is still up for debate among health experts, including screening committees, medical institutions, health advocacy groups, and global health networks. The concept of examining your own breasts for any abnormalities started back in the 1950s, before mammogram tests were available. From the get-go, there were concerns over the effectiveness and overall health effects of this practice. For example, if someone mistakenly thought they found signs of breast cancer during a self-check, it could lead to a lot of stress.
In fact, a study conducted in Shanghai in 2002 showed that breast self-examinations didn’t improve chances of survival from breast cancer, but did lead to an increase in benign (non-cancerous) lumps being found, which resulted in unnecessary biopsies – procedures to remove and test tissue.
In light of these findings, and others from Russia, an advisory group in the U.S. – the United States Preventive Service Task Force (USPSTF) – recommended in 2009 that women shouldn’t do breast self-examinations. The group was concerned about the downsides of these checks, including needless medical imaging, unnecessary biopsies, and emotional distress from false positives – thinking you have cancer when you actually don’t. However, not everyone agrees with this view due to the high rate of breast cancer, stories of positive experiences with self-checks, and the aim of giving women control over their health through self-detection.
As an alternative, several organizations propose the idea of breast awareness instead of routine self-checks. This idea encourages women to familiarize themselves with their breasts, so they can spot any changes. However, currently, there’s no research to support that this approach improves cancer-related outcomes or that it sidesteps the issues associated with regular breast self-examinations.
While breast self-checks have largely been dismissed in developed countries, some suggest they may be useful in poorer countries where mammograms aren’t widely accessible. There’s currently no data on whether self-checks work in these environments, but it’s a topic of investigation. Researchers are exploring whether teaching and practicing breast self-examinations in these settings could help reduce the impact of breast cancer in these parts of the world.
When a Person Should Avoid Breast Self-Examination
Basically, there’s no strong reason to say that a structured program for checking your own breasts is bad. However, studies have not shown that doing regular checks like this reduces the chance of dying from breast cancer. In fact, there can be negative effects of doing these checks, like unnecessary worry or unneeded medical treatment. Because of this, these self-checks may not be the best way to look for breast cancer, and people might not want to do it as part of their regular routine.
Equipment used for Breast Self-Examination
To do a thorough check of your breasts at home, all you really need is a mirror that is either freestanding or attached to a wall. This will help you to see your breasts clearly. You might also want to use a pillow for comfort. It can be placed beneath your back or shoulder when you’re lying down to feel your breasts for any unusual lumps or changes.
Who is needed to perform Breast Self-Examination?
Doing a breast self-exam is something you can do on your own, in the privacy of your home. You don’t need any medical staff or special equipment to help you with it.
Preparing for Breast Self-Examination
When you’re getting ready to do a Breast Self-Examination, it’s important to create the right conditions so you can correctly and comfortably check your breasts every time. The best time to do this is at the same time every month, ideally at the end of your period, because the structure of your breast can change throughout your menstrual cycle. If you don’t have periods for whatever reason, just pick a certain day each month to do the check. It’s also important to do this in a private, familiar place where you won’t be interrupted, so you can feel relaxed and safe.
How is Breast Self-Examination performed
A breast self-check is a way for you to check your own breasts for any irregularities or changes. It’s important to do this in a systematic way to make sure nothing is missed. If you’re checking your right breast, you need to lie on your left side and place your right hand under your head. This allows your breast to lie flat against your chest. Using your middle fingertip, make small circles with different pressures, starting lightly and gradually pressing deeper. This allows you to feel different depths of your breast tissue. To finish checking the first half of your breast, move your fingers up and down from your armpit to your nipple and from your collarbone to just below your bra line. Keep your fingers in contact with your skin so you don’t miss any parts.
To check the inner half of your breast, lie on your back, remove your hand from under your head and position your inactive arm at a right angle to your body. Use the same method you used for the outer breast, that includes the nipple and sternum area. You should also repeat all these steps for your left breast, but switch sides.
To visually examine your breasts, you need to inspect them from three different positions. With your arms relaxed at your sides, then with your arms raised above your head while bending forward and finally, hunched over with your hands on your hips. You need to look at your breasts directly, as well as from the right and left sides. It’s normal for one breast to be larger than the other, but any new changes in size should be noted. Also, look for any skin changes like rashes, redness, puckering, dimpling or changes that make the skin resemble the skin of an orange. Pay attention to your nipples and look for redness, itching, swelling, discharge, or changes in its position. Changes in the veins’ size or distribution on your breasts should also be considered.
The Maurer Foundation for breast health education offers helpful step-by-step guides for breast self-checks with easy-to-understand language and pictures of each step. Advocates for Breast Self-Examination stress that good patient education is key for successful screening, and that trained medical professionals are the best teachers for this procedure. However, there are many guides available to the public, and deciding which ones are accurate can be tricky. Your healthcare team needs to be honest with you about how reliable self-checks are, and where you’re learning it from.
Possible Complications of Breast Self-Examination
The main issues with doing a breast self-examination are usually tied to false-positive results. A false-positive result is when the test wrongly signals that a certain condition or disease is present. These false-positives can lead to unnecessary steps like identifying non-cancerous growths, undergoing unnecessary scans, having biopsies, and feeling anxious about the possibility of having cancer.
What Else Should I Know About Breast Self-Examination?
Finding breast cancer early is key to successful treatment and control. Although regularly checking your own breasts hasn’t been proven to directly improve health outcomes, it’s still important to pay attention to your body – if you notice any changes or unusual features in your breast, you should always tell your doctor or healthcare team so they can check it out further.
