Breast Self-Exam: How to Do It and What to Look For

Once upon a time, lots of us would hang laminated placards in the shower that detailed a step-by-step guide to checking our breasts. The expectation: That you would examine your breasts in a very specific step-by-step manner every month and be on the lookout for anything that just felt different from usual.

Breast Awareness and Knowing Your Normal

So where does this leave us nine years later?

The answer is that experts want individuals to shift the focus from breast "self-exam" to breast "self-awareness."

“Years ago, what we found was that many women were concerned about technique when they practiced self-exams,” says Spring Piatek, an advanced practice nurse at the Northwestern Medicine High Risk Breast Clinic in Winfield, Illinois. “They were concerned about subtle lumps or bumps which were normal breast tissue. They would raise concerns with providers and there would be a lot of unnecessary exams, visits, and calls.”

Instead, healthcare professionals are committed to demystifying the breast self-exam.

In short, their message remains: Know your body.

Unusual Changes to Look For

“Consider how your breasts normally look and feel,” Piatek says. “We want women to look at themselves in the mirror at least once a month and look at their breasts.”

While looking in the mirror, zero in on any changes in the size or shape or either breast and look for any changes that may have occurred in the appearance of the skin on your breasts.

“For example, is there a rash or redness that’s not going away or is there any skin thickening,” Piatek says. “If you lift your arms up, is there any dimpling of your breast tissue, swelling around your collarbone or under your arm?”

Ultimately, the goal is to build awareness without adding additional stress, says Deanna J. Attai, MD, an associate clinical professor in the department of surgery at UCLA David Geffen School of Medicine in Los Angeles and UCLA Health Burbank Breast Care.

“I tell patients now that we no longer scold you for not doing monthly self-exams anymore,” Dr. Attai says. “We want women to have a general idea of what’s normal for them and to be aware that breast cancer doesn’t always present as a lump. It can be a sudden swelling, a redness of the skin that doesn’t go away with antibiotics, blood from the nipple or a retraction or dimpling that can be a potential sign of an underlying cancer.”

Breast Self-Exam Tips

• Pick the same time each month.
• Look at your breasts in a mirror, with your hands at your sides, then above your head.
• Use the pads of the fingers to feel for any unusual changes around the breasts and armpit.
• Look and feel for lumps, hardened knots, or other changes.
• Check for signs of swelling, redness, or skin dimpling.
• Examine any changes in the nipples, including appearance, texture, or discharge.

And both experts agree: If you feel comfortable doing the steps outlined in your shower placard, don’t hesitate to keep doing them. Most important: If a change in or around your breast lasts for more than a week (or two) always alert your primary doctor, gynecologist or breast specialist.

“There’s no harm in doing self-exams, but we want to make it simple,” Piatek says. “And we definitely don’t want women to dread doing this or feel ashamed if they forget.”

The Takeaway

Experts recommend looking at your breasts in a mirror at the same time each month to identify changes in the shape, size, or appearance of your breasts. To perform a breast self-exam, look at your breasts in a mirror with your hands at your sides and above your head to check for signs like swelling, redness, or skin dimpling. Use the pads of your fingers to check for lumps, knots, or other changes in your breasts or armpits. Make sure to check the nipples for changes in appearance, texture, or discharge.

If a change in your breasts lasts for more than one to two weeks, alert your primary care provider, gynecologist, or breast specialist.