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How to complete a proper breast self-exam

Adult female conducting a breast self-exam

In spring 2023, the United States Preventive Services Task Force announced a new draft recommendation saying that all women should get a mammogram every other year starting at 40 years of age. Before a woman begins to receive mammograms, she can stay aware of breast cancer by completing self-exams.

One University of Alabama at Birmingham oncologist explains how to properly complete a self-exam and what each person should be looking for.

How to complete a self-exam

Catherine Parker, M.D., associate scientist in the UAB O’Neal Comprehensive Cancer Center, says

to start the exam with arms raised and to use the right hand to exam left breast and left hand to exam the right breast. A circular, radial, or up and down pattern is best to use — whichever pattern is used, Parker says to make sure to examine the entire breast. 

“Use the pads of the three middle fingers to press on the breast with light pressure, then medium, then firmer pressure, and be sure to include the breast tissue nearest the armpit,” she said. “Be sure to look at the nipple/areola, and if you have a large cup size, examine the skin under the breast.”  

Once an exam has been done of both breasts, place arms down by sides, then raise above the head, then hands on hips. This motion helps to look for any skin dimpling on the breasts. 

Parker, who is also an associate professor in the UAB Marnix E. Heersink School of Medicine’s Department of Surgery, says to complete the self-exam in the following three positions: standing in front of a mirror, lying down on your back and in the shower. She recommends completing a self-exam monthly, around the same time of the month and between seven and 10 days after your monthly cycle starts.

Breast cancer in male patients commonly presents with a painless mass under the nipple, which can be detected during a self-exam.

“Males with strong family history or high risk should know their own baseline and intermittently perform self-exams,” Parker said.

What to look for

When completing a self-exam, Parker says, it is important to learn what the baseline is for one’s breasts.  

“Know what your normal is, and then when you are doing a self-check, look for any skin changes, dimpling, nipple discharge, or inversion/retraction,” Parker said.

Other changes to be on the lookout for include:

  • new masses or lumps not felt before
  • skin color changes
  • bleeding or peeling of a nipple
  • changes in breast size or shape
  • changes in skin firmness

Parker says that pain is not often associated with breast cancer, but pain can be present with more advanced disease.

If any of these are discovered during an exam, notify your medical provider to find out whether further action is needed.  

To learn more about the advanced breast cancer diagnostic, imaging and treatment techniques available at the only NCI-designated comprehensive cancer center in Alabama, click here

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