Breast Cancer Detection - Breast Exams Anyone?
Clinical Breast Exam
A clinical breast exam (CBE) is an examination of your breasts by a
health professional, such as a doctor, nurse practitioner, nurse, or
physician assistant. The health professional will examine your breasts
for abnormalities in size or shape, or changes in the skin of the
breasts or nipple. Afterwards, using the pads of the fingers, the
examiner will gently feel (palpate) your breasts.
More attention will be given to the shape and texture of the breasts,
location of any lumps, and whether such lumps are attached to the skin
or to deeper tissues. Also, the area under both arms will also be
examined.
This exam is a good time for your health professional to teach you
how to be aware of changes in your breasts and to teach breast self-exam
(BSE) techniques if you wish to do BSE. Breast Awareness and Self-Exam
Starting in their 20s, women should be told about the benefits and
limitations of breast self-exam (BSE.) Women must be aware of how their
breasts normally look and feel and report any new breast change to a
health professional as soon as they are found. Locating a breast change
does not necessarily mean there is a cancer.
If you resolve to do BSE, the following information provides a
step-by-step approach for the exam. The best time for women to examine
their breasts is when the breasts are not tender or swollen. Women who
are examining their breasts should have their technique reviewed during
their periodic health exams by their health care professional.
How to Examine Your Breasts
-
 Lie
down on your back and place your right arm behind your head. This
must be done while lying down, not standing up, because when lying
down the breast tissue spreads evenly over the chest wall and is as
thin as possible, making it much easier to feel all the breast
tissue.
-
Make
use of the finger pads of the three middle fingers on your left hand
to feel for lumps in the right breast. Also, apply overlapping
dime-sized circular motions of the finger pads to feel the breast
tissue.
- Apply 3 different levels of pressure to feel all the breast
tissue. Basically, light pressure is needed to feel the tissue
closest to the skin; medium pressure to feel a little deeper; and
firm pressure to feel the tissue closest to the chest and ribs.
Sensing a firm ridge in the lower curve of each breast is normal.
However, if you’re not sure how hard to press, talk with your doctor
or nurse. Apply each pressure level to feel the breast tissue before
moving on to the next spot.
- Lightly move around the breast in an up-and-down pattern
starting at an imaginary line drawn straight down your side from the
underarm and moving across the breast to the middle of the chest
bone.(sternum or breastbone). Make sure to check the entire breast
area going down until you feel only ribs and up to the neck or
collar bone (clavicle).
-
 There's
evidence to suggest that the up-and-down pattern (sometimes called
the vertical pattern) is the most effective pattern for covering the
entire breast without missing any breast tissue.
-
Do again the exam on your left breast, using the
finger pads of the right hand.
-
When standing in front of a mirror with your hands
pressing firmly down on your hips, look at your breasts for any
changes of size, shape, contour, dimpling, or redness or scaliness
of the nipple or breast skin. (The pressing down on the hips
position contracts the chest wall muscles and enhances any breast
changes.)
-
Examine each underarm while sitting up or standing
and with your arm only slightly raised so you can easily feel in
this area. The raising your arm straight up tightens the tissue in
this area and makes it harder to examine.
This method for doing breast self-exam is different than
previous procedure recommendations. The changes represent an extensive
review of the medical literature and input from an expert advisory
group. There is a number of evidences that this position (lying down),
area felt, pattern of coverage of the breast, and use of different
amounts of pressure increase ability of the test to find abnormal areas. |
