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Breast self-examination

What is it?

Breast self-examination is not a screening method for breast cancer and does not replace the preventive annual medical examination, which also includes a doctor examining the breasts and a mammography, for women over 45. The ultrasound is screen method which can be used for women under 45, besides the medical examination. Screen methods allow early diagnosis, before the occurrence of any symptom. Self-examination has the great of advantage of familiarizing you with how your normal breast is: size, shape, consistency and sensitivity.

Being aware of how normal feels like helps you catch changes at an early stage. When is it done? Before beginning the self-examination, it is important to know that most women experience changes related to the menstrual cycle: usually, a few days before the menstruation, breasts become more sensitive, more tense and firmer. Therefore, it is recommendable to examine the breasts on a monthly basis, each time a few days after the onset of the cycle. 

How is it done?

Start with a breast inspection: normally, there is an asymmetry between the two breasts, in terms of size and shape. The following changes are abnormal, however:

  • Colour (redness or darker colour, in certain areas): there can also be inflammations, but you’ll receive an answer and… a therapeutic solution, only if you see a doctor.
  • Structure (flatter or bulging): the breast structure is not even, therefore the newly occurred changes are particularly important (in the interval between the previous and the current examination.
  • At the level of the nipple (secretions, lesions of any type, nipple retraction). Nipple secretion can occur spontaneously or when palpating the nipple; irrespective of how it occurs, it is not a sign of normality. Milk is the only normal secretion of the nipple. Nipple secretion (liquid leaking from the nipple) can be clear, purulent or sanguinolent; it is not necessarily a sign of cancer, but it must be handled carefully.

If any of these changes occur, it is mandatory to see a doctor for examination. It is not necessarily cancer, but the breast can suffer from other diseases, besides cancer, which must be treated and healed.

Continue with palpation: it is made by compressing the breast between the open palm and the thorax, in turn, with slow rotation movements, to cover all the four quadrants of the breast: upper outer, upper-inner, lower-outer and lower-inner.

The following can be identified:

  • Areas of increased consistency: normally, the breast is not homogenous, as it is made up of structures with firm consistency (mammary acini), converging towards the nipple. Therefore, it is important to be aware of the normal, particular structure of your own breast and possibly compare the consistency of the two breasts
  • Areas of reduced consistency (accumulation of liquid; areas also called oedema areas), particularly if they are sensitive and the skin is read, may be areas of inflammation
  • Nodules (at the level of the breast or armpit): a breast nodule is not easy to identify and not all nodules are cancer. Therefore, the spread of the self-examination method has lead particularly to the identification and biopsy of benign nodules. The occurrence of a nodule is also a sign that you must see the doctor.
  • Painful areas: if persistent, they are also a warning sign.

Warning signs:

Basically, a visit to the doctor is necessary for any change mentioned above.

The findings enumerated below are considered warning signs:

  • Firm or even hard nodule, inside the breast or in the armpit
  • Inflammation at the level of the breast (redness, oedema, increase in the local temperature)
  • Protuberance or change in shape and/or contour of the breast
  • Depression, area of skin retraction
  • Areas of desquamation or pruritus (itching sensation), especially at the level of the nipple
  • Umbilication of the nipple (change in the nipple prominence, nipple retracted inwards)
  • Nipple secretion or discharge, especially if sanguinolent (reddish)
  • Localized, persisting pain.

Self-examination is an important step for your involvement in the management of the breast cancer risk.

It is also important to:

  • discuss your personal risk of breast cancer with your doctor
  • participate in the annual preventive screening
  • be aware of the lifestyle factors, which can increase the risk of breast cancer