If you notice any lumps or changes during a self-exam, your provider can recommend next steps.
We all have breast tissue*, regardless of our gender assigned at birth. But some people are at higher risk for breast cancer because of family history, surgeries, use of hormone therapy or other reasons.
The good news is that the 5-year survival rate is 99% for people whose breast cancer is caught early, before it can spread.
That’s where self-exams come in. Understanding what’s “normal” for your breast tissue can help you track changes over time and catch early signs of cancer. And it’s simpler than you may think.
"There is no ‘one way’ to do a good breast examination,” says Sandra Smith, MD, a breast cancer surgeon at PeaceHealth in Vancouver, Washington.
Dr. Smith often hears from patients who say they don’t do self-exams because they don't know what they’re feeling. Or they think their breast tissue is too lumpy. Or they’re afraid of “doing it wrong.”
“The key is doing an examination regularly, on a monthly basis,” she says. “If you visually inspect the breasts and intentionally pay more attention when you wash the chest and armpit areas in the shower once a month, you will pick up anything that is ‘new’ or ‘different’ very reliably.”
If you notice something that looks or feels new to you, and it lasts for the next one or two months, Dr. Smith recommends scheduling an appointment with your healthcare provider.
If what you noticed one month doesn’t last to the next, she says you don’t need to make a special appointment. But you should aim to keep up with regular breast cancer screenings based on the American Cancer Society’s guidelines. If you’re at average risk, that means you’re likely to start getting regular mammograms in your 40s.
Home exam how-to
While Dr. Smith says there’s no single way to do an effective self-exam, it can help to know the basic steps and signs to watch for.
Here’s a simple, step-by-step guide you can use to make breast health one of your regular self-care habits.
Step 1: Get ready.
Find a private space with a mirror where you feel comfortable doing the exam. Disrobe from the waist up.
Step 2: Look for changes.
With your arms relaxed at your side, look in the mirror. Take note of your chest’s overall appearance, including your breasts’ size and shape.
- Changes in your skin’s texture or color.
- Swelling, redness, dimpling, rash or anything else unusual.
- Changes in the position, size or shape of your nipples and areolas.
Then repeat the process with your arms lifted overhead.
Step 3: Feel for changes.
Find a comfortable place to lie on your back. Keeping your fingers flat and together, gently press your chest tissue with the pads of your fingers. If you need to, you can put a pillow under one shoulder to make it easier to reach your breast.
Start near your armpit, at the outermost edge of your breast. Move your fingers in small circles, going gradually inward toward your nipple. Cover the full area of your breast, including the nipple and areola.
As with the visual check, take note of any changes. This could include lumps, thickening or changes in texture.
Step 4: Check your nipple.
Hold your nipple between your thumb and forefinger. Gently squeeze it, then look for any fluid discharge. It could be clear, milky, yellow or red.
Notice if you see any changes in your nipple’s shape, color or inversion (when it turns inward).
Step 5: Check your armpit.
Stand up and put your hand on your hip. Bring the fingers of your opposite hand to your armpit.
Gently press and move your fingers in a circle. Take note of any lumps or swelling.
Step 6: Repeat.
Follow Steps 2-5 on the other side of your body. Note the results.
Step 7: Notice any changes? Talk to your provider.
If you observe any lumps or changes during your self-exam, or if you have questions, reach out to your healthcare provider. They can give you more information, do an exam and recommend any other tests or next steps.
Plan for monthly self-checks
You can do a self-exam once a month. To help you remember, choose a consistent date. If you have periods, you can do it a few days after your cycle ends. If you don’t, set a time that makes sense for you.
“For people who have regular menstrual cycles, I tell them that the best time to do their self-examination is between days 5 and 10 of their menstrual cycle, after their bleeding has stopped.,” Dr. Smith says. “During this time period, the hormone influence on breast tissue is less apparent, the breasts are softer and are easier to examine reliably.”
*Usage note: The word “breast” is used here in its medical sense to mean the front of the chest, including the glands and tissue that are at risk for breast cancer. We recognize, however, that you may wish to use other words to describe your chest.