How to Perform a Breast Self-Examination


Breast development is usually a sign that a girl is entering puberty.
Most girls' breasts start to develop before their first periods. During
puberty, every girl's breasts go through regular changes. As you grow
and develop, you may notice small lumps and other changes in your
breasts, and during your period, you may find your breasts are sensitive
and tender. Most of these developments are totally normal.

Getting into the habit of examining your breasts when you're still in
your teens can help you get used to the way they normally look and
feel. When you become familiar with them, it will be easier to recognize
anything unusual.

Why Do I Need Breast Exams?



If you go for an annual checkup with a doctor, he or she will likely
examine your breasts to evaluate your development and ensure that all
changes are normal. Your doctor may recommend that you get into the
practice of examining your breasts yourself — called a breast
self-examination (BSE) — and can show you how to do this.

A BSE can help women detect cysts or other benign (noncancerous)
breast problems between checkups. It can also help some women detect
breast cancer — a disease that's extremely rare among teens.

It's easy to perform a breast self-examination, and it only takes a
few minutes. Although it might seem strange or inconvenient at first,
BSE is a skill you can use throughout your life to help ensure good
breast health.How Do I Examine My Breasts?



It's a good idea to examine your breasts once a month, and it makes
sense to choose the same time each month because breasts usually change
with the menstrual cycle. The best time to do a BSE is about a week
after your period starts.



There are two parts to a BSE:

• how your breasts look
  
• how they feel
  

The looking part is easy. Before you put on a bra, stand or sit in
front of a mirror with your arms relaxed at your sides. Make sure you
are in a place with good lighting. Look at your breasts carefully. Do
you see anything unusual, like a change in the way your nipples look?
Any dimples or changes in the skin?

Then look at yourself from different angles and arm positions. Keep
your hands at your sides, raise your arms overhead, place your hands
firmly on your hips (to tighten your chest wall muscles), and bend
forward. Watch for dimples or changes in the skin. Everyone's breasts
look different. Get to know what yours look like.

The next part is how your breasts feel. It may seem strange at first
to handle your breasts. Some girls feel self-conscious about it, but
there's no reason to feel guilty or awkward. BSE is a positive way to
stay healthy.

Lie down flat on your back, with a pillow or towel under one
shoulder. Put that arm under your head. Examine your breasts one at a
time. If you're starting with your right breast, put a pillow under your
right shoulder, raise your right arm, place your right hand behind your
head, and use your left hand to feel your breast.





Using the pads of your three middle fingers, move your fingers in in
overlapping circular motions about the size of a dime. Move up and down
from the outside of the breast (under your armpit) toward the middle of
your chest, making sure to cover every area of the breast. Examine up to
your collarbone and down to the bottom of the ribcage. Notice what
feels normal and what may feel different from the last time you examined
your breasts.

Use different levels of pressure — light, medium, and firm — to feel
each part of your breast. This will allow you to feel the various layers
of tissue in the breast. Start with light pressure, increase to medium
pressure, and finish with firm pressure to feel the deepest tissue. When
you have covered the entire breast, use your finger and thumb to gently
squeeze your nipple, watching for any discharge. Then put your left arm
behind your head and check your left breast the same way.

While you're doing the exam, it's a good idea not to take your hand
off your breast so you don't miss a spot. You should also check your
armpits for any lumps. Girls who have large breasts should also feel
their breasts from the side, while lying on one side and then the other.

As you feel your breasts, you may notice lumps or bumps. This is
usually normal — just like so many things about people, breasts are
unique. Some girls' breasts are large, some are small; some are symmetrical,
others are not. Some healthy breasts feel really bumpy, whereas others
are less so. Most teens have healthy breasts no matter what they look or
feel like. But if you're worried about the way your breasts look or
feel, let your doctor know.
Warning Signs



If you feel an unusual lump in your breast, don't panic — breast cancer is extremely rare in teens.
In fact, among teen girls, the most common type of breast lump is
usually related to normal breast growth and development. Other common
conditions can cause a breast lump, such as a noncancerous growth known
as a fibroadenomafibroadenoma, and small, fluid-filled cysts that tend to vary in size with a girl's menstrual cycle and are called fibrocystic breast changes.

Fibrocystic breast changes are common. In fact more than half of all
women have them. They're related to the normal cycling of hormones
associated with menstruation. Fibrocystic breast changes are typically
worse just before and at the start of a girl's period.

If you feel a lump in your breast, talk to your doctor to see if the
cause is one of these common conditions. If you have fibrocystic breast
changes or other breast problems that may make it difficult to perform a
good BSE, your doctor can help.

Infections can also cause breast lumps, as can an injury to the breast.

If you have any of these problems, you should talk to your doctor:

• pain in your breast that seems unrelated to your period
  
• a new lump, bump, or other change in your breast
  
• a red, hot, or swollen breast
  
• fluid or bloody discharge from your nipple
  
• a lump in your armpit or near your collarbone
  
• any questions or concerns about your breasts
  

The goal of a BSE is for you to get used to the way your breasts feel. The better you know your body, the healthier you can be!