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Follow this 5-step guide to check for breast cancer at home

Dec 24, 2020, 22:03 IST
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Samantha Lee/Insider
  • Regular self-breast exams can help you spot symptoms of breast cancer like lumps, scabbing, and other ireggularities.
  • You should check your breasts at the same time each month, around 3-5 days after your period ends.
  • Not all breast lumps are cancerous, but if you find one, make sure to see a doctor for a proper clinical exam.
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One of the most common forms of cancer is breast cancer, a disease where the breast cells grow abnormally and out of control. It's crucial to look for breast cancer early while it's still relatively easy to treat. Breast cancer evolves silently, but it can be detected by various screening tests - including one you can do at home.

Breast self-awareness, the familiarity with the normal look and feel of your breasts, will help you recognize changes as they occur and possibly detect breast cancer yourself. For some people, their first sign of breast cancer is a lump (or a detectable breast mass) that they found themselves. A medical professional should evaluate any lumps to eliminate or confirm the threat of breast cancer.

When doing a self-exam, "look out for breast lumps that are hard, as opposed to rubbery or soft," says Shoko Emily Abe, MD, breast surgeon at UCSF Helen Diller Family Comprehensive Cancer Center. "Other signs to look out for are retraction or pulling back of the nipple or skin, unusual discoloration or rashes on the skin, and nipple deformity."

Learn how you can detect breast cancer early, perform breast self-exams, and get screened for breast cancer.

How can you detect breast cancer early?

You can detect breast cancer early by performing breast self-exams, the process of seeing and feeling for any changes in the breast area.

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Currently, the American Cancer Society does not recommend breast-self exams as part of routine breast cancer screening because there is little evidence that they are effective in finding breast cancer early in people who also get regular mammograms. However, they do recognize that it can improve breast self-awareness. On the other hand, the American Society of Breast Surgeons still considers breast self-exams essential.

Knowing the normal size, shape, and appearance of your breasts will help you recognize symptoms when they occur, such as:

  • Hard breast lumps or thickening that is different from other surrounding breast tissue
  • Redness of the skin on the breast or nipple
  • Dimpling or pitting of the breast, similar to the skin of an orange
  • Skin retraction
  • Bloody or clear fluid discharge from the nipple
  • An area that is distinctly different from other areas around the breast
  • Changes in size, shape, appearance, or feel of the breast or nipple
  • A newly inverted nipple
  • Peeling, scaling, crusting, or flaking of the areola or the breast

"While non-cancerous lumps are often rubbery and soft that move around like a marble, cancerous lumps tend to be harder and don't move around as much," says Abe."Although most cancers will feel hard and relatively immobile, they don't all feel that way."

She recommends having a doctor assess your breast cancer risk around the age of 25 so you and your doctor can make individualized decisions about if and when to take breast cancer screening exams.

Having several risk factors doesn't mean that you will automatically develop breast cancer, but it's best to start screening early. "Screening exams, mammograms included, do not prevent a disease, in this case, breast cancer. Instead, they allow for very early detection," says Fishman. It's important because early detection can improve the breast cancer outcome.

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Here are the major risk factors for breast cancer:

"There is no relationship between breast cancer risk and certain specific foods or wearing versus not wearing a bra, or using versus not using deodorant," says Rebecca H. Fishman, MD, FACS, a breast surgical oncologist in Penn Medicine Department of Surgery.

Breast self-awareness is important for young women who aren't yet of age to get mammograms so they can recognize and report any changes, says Abe. "Because the risk of developing breast cancer at a young age, under the age of 50, is low, there are no concrete recommendations of when to start actual self-breast exams," she says.

How do you perform a breast self-exam?

Performing a self-exam can help you understand what is normal for you so you can more easily detect when something is out of the ordinary. To perform a breast self-exam, follow these steps:

Step 1: Observe

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The first part is visual examination, or to simply observe. Stand shirtless in front of the mirror and check the breast for dimpling, puckering, discoloration, and any other symptoms or noticeable changes. Inspect your breasts while you are standing straight, with arms raised above your head, and afterward, with your hands on your hips. Turn from side to side and bend forward in each position to check thoroughly.

Step 2: Feel for lumps with your three middle fingers

Samantha Lee/Insider

After observation, feel for changes using the finger pads of the three middle fingers. Use the opposite hand from the breast you are examining - this means feeling the right breast with your left hand, and vice versa. Check for lumps and thickening in each breast, including the area below the collarbone and under the armpit.

Step 3: Feel for lumps with an up-and-down motion

Samantha Lee/Insider

Then, support a breast with one hand and use the other hand to feel for any lumps using an up-and-down motion. Cover the entire breast area.

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Step 4: Repeat up-and-down motion for both breasts

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Repeat the process for the other breast.

Step 5: Lie down and feel for lumps with circular or up-and-down motions

Samantha Lee/Insider

Next, lie down and place a pillow under the shoulder on the side of the breast that you will examine first. Using the opposite hand, feel around the breast in a circular or up-and-down motion. Feel for anything that is unlike the surrounding breast tissue. You can use a lotion or massage oil to make your hand glide smoothly.

"Having larger breasts may make it take longer to examine the breast, but the techniques and concept are the same," says Abe.

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According to Fishman, the appearance and feel of the breasts can fluctuate during menstrual cycles. It's common for them to feel swollen and tender before or during a menstrual period, so perform a breast self-exam each month, about three to five days after your menstrual period ends.

For those who stopped menstruating, remember to perform the exam on the same day every month.

What happens if I find a lump?

"If a person feels a new lump in their breasts, they should absolutely inform their physician," says Fishman. If you discover some symptoms, breast changes that concern you, or changes that persist after your menstrual cycle, see a doctor for evaluation.

Younger women are more likely to have dense breasts, the appearance of having more dense tissue than fatty tissue in the breast when viewed on a mammogram. This is a risk factor for breast cancer because dense tissue can hide cancers. The difference between a lump and having dense breasts is that dense breast tissue will often feel rubbery and usually without discrete edges around, says Abe.

"Not all breast lumps are indicative of breast cancer," says Fishman. Most lumps are usually not cancer, and the most common benign and non-cancerous lumps are cysts and fibroadenomas.

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According to Abe, "cancerous lumps are rarely painful, while benign, non-cancerous lumps can be painful. Still, not all lumps feel the same, so notify your doctor of any breast mass that doesn't feel normal. If you find a lump, the next step is to get a mammogram or ultrasound to better characterize it, she says.

How often should I schedule breast exams?

A person aged 25 to 40 with an average risk should have a clinical breast exam every one to three years, but individuals over 40 years and those with risk factors are recommended to have them more frequently, possibly annually.

Mammograms, the best way to detect early signs of breast cancer, are recommended every two years for persons aged 50 to 74 with an average risk. However, the topic of when to start mammograms and how often to do them is still debated by many organizations. Most groups advocate in favor of having mammograms beginning at age 40, "however, I think it should be an individualized, informed decision-making process between the patient and doctor," says Abe.

Breast cancer is often detected when it presents as a new finding on breast imaging equipment like mammograms, ultrasounds, and magnetic resonance imaging (MRI). This indicates that screening exams identify breast cancers "when they are very, very early and extremely treatable and curable," says Fishman.

Insider's takeaway

"Finding breast cancer early means that you have the best chance to treat and cure your cancer," says Fishman. There are plenty of ways to screen for breast cancer, such as breast self-exams, clinical self-exams, and mammograms. Administering self breast exams will help you easily recognize any variations from the norm.

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"If you feel a new lump, talk to your doctor," says Abe. All lumps should be evaluated by a health professional, but do not panic because most lumps are usually not cancer.

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