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Maintaining Health > Best Technique for Self-Exam |
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What is the best technique to perform BSE?
There are two parts to the exam. Start by looking in the mirror, undressed from the waist up. You may discover that one breast is slightly larger than the other and that is normal for most women. Start with your arms relaxed at your sides and be sure to turn from side to side to get a good view of the outer aspects, where most breast cancers originate. Look for changes in size, shape, or skin texture and color. Also look for skin dimpling, or a puckering that may indicate something is pulling the skin or nipple inward. Check for any swelling or dry crusting of the skin, particularly around the nipple area. Pay attention to any nipple discharge (fluid), especially if it expresses spontaneously without massaging the breasts. Ensure the nipples point in the same direction and that one is not starting to invert inward. Repeat this inspection with your arms raised above your head, turn from side to side. Now place your hands on your hips and press down to flex the chest muscles, turn side to side. Finally, lean forward as your breast falls toward the floor, again, look for any changes. Remember to check beneath your breasts, you may need to use a hand mirror in the leaning forward position.
The second part of the exam is done lying down. Use the left hand to examine the right breast and the right hand to examine the left breast. Regardless of which side you start on, you want to position yourself so that the breast tissue falls evenly over your chest. The best way to do this is to start on your side, curved into a fetal position with your legs bent. Then roll your outer shoulder back and place the back of your hand on your forehead. You may need a small pillow under your lower back to be comfortable.
Your nipple will now point to the ceiling and the outer aspect of your breast should float evenly with the rest of your breast tissue on your chest. Use your opposite hand, the middle three finger pads, to feel the breast tissue. The more bowed your hand, the more likely you will use the more sensitive pads, rather than the less sensitive tips of your fingers. 
Use a circular motion, about the size of a dime, and spiral down three pressures. Start with light, barely moving the surface of the skin. Continuously spiral down to medium, half way to your chest wall. Finally, spiral down to deep, all the way to your muscle or ribs. You will then lift, and move one finger width to the next area and repeat. Start in the armpit and move down the seam of your blouse to below the bra line. Go over one strip, one finger width from the last strip. Come back up to the collarbone. Go over one strip and back down to below the bra line. Continue this vertical strip pattern until you reach the middle of your breastbone.
Then examine the other breast the same way. Remember when you are directly over each nipple, the motion is the same and you want to spiral down to your chest. Staying on the pads of three fingers makes the deeper pressure more comfortable. In this part of the exam, you are looking for a lump that feels distinctly different than the surrounding breast tissue. While all normal breast tissue can feel slightly lumpy, the change you are looking for will feel different than your normal nodularity. Remember, you are looking for a change, and over time, you will become confident with what feels normal for you.
Information coutesy of: Nancy Dunn, RN, MS. Nancy is a consultant with PRO-Health Inc
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