By Marissa Harshman,, The Columbian, Vancouver, Wash.
While breast self-exams are no longer considered an essential early cancer detection method, health care providers say they still have value.
The goal of self-exams is to increase familiarity with the breast tissue, which will make it easier to notice changes, said Joan Wendel, a nurse at The Vancouver Clinic's Breast Care Center.
"The women familiar with their tissue will be the ones that pick up the abnormality most quickly," Wendel said.
Those abnormalities can then be reported to a health care provider for further examination and, if necessary, testing, she said.
A study of women undergoing breast cancer surgery found that despite frequent screening mammograms, about 40 percent of breast cancers were discovered as the result of lumps or suspicious changes found during breast self-exams, according to the Mayo Clinic.
Breast exams don't, however, appear to affect breast cancer death rates.
An analysis of results from the two largest trials on breast self-exams found no difference in rates of breast cancer death after 15 years between women who did routine self-exams and those who did not, according to the Susan G. Komen organization.
Still, health care providers recommend women conduct monthly exams beginning at age 20. The best time of the month to perform the exam is during the week after menstruation, when the breast tissue is softest and easiest to examine, Wendel said.
Women who don't have monthly periods should pick a date and perform the exam on the same date each month, she said.
The self-exam has two parts: visual and physical.
Women should begin by examining their breasts in a mirror. They should inspect their breasts for bulges, dimpling in the skin and changes in skin color, Wendel said.
Women should also lift their arms above their heads and check the underside of the breasts for unusual bulges or dimpling, she said. Wendel also recommends women examine their breasts while placing their hands on their hips and pressing inward.
Women should also check their nipples for changes, such as discharge or the nipple becoming itchy or crusty, Wendel said.
For the second part of the breast self-exam, women should lie on their back on a bed with a towel or small pillow under their right shoulder, Wendel said. With the right arm raised above the head, the woman should use the pads (not the tips) of her middle three fingers on her left hand to feel for lumps in her right breast, she said.
Health care providers recommend women use one of two methods. One method is to use an up-and-down motion, beginning at the outside of the breast and working across the entire breast. The other method is to use a circular motion, beginning at the outside of the breast and working toward the nipple.
"Either is good," Wendel said. "The important part is covering all the breast tissue."
While feeling for lumps, women should apply different amounts of pressure to reach different depths of breast tissue, Wendel said. After finishing the examination of the right breast, switch arms and check the left breast.
"If you feel something that just feels different, that's the important message to take to your physician or your health care provider," Wendel said.
"Becoming familiar with breast tissue gives women the most information about what's normal for them and what's not," she added.
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