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Breast Examination 

Introduction
Breast cancer is a common cancer in women.  Breast cancer occurs when cells in the breast grow abnormally or out of control.  The exact cause of breast cancer is unknown.  Breast examinations are used to help detect breast cancer as early as possible and to ensure that further diagnostic testing and prompt treatment are received.  Such detection methods include self-examinations, clinical examination, and mammogram.

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Diagnosis
Breast Self-Examination
 
It is appropriate for self-breast examination to begin in the teen years, but by the age of 20, you should perform regular self-breast exams.  A self-breast exam is easy and only takes a few minutes.  The best time to perform breast self-examination is one week after your period starts.
 
There are two parts to a self-breast examination, looking at your breasts for changes and feeling your breasts for changes.  Look at your breasts from different angles in front of a mirror.  Look for changes in your breast size or shape, swelling, and skin texture.  Check for red, scaly, or irritated skin.  Look for dimpled, puckered, or retracted skin areas.  Evaluate the appearance of your nipple.  Note if it turns inward or seems enlarged.  Check your nipple for any fluid discharge.
 
You may perform the second part of the breast self-examination standing up or lying down.  Some women prefer to examine their breasts in the shower.  Examine your breasts individually.  To examine your right breast, raise your right arm and place your right hand behind your head.  Examine your right breast with your left hand.  Check your armpit tissue as well. 
 
Feel your breast tissue with the pads of your three middle fingers.  Use light, medium, and firm pressure to feel the different tissue layers in your breast.  You should check for a lump or mass.  A suspicious lump may feel very firm or hard.  They are usually painless.  Squeeze your nipple with your finger and thumb while watching for any discharge.  When you have completed examining your right breast, put your left arm behind your head and examine your left breast with your right hand in the same manner.
 
You may notice normal lumps in your breasts during your self-examination.  Some women experience fibrocystic breast changes, especially just before their periods.  If you are uncertain about a lump in your breast, talk to your doctor.  You should contact your doctor if you notice a new lump or change of appearance in your breasts or armpits, red hot swollen breasts, discharge from your nipple, or pain in your breast that is unrelated to your period.
 
Clinical Breast Examination
 
A clinical breast examination is similar to your breast self-examination.  Your doctor or a nurse may perform it.  It is convenient to have a clinical breast examination at the same appointment that you have your annual pelvic examination.  It is recommended that women over the age of 40 have a yearly clinical breast examination and that women under 40 receive it every other year.  You should tell your doctor about any changes in your breast and discuss any concerns or risk factors.  This is a good time to point out any questionable lumps or ask your doctor questions about self-examination methods.
 
For your clinical breast examination, you will undress from your waist up and wear a paper or cloth gown with the opening in the front.  Your doctor will only uncover the parts of your body that are being examined.  Your doctor will examine your breasts, armpits, neck and chest area.  Your doctor will look at your breasts to see if they have changed in size or shape.  Your doctor will use the pads of his or her fingers to check for lumps or masses.
 
Mammogram
 
A mammogram is a type of X-ray used to identify breast masses or tumors.  The American Breast Cancer Foundation and American Cancer Society recommend that every woman over 40 years old should receive an annual mammogram.  Women with a family history of breast cancer or other high risk factors may talk to their doctor about earlier screening.
 
A mammogram is a short procedure.  A radiation technician will carefully help you place your breast placed between two plates before images are taken.  The two plates compress your breast to flatten and spread the tissue in order to obtain the best picture possible.  This test may be uncomfortable, but only for a very brief period of time.  A mammogram may only tell if a tumor is present.  It cannot tell if a tumor is cancerous or not.  In many cases, a radiologist can let you know your results before you leave your appointment.
 
Your doctor will order more tests if the results of your mammogram or clinical breast examination are suspicious.  Additional tests are necessary to determine if a mass contains cancer cells or not.  Early detection and treatment of breast cancer is important to ensure the best outcomes.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.