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Why Should I Perform A Breast Self Exam?

The main reason is to catch breast cancer as early as possible. If caught early, the prognosis is far more likely to be a favourable one.

Women with breast implants may also be able to detect the following through a breast self exam: capsular contracture, breast implant rupture, ridges and rippling and breast implant extrusion.

Breast Cancer Facts

Let's look at some of the facts regarding breast cancer:

• Breast cancer is now the most common cancer in the UK.
• In the UK in 2006 more than 45,500 women were diagnosed with breast cancer, that's around 125 women a day.
• Breast cancer incidence rates have increased by more than 50% over the last twenty-five years.
• In the last ten years, female breast cancer incidence rates in the UK have increased by 6%.
• In England the NHS breast screening programme diagnoses around 10,000 cases of breast cancer each year.


• Breast cancer survival rates have been improving for thirty years.
• In the 1970s around 5 out of 10 breast cancer patients survived their disease beyond five years. Now it's 8 out of 10.
• Breast cancer survival rates are better the earlier the cancer is diagnosed.
• Around 9 out of 10 of women diagnosed with stage I breast cancer survive their disease beyond five years. This drops to around 1 out of 10 diagnosed with stage IV.

What Should I Look For In My Breast Self Exam?

In General

You are looking for changes to your breasts and nipples. You might want to take some photos of your breasts using a mirror or take some notes in your diary so that you have a reference point for when you perform subsequent breast self exams. Look for:

• Any changes in the appearance of your breasts such as any changes in size and shape.
• A change in position e.g. one breast being lower than the other.
• Changes in texture or firmness of your breast tissue as you examine by touch and feel.
• Appearance of lumps within the breast tissue.
• Examine your nipples and areola to see if they have changed position or shape at all. Check for colour changes. The small lumps on the areola around the nipple are called Montgomery glands or areolar skin glands. They are perfectly natural but you should look for changes is size, colour and numbers of these. Taking photos can help.

What To Look For If You Have Breast Implants

In addition to the above, if you have breast implants you will be able to feel them and distinguish them from your natural breast tissue. Note how firm they feel and learn to locate their boundaries so that you become familiar with their shape and size. Look for changes in:

• Firmness
  If the implant feels tighter and firmer then it may indicate that capsular contracture is setting in.


• Texture
  Feel for ridges and ripples on the implants. Note that ridges and ripples may start to occur after the implants have been in place for a few years as the implants age. If ridges or ripples occur sooner than this, it may indicate a problem with your implants.


• Size
  In particular with saline breast implants, if you notice a reduction in size, then it may indicate implant rupture or a leak.


• Lumps
  If you notice a lump or a bump in the skin on your breasts that feels like the breast implant pushing into your skin, this this may indicate breast implant extrusion.

Of course your breasts may change in size and shape depending upon they day in your menstrual cycle. They will also change with pregnancy. If you dieting or putting on weight, then this will also affect the size and shape of your breasts. You will need to allow for these factors when assessing any changes.

How Do I Carry Out My Breast Self Exam?

The procedure described below represent an extensive review of the medical literature and input from an expert advisory group. There is evidence that the lying down position and using different amounts of pressure increase your ability to find abnormal areas.

Step 1: Standing Up

Stand in front of a mirror with your hands on your hips and look at your bare breasts. This is a visual check only, so look at size, shape and position of your breasts and nipples. See above for more details.

Repeat the above check, this time with your hands above your head.

Now examine your nipples and areola as described above.

Step 2: Lying Down

When lying down, your breast tissue will spread evenly over your chest and will be as thin as possible. This will make it easiest for you to be able to examine all your breast tissue.

Lie down and place your right arm behind your head.

Use the finger tips of the 3 middle fingers on your left hand to feel for lumps in the right breast. Use overlapping, small (10 pence sized) circular motions of the finger tips to feel your breast tissue.

Use 3 different levels of pressure to feel all your breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. A firm ridge in the lower curve of each breast is normal. If you are not sure how hard to press, talk with your doctor or nurse. Use each pressure level to feel the breast tissue before moving on to the next spot.

Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone (sternum or breastbone). Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone (clavicle).

Feel for changes in texture of your breast tissue since you last performed the self exam or for lumps that appear within your breasts. See above for more details.

There is some evidence to suggest that the up-and-down pattern is the most effective pattern for covering the entire breast, without missing any breast tissue.

Now place your left arm behind your head and repeat the exam on your left breast. Use the finger tips of the right hand.