Stay Healthy: Breast Exam

How to Do a Breast Self-Exam
Adapted from American Cancer Society Recommendations
• Lie down and place your right arm behind your head.
• Use the finger pads of the three middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-sized circular motions of the finger pads to feel the breast tissue.
• Use three different levels of pressure to feel all the breast tissue:
– Light pressure to feel the tissue closest to the skin.
– Medium pressure to feel a little deeper.
– Firm pressure to feel the tissue closest to the chest and ribs.
A firm ridge in the lower curve of each breast is normal. If you’re not sure how hard to press, talk with
your doctor or nurse. Use each pressure level to feel the breast tissue before moving on to the next spot.
• Move around the breast in an up-and-down pattern —start at an imaginary line drawn straight down your side from your underarm. Move across the breast to the middle of the chest bone (sternum or breastbone).

Be sure to check the entire breast area—going down until you feel only ribs and up to the neck or collar bone (clavicle).

There is some evidence to suggest that the up-anddown pattern (sometimes called the vertical pattern)
is the most effective pattern for covering the entire breast without missing any breast tissue.
• Repeat the exam on your left breast, using the finger pads of your right hand.
• Stand in front of a mirror. Press your hands firmly down on your hips. Look at your breasts for any changes of size, shape, contour, dimpling, pulling, or redness or scaliness of the nipple or breast skin.
(The pressing down on the hips position contracts the chest wall muscles and enhances any breast changes.)

Continue to look for changes with your arms down at your sides. Then look for changes with your arms raised up over your head with your palms pressed together.
• Examine each underarm while sitting up or standing. Raise your arm only slightly so you can easily feel in this area. Raising your arm straight up tightens the tissue in this area and makes it difficult to examine.

Note From American Cancer Society:
This procedure for doing breast self-exam is different from previous procedure recommendations. These changes represent an extensive review of the medical literature and input from an expert advisory group. There is evidence that the woman’s position (lying down), area felt, pattern of coverage of the breast, and use of different amounts of pressure increase the sensitivity of breast self-exam, as measured with silicone models, and of clinical breast exam, using patient models with known small, noncancerous lumps in their breasts.

Provided as an educational resource by Merck