aLife Singapore | Breast Self-Examination
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07 Apr Breast Self-Examination

Breast self examination or BSE, is an effective way to detect changes (such as lumps or thickenings) in the breast that may signal breast cancer. When breast cancer is detected in its early stages, chances for surviving the disease are greatly improved.

Anatomy of Normal Breast

Before doing breast examination, it is important to understand the structures of normal breast.

In the female, each breast consists of an abundant amount of fat surrounding the glandular tissues which produce milk during pregnancy. The nipple is a cylindrical eminence that projects from the centre of the breast. Surrounding the nipple is a darker area of skin called the areola. The areola contains small glands that lubricate the nipple during breast-feeding. There are15 to 20 lobes of glandular tissues that converge towards the nipple like spokes on a wheel. Inside these lobes are smaller lobes, called lobules. At the end of each lobule are tiny “bulbs” that produce milk. These structures are linked together by small tubes called ducts, which carry milk to the nipples. Fat fills the spaces between the lobes and ducts. There are no muscles in the breasts, but the pectoral or chest muscles lie under each breast and cover the ribs.

Each breast contains blood vessels, as well as vessels that carry fluid called lymph. Lymph travels throughout the body through a network called the lymphatic system, carrying cells that help the body fight infections. The lymph vessels lead to the lymph nodes (small, bean-shaped glands). One group of lymph nodes is located in the armpits; they are called axillary nodes.

Breast development and function depend on the hormones estrogen and progesterone, which are produced in the ovaries. Estrogen elongates the ducts and causes them to create side branches. Progesterone increases the number and size of the lobules in order to prepare the breast for nourishing a baby.

After ovulation, progesterone makes the breast cells grow and blood vessels enlarge and fill with blood. At this time, the breasts often become engorged with fluid and may be tender and swollen.

The breasts should be examined once a month, a few days after the menstrual period ends. BSE should be continued even after menopause. They could be done on a fixed date each month; with each exam, one may become familiar with the contours and feel of the breasts, and will be more alert to changes.

Breast self-examination Procedure

1. Look for changes in front of a mirror

Stand undressed from the waist up in front of a large mirror in a well-lit room. Look at your breasts. Don’t be alarmed if they do not look equal in size or shape. Most women’s breasts are unequal.

  • with arms at your sides
  • with arms raised above your head
  • with hands pressed firmly on the hips, with chest muscle contracting

In each position

  • Look for any changes size, shape or texture, or any changes to the skin of the breasts.
  • Look for any skin puckering, dimpling, sores or discoloration.
  • Inspect your nipples and look for any sores, peeling or change in the direction of the nipples.

2. In the bathroom

It is helpful to have your hands slippery with soap and water. Check for any lumps or thickening in your underarm area. Place your left hand on your hip and reach with your right hand to feel in the left armpit. Repeat on the other side.

With hands soapy, support the breast with one hand while using the other hand to feel the tissue. Use the flat part of your fingers to press gently into the breast. Starting on the outer edge of the breast, feel around the whole breast in circular motion. Continue the pattern until you have covered the entire breast. Repeat on the other side.

3. Lying down

Next, lie down and place a small pillow or folded towel under your right shoulder. Put your right hand behind your head. Place your left hand on the upper portion of your right breast with fingers together and flat. Keep your fingers flat and in constant contact with your breast. Feel the entire breast in circular motion.

4. Squeeze the nipple gently to see if there is any bleeding or discharge.

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