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Breast Self Examination
   
Breast self examination (BSE) is to be performed each month in addition to an annual mammogram or a clinical exam. Knowing your cyclical changes, what is normal for you, and what regular monthly changes in the breast feel like is the best way to keep an eye on your breast health. Breast tissue extends from under your nipple and areola up toward your armpit.
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Difficulty:  Easy
   
Time Required:  15 minutes a month
   
What You Need:
  • A mirror which lets you see both breasts
  • A pillow for your head and shoulders
  • Privacy
   
1. Make a regular date for your BSE
   
If you are pre-menopausal: Set a regular time to examine your breasts a few days after your period ends, when hormone levels are relatively stable and breasts are less tender.

If you are already menopausal (have not had a period for a year or more): Pick a particular day of the month to do the exam, and then repeat your BSE on that day each month.
   
2. Visual Exam - Hands on Hips
   
In the privacy of your bathroom, strip to the waist and stand before a mirror. You will need to see both breasts at the same time. Stand with your hands on your hips and check the appearance of your breasts. Look at size, shape, and contour. Note changes, if any, in the skin color or texture. Look at the nipples and areolas, to see how healthy they look.
   
3. Visual Exam - Arms Over Your Head
   
Still standing in front of the mirror, raise your arms over your head and see if your breasts move in the same way, and note any differences. Look at size, shape, and drape, checking for symmetry. Pay attention to your nipples and areolas, to see if you have any dimples, bumps, or retraction (indentation). Look up toward your armpits and note if there is any swelling where your lymph nodesare (lower armpit area).
   
4. Manual Exam - Stand and Stroke
   
Raise your left arm overhead, and use your right-hand fingers to apply gentle pressure to the left breast. Stroke from the top to the bottom of the breast, moving across from the inside of the breast all the way into your armpit area. You can also use a circular motion, being sure to cover the entire breast area. Take note of any changes in texture, color, or size. Switch sides and repeat. This is best done in the shower, as wet skin will have the least resistance to the friction of your fingers
   
5. Manual Exam - Check Your Nipples
   
Still facing the mirror, lower both arms. With the index and middle fingers of your right hand, gently squeeze the left nipple and pull forward. Does the nipple spring back into place? Does it pull back into the breast? Note whether or not any fluid leaks out. Reverse your hands and check the right nipple in the same way.
   
6. Manual Exam - Recline and Stroke
   
This is best done in your bedroom, where you can lie down. Place a pillow on the bed so that you can lie with both your head and shoulders on the pillow. Lie down and put your left hand behind your head. Use your right hand to stroke the breast and underarm, as you did in step 4. Take note of any changes in texture, color, or size. Switch sides and repeat.
   
7. Tips For Doing Your BSE
  1. Mark your calendar to remind yourself to do your BSE regularly. This is a good way to prevent worry if find a normal cyclic change
  2. Stay relaxed and breathe normally as you do your BSE. Becoming tense will produce some knots that you may mistake for something worrisome.
  3. Report any changes or unusual pain to your doctor or nurse practitioner. Keep a log of changes, if that helps you remember.
  4. Remember to have an annual clinical exam and a mammogram.
   
               
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