Breast self examination - bse

Breast self exam


URL of this page: Breast self exam: MedlinePlus Medical Encyclopedia



Many women feel that doing a breast self exam is an important part of their health care. It helps them learn how their breasts normally feel, so that if they find a lump they will know whether it is something to discuss with their health care provider.
However, there is controversy about recommending breast self exams. There is no evidence that doing breast self exams saves lives from breast cancer, so if you are not comfortable checking your breasts, don't be concerned.
What is most important is to have routine screening mammograms if your health care provider recommends them. Even getting a yearly exam is controversial, but many women and their health care providers feel that this is still an important part of breast cancer screening.
Talk to your health care provider about whether or not you should do breast self exams. If you do decide to perform breast self exams, be sure to do the exam about 3 - 5 days after your period starts, when your breasts are not as tender or lumpy. If you have gone through menopause, do your exam on the same day every month.
[SIZE=-1]<table width="560" border="1" cellpadding="5" cellspacing="5"><tbody><tr><td valign="top">Breast Self Exam
Looking
The self-exam should always be done in good light. Stand or sit in front of a mirror. Place arms at your sides. Look for dimpling, puckering, or redness of the breast skin, discharge from the nipples, or changes in breast size or shape. Look for the same signs with your hands pressed tightly on your hips and then with your arms raised high.
Feeling
Lie flat on your back. Place a folded towel or a pillow under your left shoulder. Place your left hand under or over your head. You also can feel for changes when you are standing.
With your right hand, keeping the fingers flat and together, gently feel your left breast without pressing too hard. Use one of the three methods shown here. Then lower your right arm and do the exam on the other breast.
<table align="left" cellpadding="0" cellspacing="5"><tbody><tr><td valign="top"></td></tr><tr><td>
</td></tr></tbody></table> Choose one of these methods
Circle. Circle. Begin at the top of your breast and move your fingers slowly around the outside in a large circle. When you return to the top, move your hand a little closer to the nipple and make a smaller circle. Do this in smaller and smaller circles until you have examined all of the breast tissue.
Lines. Begin in the underarm area. Slowly move your fingers down until they are below your breast. Move your fingers closer toward your nipple and go slowly back up, using the same motion. Use this up-and-down pattern all the way across your breast.
Wedge. Begin at the outside edge of your breast. Slowly work your way in toward the nipple, doing one wedge-shaped section at a time. Do this until the entire breast area has been examined.
<table bgcolor="#99cccc" cellpadding="5"><tbody><tr><td>Don't Forget

• 
  [*]With any pattern, be sure to examine the nipples also. Gently squeeze the nipple and check for any discharge.
  [*]Examine the upper chest area and below the armpits—these places also have breast tissue.
  [*]Call your doctor if you notice any lumps or changes in your breasts.

</td></tr></tbody></table>
</td></tr></tbody></table> [/SIZE] [SIZE=-1]Looking [/SIZE]
[SIZE=-1]In the first part of the exam, you are looking in the mirror for any changes. This means you should make sure you have enough light when you are doing the exam. [/SIZE]
[SIZE=-1]Feeling [/SIZE]
[SIZE=-1]In the second part of the exam, you are feeling for any changes. You can do this lying flat on your back, standing, or when you are taking a shower or bath. It often is easier to examine your breasts when they are smooth and wet with soap and water. It is a good idea to examine your breasts both ways—lying down and standing. [/SIZE]
[SIZE=-1]Examine one breast at a time. Feel with the pads (not tips) of your three middle fingers. [/SIZE]
[SIZE=-1]There are three methods you can choose from to feel for changes. You may find that one pattern works better for you than the others. Once you find the pattern that is easiest for you, use that pattern only. The box on the reverse shows you how to do a breast self–exam. [/SIZE]
[SIZE=-1]Remember how your breasts feel each month. Mark any lumps or other changes on the diagram shown here. Show it to your doctor. [/SIZE]
[SIZE=-1] <table align="right" border="1" hspace="5"><tbody><tr><td></td></tr></tbody></table> [/SIZE]
[SIZE=-1]Signs of a Problem [/SIZE]
[SIZE=-1]If you notice any of these symptoms during your breast self-exam, call your doctor: [/SIZE]

• [SIZE=-1]
• A lump
• Swelling
• Skin irritation
• Dimpling
• Pain
• Nipple retraction (nipple turns in)
• Redness of nipple or breast skin
• Scaly nipple or breast skin
• Nipple discharge[/SIZE]

[SIZE=-1]Any lump should be checked right away. Tests may be needed. In some cases, a biopsy may be done to look at the tissue. [/SIZE] [SIZE=-1]Finally... [/SIZE]
[SIZE=-1]Do the breast self-exam once a month. If you detect any signs of a problem, talk to your doctor. By doing routine breast self-exams and having routine mammograms and checkups, you can help detect breast problems early—when they most likely can be treated with success.[/SIZE]

 

Initially cancer of the breast might not present with any symptoms. Symptoms become apparent only when the cancer has grown in size.So, it is quite necessary to self examine the breast every month so that even minute changes in breast can be seen and reported early.

But for this purpose you need to have an idea about the signs and symptoms of breast cancer.

Here is a list of most commonly encountered symptoms of breast cancer-

1. Lump in breast- Earliest symptom of breast cancer is a lump which is felt while palpating the breast with the finger. This lump is generally hard, immobile and with irregular edges.You may notice an increase in the size of the lump with time.
2. Skin thickening- Sometimes changes in the skin of affected breast can be noticed in the form of its thickness ,texture and color. The skin may feel like orange peel and may have prominent pits over it.This type of skin appearance is called Peau'd'orange and occurs due to obstruction in lymph vessels caused due to cancer cells.
3. Skin ulcer- An ulcer or denudation of skin overlying the breast tissue may point towards an underlying breast cancer.
4. Nipple retraction or inversion- Recently inverted or retracted nipple is an important symptom of breast cancer. If noticed this should be reported to a doctor at earliest.Nipple retraction occurs due to infiltration of stroma of breast by breast cancer cells.
5. Nipple discharge- Discharge from nipple may be due to cancer. Although it also occurs in a variety of benign breast tumors but it is an important symptom of breast cancer too.In breast cancer the discharge can be bloody or serosanguinous.
6. Breast Pain- Pain is not an characteristics symptom of breast cancer but it may be present in some rare variants of breast cancer like,inflammatory breast cancer.
7. Dimpling or pitting of breast- dimpling or pitting of a part of breast is an important and early symptom of breast cancer.It occurs most probably due to invasion of stromal tissue by cancer cells.
8. Immobility or fixity of breast
9. Enlargement of axillary lymph nodes- Enlargement of lymph nodes present in and around underarms is an important symptom of breast cancer. If present it points relatively advanced breast cancer with spread upto the lymph nodes or even further.
10. Bone pain- Bone pain may signify an advanced cancer which has spread to the bones.
11. Anorexia and weight loss- Due to spread of breast cancer to the liver.
12. Shortness of breath- This occurs if breast cancer has metastasized to lungs.

 

Mammography:

A mammogram is an x-ray exam of the breast. It is used to detect and evaluate breast changes.
The special type of x-ray machine used for the breasts produces lower energy x-rays. These x-rays do not go through tissue as easily as that used for routine chest x-rays or x-rays of the arms or legs, but this improves the contrast of the image. Modern mammograms also expose the breast to much lower doses of radiation compared to devices used in the past.

Indications
(1) Baseline screening mammogram for women between 35 to 40 yrs.
(2) Screening mammograms at yearly intervals for women after 40 yrs, and should continue to do so for as long as they are in good health.
(3) Initial Screening at 30 yrs in high risk group (if 1st relative with breast cancer in pre-menopausal period)
(4) Annual follow up for all women who have had previous breast cancer.
(5) Diagnostic mammograms on women > 30 yrs who have breast lumps or other symptoms
(6) Sonomammogram is to be considered for initial breast evaluation in women < 30 yrs & during pregnancy / lactation with palpable lump, nipple discharge etc


Screening mammograms
Screening mammograms are done to look for cancer in women who have no symptoms.
The goal of a screening mammogram is to find cancer when it is still too small to be felt by a woman or her doctor.
Finding small breast cancers early by a screening mammogram greatly improves a woman's chance for successful treatment.
A screening mammogram usually takes 2 x-ray pictures (views) of each breast.



Diagnostic mammograms
Diagnostic mammograms are done on women who have lumps or other symptoms such as nipple discharge, or who have a suspicious change seen on a screening mammogram.
During a diagnostic mammogram, more pictures are taken to carefully study the area of concern. In most cases, special pictures (Magnified views & spot compression views) make a small area of suspicious breast tissue bigger and easier to evaluate.
Sono-mammogram (Breast Ultrasound)
Sonographic evaluation of breast in addition to x-ray mammography can help in better characterizing a breast lesion & increasing the diagnostic accuracy.

Sono-mammogram (Breast Ultrasound)
Sonographic evaluation of breast in addition to x-ray mammography can help in better characterizing a breast lesion & increasing the diagnostic accuracy.



Limitations


(1) Although mammograms will detect most breast cancers, a small percentage will be missed.
(2) Sometimes signs on a mammogram that look abnormal may require a biopsy that may turn out not to be breast cancer. In such cases patient may have to go through a period of anxiety about the possibility of having breast cancer.
(3) A suspicious area in the breast may be found by physical exam, mammogram or another imaging method, or by some combination of these. But no matter of how it was found, cancer can only be confirmed by a biopsy. However mammograms, despite their limitations, are the most effective and valuable tool for decreasing the morbidity & mortality from breast cancer. Women should be told about the benefits, limitations, and potential harms linked with regular screening.