By Kimberly Diltz, MS, CNS
Mammograms can detect breast cancer before a lump is ever felt, however, according to the National Breast Cancer Foundation (NBCF), a significant portion of the disease is caught when a woman conducts a self-examination outside of a clinical setting.
One in eight women will be diagnosed with breast cancer in their lifetime. Most women can be treated with success when breast cancer is caught early. Monthly self-exams, mammograms and clinical exams by a healthcare provider are vital to detecting the disease in its earliest stage.
Breast self-exams help a woman become familiar with how her breasts look and feel so she can best detect any changes that might need professional evaluation. Studies have shown that up to 25 percent of breast cancer cases originate from breast self-examinations (BSE).
There are many ways a woman can conduct a BSE. It’s important for a woman to find an approach that is conducive to her lifestyle and makes her feel most comfortable. Women need to remember that the goal, with or without a systematic approach to a BSE, is to report any changes to their breasts to their doctor.
It is recommended that women begin BSE in their early 20s and conduct them once a month. The best time for a woman to perform a BSE is seven to 10 days after her menstrual period starts. This is the time when the breasts are less tender and lumpy.
Women should understand the signals or signs that would indicate they need further examination. These include: development of a lump or swelling, skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk (such as staining of bed sheets or bra), the American Cancer Society said.
Leading breast cancer organizations have created a five-step process that women can follow or use as a starting point to conduct a BSE.
Step 1: Begin by examining your breasts in a mirror. Face the mirror with hands on your hips and shoulders straight. Look for any visible changes in your breasts such as size, shape and color. Also, look for any of the signs that were previously mentioned.
Step 2: Raise your arms and look for the same changes.
Step 3: Still facing a mirror, look for any fluid coming out of one or both breasts.
Step 4: Lie down on a bed and feel your breasts. Use your right hand to examine your left breast and your left hand to examine your right breast. Use a firm, smooth touch with the first few finger pads of your hand. You can examine your breast by using circular motions the size of a quarter or some women find it easy to go up and down vertically as if they were mowing a lawn. Be sure to feel the entire breast – from the front to the back and gradually apply more pressure until you feel the deepest tissue and eventually your rib cage.
Step 5: Feel your breast while standing up using the same methods as applied in Step 4. Some women find it easiest to do this when their skin is slippery and wet, which is why it is often recommended that women examine their breasts in the shower.
Women who do suspect a change in their breasts should contact their doctor right away, but should not panic. A lump or change in a breast is not always a sign of breast cancer. In the United States, 20 percent of suspicious lumps that are biopsied turn out to be breast cancer, according to the National Institutes of Health. There are many other causes for changes in a woman’s breast including infection, trauma, fibroadenoma, cyst or fibrocystic conditions.
A BSE can help women know what is normal for them and identify changes in their breasts, however, women should not completely rely on their own exam to detect breast cancer. It should always supplement a yearly mammogram and clinical exam.
Kimberly Diltz, MS, CNS, is a certified nurse practitioner with Premier Health Specialists who practices at Upper Valley Women’s Center in Troy.