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Patient Education (17) BSE

 

 


Breast Self-Examination

BSE


Performing Breast Self-Examination can save your life. Knowing how to examine your breasts is an important defense against breast cancer. Detecting breast cancer early, when the disease is in a more curable stage allows for more options in treatment and increases the chances for success and cure. The smaller the lump, the better your chances of being treated successfully. Nine out of ten women who receive early treatment for breast cancer are considered disease-free five years later.

Women twenty years of age or older should examine their breasts at least once a month, every month. The last day of your menstrual period is the best time for BSE, because by then any premenstrual changes will have subsided. If you are no longer menstruating, check your breasts on the first day of each month.

By practicing BSE you will become familiar with how your breasts normally feel, and you will be more aware when a change does occur in your breasts. The purpose of BSE is to discover any change in your breast.

The most effective method to exam your breasts is a three-step procedure: (1) Mirror Inspection, (2) Soaping the Breasts and (3) Palpation

1. MIRROR INSPECTION: VISUAL INSPECTION

Inspect your breasts with your arms at your sides. Check for anything unusual, such as any discharge from the nipples, puckering, dimpling, or scaling of the skin.

Next, raise your arms high overhead. Look for any changes in the contour of each breast. Look first at the front and then turn to each side.

Finally, place yur hands on your hips and press down firmly to flex your chest muscles, and again check the front and side views. Your left and right breast will not exactly match-few women’s breasts do. Only be concerned if there has been an unusual increase in the size or change in position of one breast.

Regular inspection of your breasts will show what is normal for you and will give you confidence in your examination

2. SOAPING THE BREASTS

During your bath or shower examine your breasts. Wet, soapy skin makes this step easier. Raise you left arm over your head, with your fingers held flat, feel the left breast with your right hand. Beginning at the outer edge, press the flat part of your fingers in small circles, moving the circles slowly around the breast. Gradually work toward the nipple. Be sure to check the complete breast. Examine very carefully the area between the breast and the armpit, including the armpit itself.

3. PALPATION

The grid method of BSE is considered the most thorough and reliable approach of examination. In order to perform this method of BSE you need to know how to "palpate"or feel for lumps in your breast.

The correct method to palpate your breasts is as follows:

  • Use the flat portions of your three middle fingers-the whole area from the tip to the first joint.
  • Your fingers should be kept flat or even a bit bowed so that they are parallel to the base of the breast.
  • Always press straight down toward your rib cage. You may push away a lump if you claw or press your breast sideways.
  • While your fingers are kept in one place, move the flats of your fingers in three small circles about the size of a dime.
  • Use very LIGHT pressure for the first circle-almost no pressure-to feel for lumps at the surface. The second circle should be made straight down in the same spot, using MEDIUM pressure to go midway into the breast. The third circle is made by using FIRM pressure and pressing as far and as firmly as you can without hurting, to find lumps deep in the breast tissue, near the ribs.

In order to perform this grid method of BSE, set aside a specific time for yourself to learn and practice this technique.

  • Use your right hand to examine your left breast and your left hand to examine your right breast.
  • The area to be examined extends from your collarbone down to your bra line, and to your armpit on the side.
  • Lie flat on your back, then turn over on your side with your legs bent. Now turn just your shoulders back and put the back of your hand across your forehead, so that there is no bulge on the outside of your breast and your nipple seems to float on top of your breast. A small pillow beneath your lower back may make you more comfortable.
  • Begin by examining the outer half of your breast. Starting underneath your armpit, work straight down and then back up in parallel vertical strips, as if you were mowing a lawn.
  • Using your three fingers, make three small circles in one spot, as described previously, then move your fingers down one finger-width away and palpate the next spot. Continue down in a straight vertical line until you reach your bra line, next move your fingers one finger-width sideways and work upward. By slightly overlapping each spot and each strip, you will be sure not to miss anything.
  • When you reach the nipple, hold your fingers in place and roll back flat on your back, placing your arm to the side straight out. Continue to work in vertical strips from and including the nipple over to the center of your chest. You will probably be able to fit four to six vertical rows on the outer half of the breast, and three to four rows on the inner half, depending on the size of your breasts. Once you have finished doing the vertical strips, do one or two horizontal strips under your collarbone.
  • Turn on your other side and examine your other breast the same way, working from the outside into the center.
  • Finally, sqeeze the nipple of each breast gently between thumb and index finger. Any discharge, clear or bloody, should be reported to your doctor immediately.

By establishing BSE as a regular habit, you will become more skilled and more familiar with the normal feel of your breasts. Learn BSE today! It is one of the best things you can do for yourself.

Remember, if a lump or change is discovered during BSE, it is important to see your doctor as soon as possible. Do not be frightened. Most breast lumps or changes are benign (not cancerous), but only your doctor can make that diagnosis.



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