How to Do a Self Breast Exam at Home

Breast cancer is an ongoing battle that thousands of women fight every day. In fact, it’s the most common cancer around the world. According to BreastCancer.org, a nonprofit organization providing education and resources for those afflicted by the disease, about 13 percent of women (1 in 8) in the U.S. are going to develop invasive breast cancer in their lifetime. Self breast exams are something we can easily do at home to check in with our breasts each month and become aware of any possible changes. Here, leading OB/GYNs discuss the importance of breast exams and breast awareness, as well as how to do a self breast exam at home.

Featured Experts:

• Carolyn Delucia, MD, a board-certified OB/GYN based in New Jersey, and founder of The Secret Orchid
• Stephanie Hack, MD a board-certified OB/GYN based in Washington, D.C., and founder of Lady Parts Doctor

Why Are Self Breast Exams Important?

“Self breast exams have received vary reviews in the medical literature questioning their value,” says New York OBGYN Carolyn Delucia, MD. “However, I have seen many women who identified their own breast mass by doing their monthly self exam. I think women should use all the tools we have at our ‘fingertips’ in order to detect breast cancer as early as possible: mammogram, self breast exam and physician exam. I always say, ‘Early detection is our only protection.'” Dr. Hack recommends beginning self breast exams at age 18 to become more comfortable with your body. “But, many other doctors and experts suggest starting them in your 20s.”

How to Determine Your Risk for Breast Cancer

First and foremost, discuss your health and family health history with your OB/GYN and/or primary care doctor. They will provide the most accurate assessment, taking your personal information into account. According to the BREM Foundation, “several factors that increase estrogen exposure carry an increased risk of breast cancer, to varying degrees.” Some of these include early menstruation before age 12, later menopause after the age of 55, and the use of hormone therapy, among others.

Some races and ethnicities have a higher risk for breast cancer as well. BREM reports that African American women are 40 percent more likely to die from breast cancer than white women. “This massive disparity is caused by many factors, including access issues, systemic barriers and biology. Black women are diagnosed at younger ages with aggressive, harder-to-treat cancers, including Triple Negative Breast Cancer.” Ashkenazi Jewish women also have higher rates of breast cancer. They have higher rates of gene mutations (BRCA1 or BRCA2), too.

Dr. DeLucia says certain lifestyle factors can increase your risk for breast cancer (and other cancers) as well. “These include using alcohol, tobacco and being overweight.” BREM offers a free short quiz that can help determine your risk of breast cancer, and will email your results.

Do I Still Need to Do Monthly Exams If I am Average-Risk?

Dr. Hack says the current guidelines from the American College of Obstetricians and Gynecologists (ACOG) and the U.S. Preventive Services Task Force (USPSTF) emphasize the importance of breast self-awareness rather than breast self-examination for average-risk women. “Breast self-awareness as a woman’s awareness of the normal appearance and feel of her breasts,” she explains. “This is different from breast self-examination, which involves systematic and regular checks specifically for breast cancer detection. Breast self-awareness encourages women to know their breasts. That way, they are attuned to noticing any changes or potential problems with them.”

Does Breast Density Matter?

Yes. According to Dr. DeLucia, breast density is determined during a mammogram, and many women have dense breasts. “This means there is more fibroglandular tissue and less fatty tissue.” In fact, BREM says about 50 percent of women over age 40 have dense breast tissue. “Dense tissue carries a higher risk for breast cancer and hides cancers on mammograms.”

What Time of the Month Should You Perform a Self Breast Exam?

Dr. Hack says the best time to conduct a self-breast exam is about a week after your period starts. “This timing is recommended because the breasts are less likely to be swollen or tender post-period,” she explains. “This can make the examination less uncomfortable and allow for clearer detection of any possible changes. For women who do not menstruate, choosing a consistent day each month is advisable.”

How to Perform a Self Breast Exam at Home

According to BreastCancer.org, these are the five steps to follow at home. And to help make the experience better, Colleen Rothschild Beauty created a product called “Breast” Friend Self-Exam Butter. “About seven years ago, I had a breast cancer scare,” founder Colleen Rothschild says. “I was doing self-exam, and I found something unusual. I thought, I’m going to go for a mammogram. They found two suspicious clusters, which was intense.”

Rothschild ended up having a lumpectomy, but the results came back benign. “The lesson I learned though, was that it’s so important to do those exams and get mammograms,” she continues. “This butter contains really nourishing oils, as well as shea butter and bacuri butter. When you’re doing your self-exam, it helps you with the slip and slide and glide across your breasts. You want your hand to be able to move smoothly. I love the fresh, feminine, floral scent, too. Also, as a woman-owned business, I love to make products that help other women.”

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Step 1: Examine Your Breasts in a Mirror With Hands on Hips

Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Here’s what you should look for: Breasts that are their usual size, shape and color, and breasts that are evenly shaped without visible distortion or swelling. If you see any of the following changes, bring them to your doctor’s attention: Dimpling, puckering or bulging of the skin; a nipple that has changed position or an inverted nipple (pushed inward instead of sticking out); redness, soreness, rash, or swelling.

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Step 2: Raise Your Arms, Examine Your Breasts and Look for Signs of Breast Fluid

Raise your arms and look for the same changes mentioned in Step 1. Also look for any signs of fluid coming out of one or both nipples, which could be a watery, milky or yellow fluid, or blood.

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Step 4: Feel for Breast Lumps While Lying Down

Next, check for breast lumps or abnormalities by feeling your breasts while lying down, using your right hand to feel your left breast, and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Press down with your fingers and move them in a circular motion that’s about the size of a quarter (or an inch around). “You are feeling for small masses the size of a tiny bead or lymph nodes that would feel like a lima bean,” says Dr. Delucia.

Cover the entire breast from top to bottom, side to side—from your collarbone to the top of your abdomen, and from your armpit to your cleavage. Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women.

Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you’ve reached the deep tissue, you should be able to feel down to your ribcage.

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Step 5: Feel Your Breasts for Lumps While Standing or Sitting

Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.