Understandably with the bombardment of information about breast cancer, many female members are understandably concerned about symptoms that affect their breasts or the surrounding area. Here is a guide to help you know how to check them, what signs may indicate something sinister, and what is normal. Regularly examining yourself will help you understand what is normal for you. It may make you feel uncomfortable at first, but you will soon develop a habit of being able to check yourself confidently. If your breasts become particularly tender whilst ovulating or menstruating, then try to self-examine around a week after your period.A Woman’s Guide to Breast Self-Examination
Self-examination
A good basic method, which can become an easy habit to follow is:
Look: Although this is second in standard advice, I believe this is a better starting point. First off is to look at yourself in the mirror. A healthy breast has a distinctive shape, becoming fuller and rounder at the bottom and at the outer sides. The shape should be smooth and curved around the edge. One breast may appear noticeably larger than the other – this is normal. Raise your arms above your head, look side-on and from the front, lift the breast up – practically all angles in good light if you can.
Feel: With a flat hand feel the breast with the fingers of one hand (preferably the opposite hand) across the entire area from the top outer edge working inwards towards your breast bone, and repeating downwards. Do not be afraid to use some pressure, and use a wave motion. Notice how the breast feels, and what should be where. This is generally slightly different for each individual, depending on breast size and shape, although towards the bottom there is much more glandular and subcutaneous tissue. Pay particular attention to the larger parts and around the nipple and areola where the glandular tissue is more developed.
Feel around the inner portion by the sternum, moving from the top downwards. When feeling the areolar and nipple, you may want to only use one or two fingers, and some pressure, and feel around the whole area.
Notice the weight of each breast. This may feel different for each one, and is to be expected given the differing sizes of each.
Next use one hand to cup the breast and gently lift it, and use the other to feel along the underside and your chest underneath and at the side. It is usually best to use the hand on the same side as the breast to lift and the other to feel. Don’t be afraid off using pressure to feel around this area, as the tissue is often fairly deep and denser.
This whole examination takes but a few minutes. When you repeat this, remember what feels normal, how they usually are. Your breasts may increase and decrease in size during your menstrual cycle – this is normal. You may notice tenderness and lumps along with the increase in size, and again this is perfectly normal, and is engorgement of the glandular tissue, which is usually responsible for the tender feeling.
What to Look For:
There are several signs which can be noticed during self-examination. It should be stressed that there are various causes of breast changes, and the following are not limited to signs of cancer, some of them not related to cancer at all. Aside from cancer, these may be benign tumours or cysts, infection, blocked ducts or glands, related to other illness, such as systemic infections, abnormal menstrual cycles or indeed – nothing at all. Do not attempt to self-diagnose until you have seen a healthcare professional who can further evaluate the signs and carry out tests. Most breast changes are not the result of anything serious. Up to 90% of lumps presented in clinical settings are not cancerous!
Shape and outline: Any abnormal outline of the breast from the usual smooth curve should be examined by a healthcare professional. Pay particular note to any outline or shape changes when you raise your arm above your head. It is normal for the breast to appear ‘stretched’ of course in this position and the base raise slightly, but the normal contour should always be present.
Lumps: These may be located in or on the breast itself, or under the armpit. Breast lumps which are abnormal may be of several types – Small hard lumps, which are different from usual may indicate swelling of mammary gland nodes, or lymph nodes. In the majority of cases this may be short-term and of little significance.
Larger hard lumps may be round, irregular or flat. In all cases lumps which are larger than a 5p coin (or dime) should always be checked by a medical professional, particularly those which are irregular in shape.
Softer lumps may feel ‘rubbery’ or sore. Generally this is a sign of infection and not cancer, but should always be checked.
Glands which usually increase in size during your cycle, and which do not reduce in size throughout your cycle as normal should be checked by a doctor or nurse.
Skin Changes: Signs of problems are the following:
- Dimpling of the skin, especially around the nipple, or anywhere on the breast when it is lifted
- An ‘orange peel’ appearance
- Redness or inflammation
- An unusual area of darkened skin
- Rashes around the nipple or areola
- Any areas of thickened or rough skin
- Any unusual redness around the nipple, including sores, swelling, etc
- Any area which feels unusually soft
Pain: Pain which is tender, in one breast only, in a specific area, is around any area
Other abnormalities:
- Bleeding from the nipple
- Non-lactating discharge – note that occasionally, healthy women may produce milk or colostrum without pregnancy. Any discharge from the nipple should generally be checked, but non-milky discharge especially
- A small area of dull pain, which doesn’t move.
- Lymph and gland swelling near the collar bone or armpit
- A significant different in weight to normal, at the same time during your menstrual cycle.
- Any movement of the nipple, either from its usual position, or its direction.
- An area which is much warmer than the surrounding area
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What to do if you notice any of the above
The first thing is not to worry unnecessarily! The majority of changes in breasts are not cancerous, and many signs may not signify any disease at all. If there are signs of a large infection like mastitis, such as pain and swelling, along with abnormal discharge and a distinctive red patch, along with any general signs, such as temperature, etc, then you should contact emergency healthcare.
However, trying to alleviate worry should not mean ignoring signs and symptoms. Any of the above changes should be investigated, if only to put your mind at ease.
Of course, people do become sick, and that is why it is important that you are aware of what changes to look out for in order to safeguard your health. Only a doctor can diagnose based on testing and experience, and changes should not automatically be seen to indicate the worst thing, although that can be very difficult at times. If you follow a regular habit of self-examination, it can help you catch any problems early, which, even if cancer is present, hugely increases the chances of full recovery, especially with modern advancements in treatment of female cancers.
