Breast Self Examination

In order to be successful at BSE we need to examine our cultural beliefs.

New Zealand women like most women of the western world are not encouraged to look at or touch their breasts. We may not be comfortable with the thought of doing BSE. To be successful at examining our breasts we may need to change our belief system.

As women we are not asked to expose our breasts naturally as  women from Murray Island, Queensland, Australia when they join a dance troop. This is what is meant by culture. It is the norm and everyone feels comfortable doing it.

Exposing our breasts to ourselves in the comfort and privacy of our homes is an OK thing to do. The bathroom is usually a good place, as you need to look in a mirror and a soapy hand while showering helps the fingers to glide over the breast tissue.

Looking in the mirror place both hands on the hips and take a good look.

Are the breasts even?

Are there any changes in contour, or are they dimpled and distorted in any way?

Raise the arms above the head with your hands on your head.

Are they still the same and finally push the elbows forward.

To examine the breast with your fingers bring the arm up with the hand resting on your head of the side you are starting on.

With the pads of 3 fingers (1st, 2^nd and ring) begin to examine the breast. Start kneading the breast tissue working from the nipple in a circular manner and go further and further out, making sure you go up into the tissue under the arm, as it too is a high-risk area. You may also examine the breast in strips like railway tracks starting from the outside (armpit) and working towards the midline if that is easier for you. The important thing is to do it in a consistent pattern so that you will recognise any changes.

Finally squeeze the nipple.

Check for a bloody or discoloured discharge, because ductal cancer can present itself as such.

Repeat the procedure for the other breast.

Do this after a period when the breasts are not full and do it at the same time each month. Make it a regular habit.

Start in your teens 16-18 and continue for the rest of your life-its not a big deal!

Apart from seeing any changes what you are feeling for are changes like thickenings and lumps. A lump is often described as similar to a frozen pea about the size of your little pinky finger nail. Mushy baked beans are not usually a problem, as they are probably glands, or even cysts but you must determine that what you have found is infact normal breast tissue for you and not something more sinister.

If you find something then it is time to take the first step

Source: NZBCF newsletter May98 written by Dr Tony Bierre.

STEP ONE –Get an examination of both breasts by a medical professional trained in the clinical examination of the breast. In the first instance your general practitioner GP is probably the best person to turn to. He or she will examine your breasts, armpits and lower neck regions for lumps. Your GP may decide at this stage to refer you to a surgeon or surgical outpatients clinic, (or a breast clinic if there is one in your area.) He/she may decide to proceed with some initial investigations before referral.

STEP TWO-If you have not had a mammogram, then this is the next step. This is a special high quality xray of both breasts which identifies most but not all breast lumps and identifies abnormal areas, in particular, areas of calcification ( calcium deposits).

If you have discovered a lump in your breast then mammography provides information about the rest of the breast tissue in that breast and your other breast.

Examination by ultrasound may also be performed which may provide extra information over and above that obtained by mammography.

STEP THREE- The next step is to obtain some cells for examination by a pathologist under the microscope from the lump or abnormal area detected on the mammogram. Examination of the cells under the microscope by an experienced pathologist is the only true way to establish whether the abnormality is cancer or not.

There are a number of ways cells can be obtained.

1. Fine needle Aspiration Biopsy
2. Core Biopsy
3. Hookwire Biopsy
4. Open Biopsy