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Make it monthly: the importance of breast self-exam

I'm 27 years old and my physician recently told me that I should begin regular breast self-exams. Is it too soon to be thinking about breast cancer?

With more than 175,000 women in the United States diagnosed with breast cancer each year, it's never too soon to learn and practice self-examination. Although breast cancer in women under age 40 is rare, it is recommended that all women, age 20 and older, perform a breast self-exam on a monthly basis.

Monthly self-examinations may seem like an awkward or tedious chore, but it is important for the early detection and successful treatment of breast cancer. "You are the best person to examine your breasts because doing so allows you to know your own breast tissue better than anyone else," says Karen Freund, M.D., associate professor of medicine at Boston University School of Medicine and director of Women's Health at Boston Medical Center. "At first it may be hard to tell what your breasts should feel like, but with monthly practice, women should develop a sense of what is considered normal for their breasts and will be able to notice any changes."

A complete breast self-exam includes both looking at and feeling the entire breast and chest area. Because exam methods vary, it's best to check with your physician to determine which is the proper method for you. The ideal time to conduct an exam is usually two or three days after the end of your menstrual period, when your breasts are likely to be less tender and easier to examine. Women who no longer have periods because of menopause, hysterectomy, pregnancy, or some other health reason should choose a date that is easy to remember, such as the first or last day of each month.

When conducting a self-exam, consider the following: a breast lump or thickening; a lump in your underarm or around your collarbone; a persistent sore, skin rash, or flaking near your nipple; redness or swelling; dimpling, pulling, or retraction in one area of your breast; unusual nipple discharge; or a sudden change in nipple position, such as inversion. If you notice any unusual changes or lumps, have pain in your breast, or have any worries about what you have found, you should consult your physician immediately.

"If you haven't performed a breast self-exam before, it's important to make sure that you're doing it correctly," says Freund. "At your next doctor's appointment, ask your physician to observe how you perform your exam, and don't be afraid to ask questions."

Some women are reluctant to perform a breast self-exam because they are afraid of what they might find. Understandably, the thought of discovering cancer is a scary one, but, Freund says, it should not be a deterrent. "Keep in mind that most breast lumps turn out not to be cancer and that early detection may save your life," she says.

While self breast-exams are the most convenient and simplest method of early detection, mammograms and regular clinical breast examinations by a health-care professional are also important components of a complete breast health program. It is suggested that women age 40 to 50 get a mammogram every one to two years, and every year for women over 50.

"By performing a simple breast self-exam every month and having regular clinical breast exams and mammograms if you need them," says Freund, "you'll go a long way toward staying healthy."

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on breast cancer or other health matters, call 617-638-6767.

13 April 2001
Boston University
Office of University Relations