Breast Examination

Women from the age of 20 and onwards should practice breast self-examination. This should be done every month approximately one week after the start of the period. If you do not have any periods or you are menopausal, then you should do this on the same date every month.

What to look for in breast self-examination

Changes to look for in your breasts include development of a lump, a discharge from the nipple other than milk, swelling of the breast, skin irritation, dimpling and nipple abnormalities such as pain, redness and inversion.

How to perform a breast self-examination

The first step is to stand in front of a large mirror where you can clearly see both breasts. Check both breasts for discharge from the nipples, puckering, dimpling and scaling.

Next, put both your hands behind your head and press forward against your head. Check for the same features as above.

The third step is to place your hands on your hips and bend slightly forward. Again, look for the changes as above.

The fourth step is to gently squeeze each nipple and look for any discharge.

For the fifth step you will need to lie down. Put your left hand over your head and with the right hand palpate the left breast. Move in circles around the whole of the breast, looking for lumps and tenderness. Now place your right hand behind your head and check the right breast

with the left hand. Remember to check the breasts towards the sides and into the armpits.

What to do if you find a lump

Women need to get to know their breasts as they lumpiness of a woman’s breasts varies. It may also vary within the same woman, depending on whether they are on any hormonal treatment.

Most lumps discovered by women at breast self-examination are of no concern, but you should have your GP perform the examination as well. Discovery of a lump may warrant ordering of a mammogram, ultrasound of the breast or a fine needle biopsy of the lump.

In the medical literature doctors are divided as to the usefulness of breast self-examination. Multiple studies have shown that breast self-examination does not decrease the detection rate for cancers. There may be multiple reasons.

Formal breast screening programmes are tending to detect cancers at a much smaller stage (mammograms, ultrasound of the breasts). Surveys conducted which asked women how their tumours were discovered have shown that up to 40% of women detected their breast cancer themselves.

I believe there is a case for women to engage in regular breast self-examination as it is an easy and cheap form of breast cancer screening.