Performing a breast self-exam (BSE) on a monthly basis is a recommendation for all women beginning at age 20. BSEs are important in keeping you aware of changes in your breasts. Knowing how your breasts normally look and feel is crucial in detecting abnormalities.  

Whether you’ve had breast implants, you’re pregnant, breastfeeding, or going through menopause, it’s important to understand that women in all stages of life should continue to perform BSEs.   

• When to Perform a BSE
• Visual BSE
• Manual BSE
• When to Contact Your Health Care Provider

When to Perform a BSE

Your health care provider performs a clinical breast exam (CBE) during your annual Pap smear and pelvic exam, but you should perform a BSE once a month. Self-examination will help alert you to changes sooner and allow you to address any problems before they become advanced.  

It is recommended that you perform your BSE about a week after your period, when breasts are less tender and swollen. If you no longer have periods, you may choose to perform your BSE the same time every month. Pick a date that you are more likely to remember, for example, the first Sunday of the month, or the first day of the month, etc.  

Visual BSE

Perform the following, first with your arms relaxed at your sides, then repeat the steps with with your arms raised over your head, and then with your hands pressed on your hips while flexing your chest muscles (bend forward and look for changes).

• Stand or sit in front of a mirror (without your shirt and/or bra).
• Look for changes in the shape and size of each breast.
• Look for dimpling or puckering of the skin and nipples.
• Look for scaling and/or rashes on the breasts or nipples.
• Look for new inverting of the nipples.   

Please be aware that it is normal for the sizes of your left and right breast to be slightly different.  

Manual BSE

You may choose to do your BSE while in the shower or lying down. If doing your BSE in the shower, you can lather your hands and skin with soap to allow your hands to move easier across your skin. If lying down, place a towel or pillow under your shoulder on the side of the body you are examining to elevate your breast.  

Examine one breast at a time. When examining your right breast, use your left hand. When examining your left breast, use your right hand.  

• Raise your right arm and place your right hand behind your head.
• Using the pads (not the tips) of your index, middle, and ring fingers move your fingers in a quarter-sized circular motion to feel the breast tissue. You will need to use various levels of pressure to feel the multiple levels of tissue in the breast down to the chest wall.
• You can use a circular pattern, an up-and-down pattern, or a wedge pattern to continue examining the breast.
  • Circular Pattern – Move your hand in a circular pattern around the breast, starting at the outside top of your body and moving inward.
  • Up-and-Down Pattern – Beginning at the inner portion of the breast, near the breast bone, move your hands in an up-and-down, grid-type pattern from the collar bone to ribcage.
  • Wedge Pattern – Imagine your breast divided into wedges, similar to a slice of cake or a pie. Start at the outermost top of the breast, near the collarbone. Move your hand towards the nipple then back up to the collarbone. Move your hand clockwise to the next wedge. Move your hand towards the nipple then back to the top. Repeat this pattern until the entire breast has been examined.
• Cover all areas of the breast, including the upper chest above the breast to the collarbone, down to the ribcage below the breast, as well as the armpit.
• Repeat these steps with your left hand behind your head.  

Be sure to use the same method each time you perform your BSE, regardless of which pattern you choose to use.  

When to Contact Your Health Care Provider

While performing your BSE, you may notice some lumps or bumps. Scattered lumps or bumps may be normal; however, if you feel something that is noticeably different from your previous BSE, you should contact your health care provider for evaluation.  

Contact your health care provider if you:  

• Find a new lump or bump in your armpit or breast.
• Notice a change in the size or shape/symmetry of your breast.
• Notice a change in the texture of the skin or nipple, such as dimpling, puckering, or an unexplained rash.
• Experience pain in your breast that is not related to your menstrual cycle.
• Find an area of one-sided thickening that does not lessen after your next menstrual cycle.
• Notice nipple discharge (other than breast milk if you're pregnant or nursing).
• Notice a new inversion of the nipple (nipple is pointing inward instead of outward) or if the nipple seems to be pointing a different direction than usual.