As a board-certified general surgeon in Charles County with a focus on breast health, I look forward to October every year.
Breast Cancer Awareness Month is an important annual reminder for women of all ages to take their breast health into their own hands. If there’s one message that I can share with women, it’s that you have the power to change your life by being consistent and intentional about your own breast health.
Self breast examinations can be an important first step to an early diagnosis, a more hopeful prognosis, and successful treatment. There is no perfect method for finding cancer, but you can get on a healthy track by conducting routine monthly self breast examinations — as recommended by the National Breast Cancer Foundation — in conjunction with annual screening and mammogram imaging starting at 40 years old.
Benefits & Risks of a Regular Breast Self-Exam
Self-examination only takes a few minutes out of your day and doesn’t require any medical equipment. Consistency is key. The more routinely you perform your self-exams the more familiar you will be should anything abnormal arise.
While the self-exam is a valuable strategy for many women, it’s important to understand that finding a lump or an abnormality in your breast is not a definitive cancer diagnosis. Many women report increased anxiety from the moment they notice something unusual. It’s a natural reaction, but don’t assume the worst. Be cautious and be diligent. Call your primary care provider for evaluation because the next step is to schedule an appointment for a formal breast exam to help determine what you’re dealing with.
Most often, it’s not cancer. But if it is, you’ve taken a crucial first step by identifying the issue.
How to Conduct a Self Breast Examination
You can prepare by asking your doctor for a simple demonstration during your next physical exam in the office. It may also be helpful to keep a notebook in order to track any variances. When possible, the best time to perform a self-exam is the week after your period ends, in order to avoid natural tenderness and swelling related to our normal hormone cycles. For postmenopausal women, I recommend picking any date on the calendar from the 1st to 28th and performing them monthly as a routine. Some common steps for a routine self-exam are as follows:
- Choose a comfortable position. Laying down is good because it causes the breast tissue to spread out, making it easier to feel some areas. You can also mimic this sensation by raising your arms while standing. Performing your breast exams in the shower can also help your finger glide more easily along the skin.
- Conduct a visual inspection in front of a mirror in multiple positions. Look from the front. Lean forward and lean back. Some changes you may be able to notice before you even begin to feel for lumps. Things to look out for include: visible distortion or swelling; dimpling, puckering or bulging of skin; redness, soreness, rash or swelling; a nipple that has changed position or is inverted; or any fluid coming out of either nipple. Simply apply gentle pressure at the nipple to examine if any discharge is expressed.
- Use a firm, but smooth touch. Don’t poke directly with your fingertips, rather connect the pads of your three middle fingers close to one another, side by side on your breast. Follow a circular motion in a pattern that covers the entire breast — from the collarbone to the top of your abdomen where your bra sits and from the breast bone out to the chest wall under the armpit. You may perform this exam in a circular pattern from outward to inward or vice versa from the nipple out. I usually perform my clinic exams in a typewriter fashion traveling up and down the entire breast area. You can also perform them this way from right to left and back. Vary your pressure level to feel every layer of breast tissue recognizing that the ribs sit beneath the breasts and sometimes you may be able to feel these through the breast tissue. It is also extremely important not to neglect checking for lymph nodes which may reside in the breast tissue that you will already be checking, but additionally in the armpit and above the collar bone. Some patients may actually identify a mass in a lymph node before the breast itself.
What’s Normal & When to Seek Help
There is no reason to panic if you find abnormalities during your self-exam. In fact, certain lumps in the breast are normal, such as a firm ridge along the bottom of each breast and changes due to menstruation. Other lumps could be non-cancerous and caused by injury, hormonal changes, or a benign breast condition.
If you find something that alarms you — especially changes that last more than one menstrual cycle, or equaling one month — do not hesitate to call your primary care provider. They will be able to provide additional support, such as necessary examinations and tests, probable explanations for your symptoms, and a plan for monitoring or treating the condition moving forward.
And as a breast health specialist, I want to remind you that being in control of your health means being “aware” all year long. So let’s use the month of October to spread the word and then let’s maintain the focus every single month.
Your health depends on it!
About Dr. Charity Dugan
Dr. Charity Dugan is a board-certified general surgeon who specializes in breast health. Her new practice, University of Maryland Charles Regional Medical Group – Breast Health offers routine evaluations, comprehensive screenings, rapid diagnosis, and advanced treatment options for women with a wide variety of conditions related to breast health — including breast cancer and benign breast disease. And it’s all available in a setting that is comfortable and close to home.
To learn more about this new specialty practice, visit our website or call (301) 609-6363 to schedule an appointment today.