Patient guide
Breast self-examination
The point of self-examination is not to make a diagnosis — it is to know your own body. Once you know what is normal for you, noticing a change becomes much easier. Any change you find does not mean cancer, but each one does need a medical examination.
Self-examination does not replace screening
Self-examination does not replace ultrasound and mammography. Many early changes cannot be felt by hand — which is exactly why age-appropriate screening has to be carried out separately.
When to do it
- If you have periods — 3 to 5 days after the period ends, when the breasts are least tender
- After the menopause — on any fixed day of the month, for example the same date each month
- During pregnancy and breastfeeding — the breasts change, so it is better to plan the examination with your doctor
Once a month is enough. Examining more often adds nothing and can create anxiety.
How to do it
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In front of a mirror — arms down
Look at the size, shape and symmetry of your breasts. Check for puckering, dimpling, redness or an “orange peel” appearance of the skin. Slight asymmetry is usually normal.
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In front of a mirror — arms up
Raise your arms above your head and look again for the same signs. Skin tethering is clearer in this position. Then put your hands on your hips and push your shoulders forward.
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Lying down
Lie on your back, place a pillow under the shoulder of the side you are examining and put that arm behind your head. This spreads the breast tissue over the chest wall and makes the examination easier.
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With the pads of three fingers
Use the flat pads of the middle three fingers, not the thumb, in small circular movements. Go over the area with three different pressures — light, medium and deep — so that both superficial and deep tissue is assessed.
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Systematically, leaving nothing out
Work in vertical strips from top to bottom, or in circles from the centre outwards — whichever you choose, repeat the same sequence every time. Be sure to include the armpit and the area below the collarbone.
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The nipple area
Look at the shape and direction of the nipple, and squeeze gently to check whether there is any discharge.
What to look for
- A new lump or area of firmness — particularly one-sided and persistent
- A change in the shape or size of the breast
- Skin dimpling, puckering or thickening
- The nipple pulling inwards or changing direction
- Nipple discharge — especially one-sided, bloody or spontaneous
- Persistent redness, scaling or ulceration
- A lump you can feel in the armpit
- Persistent pain in one area that does not settle
I have felt something — what now?
Do not panic: most changes found in the breast are benign. But do not wait to see what happens and do not leave it to next month — see a doctor. The examination is short and either removes the concern or allows it to be investigated in good time.
Knowing what is normal
Breast tissue is naturally uneven — small irregularities can be felt on examination and that is normal. Tenderness and swelling increase during the menstrual cycle and then settle. In many women there is a difference in size between the two breasts.
This is where the real value of self-examination lies: done regularly, it teaches you what is ordinary for you, and that makes a new change much easier to notice.
Frequently asked questions
Can self-examination find breast cancer early?
Self-examination helps you notice changes, but many early findings cannot be felt by hand. So it is useful, but it does not replace age-appropriate ultrasound and mammography.
I can always feel small lumps in my breast — is that normal?
Breast tissue is naturally uneven, and many women feel small irregularities on examination. What matters is a change that is new, persistent or growing. If you are unsure, get it examined.
Is a painful lump less dangerous?
That assumption is not correct. Lumps associated with breast cancer are often painless, while inflammatory conditions are painful. In other words the presence or absence of pain says nothing on its own — an examination is needed either way.
Should men examine themselves?
Breast cancer in men is rare, but it happens. Firmness or a lump found around the nipple in a man always needs to be examined, and because it is rare, men often come late.
At what age should I start?
Getting into the habit of knowing your own body is useful from a young age. The age at which screening starts depends on your level of risk and is set individually at the consultation.
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