The breast exam should be performed once a month. This way you become familiar with the normal feel and appearance of your breasts. The best time to examine your breast is a few days after your period ends when the breast tissue is less tender and less swollen. In males the exam should be performed on the same day of each month. There are two parts to the exam: visual inspection and manual examination.
During the visual inspection, stand in front of the mirror. Look at your breasts for any changes such as puckering, dimpling and scaling of the skin. Look at the nipples to see if there are any discharge. While standing hunch your shoulders forward and look for any changes in the shape of your breasts. Then put your hands behind your head and press forward against your head, again checking for any changes in the shape of your breasts.
The manual examination should be performed while standing and while lying down. During the examination, you are checking to see if there are any unusual asymmetry, masses, or discharge of the nipple. This exam can be performed with three different patterns: vertical stripes, circular, and spokes. The first three finger pads are used to palpate the breast, using light pressure, medium pressure and then with deep pressure. The arm on the same side of the breast being examined should be raised above your head. In the vertical pattern palpate the breast top to bottom using light pressure. Then repeat using medium and then finally with deep pressure. In the circular pattern start at the nipple and using a spiral pattern, palpate out using first light pressure then medium and then finally deep pressure. The last pattern is like spokes of a wheel. Start at the nipple and palpate out in a straight line to the outer edge repeating in a radial pattern using light, medium, and then deep pressure. Lastly gently squeeze the nipple and look for any discharge. If you notice anything unusual, check with your doctor as soon as possible.
Every female age 20+ should perform a monthly self-exam. Over age 40 a clinical breast exam should be done on a yearly basis. Under age 40, the clinical breast exam should be done every 1-3 years. For women age 40-49 at average risk, the mammogram should be done every 1-2 years and then every 1-2 years over age 50. For women at high risk, mammograms should be done beginning at age 35.
The risk factors associated with breast cancer is:
- Age (80% of cases occur after age 50)
- Sex (It’s more common in females)
- Prior history of breast cancer
- Family history of breast cancer
- Beginning menstruation early (before age 12)
- Late menopause (after age 50)
- Having no children or having children after age 30
- History of fibrocystic disease