Every woman should know her own breasts. Perhaps 90 percent of all breast cancer is discovered first by the woman herself, or by her sexual partner. Because breast cancer, like other cancers, is most easily cured in its early stages, the American Cancer Society recommends monthly self-examinations for all women over age twenty.
The technique is simple and takes ten or fifteen minutes, depending on the size of the breasts. Some women find it easier to begin after a physician’s assurance that their breasts are normal. Before menopause, women should examine themselves a week after the start of the menstrual period, when the breasts are not swollen or tender. After menopause, the first of every month (or some other easy-to-remember date) is fine. The important thing is to establish a monthly routine and follow it. Although four out of five breast lumps are benign, any abnormality should be checked promptly by a physician.
The procedure has four steps;
Women should begin by examining the surface of their wet skin in the bath or shower, using flat fingers to glide over every part of both breasts, feeling for lumps.,
Second, the breasts should be examined in a mirror, both with arms raised overhead and with hands pressed down on hips to flex the chest muscles. Changes in contour, swellings, dimpling or puckering of the skin, or changes in the nipple may be danger signs. Some healthy women have inverted nipples, but nipples that suddenly turn inward may indicate cancer. A lack of symmetry breasts that don’t exactly match is not important unless it represents a recent change.
Third, the woman should lie on her back with a pillow or folded towel under one shoulder and the arm on that side under her head. With the other hand, she should press the breast gently in circular motions, as if touching the numerals on a clock face, beginning at the outside top of the breast. (Some women find it easier to examine their breasts in vertical strips rather than in a circular manner, a variation that is acceptable.) This procedure should be repeated an inch closer to the nipple, and then another inch closer, and another, until the whole breast has been examined. A ridge of firm tissue in the lower part of the breast is normal. Attention to individual breast structure will make any change more obvious.
The last part of breast examination involves squeezing the nipple gently between thumb and index finger. Any discharge, either clear or bloody, should be checked by a physician. Scaly skin around the nipple may also be a sign of cancer and should be seen by a doctor.
The physician should not only examine the breasts of women patients on a regular basis, but ensure that each woman can do it for herself. Personal instruction seems to provide better motivation than pamphlets or audiovisual methods of teaching alone.
To summarize, although four out of five breast lumps prove to be benign, depending upon the age of the woman, biopsy is the only way to be sure. Other signs that should send a woman to her physician are dimpling and puckering, crusting around the nipple, inversion of the nipple, or nipple discharge.