Breast cancer: A visual guide to self-examination

Monthly breast self-examination can help detect abnormalities or changes that may be signs of cancer.

Not every form of breast cancer can be found through a physical examination. However, regular self-examination can increase the chances of discovering certain breast cancers early.

The earlier breast cancer is detected, the more likely it is that treatment will be effective.

A person needs to understand the areas around the breast that are most vulnerable to cancer in order to be able to carry out a self-examination. Seeing pictures of these areas and how a breast may appear if there is cancer present can help.

Where cancer forms

Most breast cancers begin in the milk ducts. These are tube-like structures that deliver milk to the nipples.

Cancer may also form in the glands that produce milk, called lobules. Individual lobules are grouped into larger structures called lobes, and each lobe is connected to a duct.

As this system of lobes and ducts surrounds the nipple from within, ductal or lobular cancers may affect the appearance and feel of the nipples and the areolae around them.

The following carousel is a step-by-step guide, with pictures, of how to perform self-examination of the breasts. It also includes some breast cancer pictures to help people understand what cancer warning signs may look like.

How to perform breast self-examination

The National Breast Cancer Foundation suggest three steps for an effective breast self-examination:

visual examination

physical examination while standing

physical examination while lying down

1. Visual and standing examination

A visual examination can be done in front of a mirror. The breasts and nipples should be carefully checked for abnormalities or discharge.

A visual examination can be done in front of a mirror. The breasts and nipples should be carefully checked for abnormalities or discharge.

A standing examination is often performed in the shower, because the skin is easier to examine when slippery. Each breast should be checked from its sides to its center for lumps or knots.

Using circular motions, varying amounts of pressure should be applied to each spot along the breast. This ensures that both the superficial and deep layers of the breast tissue are examined.

2. Laying down examination

Lying down to examine the breasts is important because it allows breast tissue to spread out evenly along the chest wall.

Both breasts should be examined in their entirety. The armpit, collarbone, and breastbone areas should also be examined. The Maurer Foundation provide a method for the lying examination that is thorough and easy to follow:

• Starting at the armpit, feel for lumps by making circles with the pads of the fingers.
• After making 3 circles at varying pressures, slide downward a finger’s width and begin a new set of circles.
• Repeat until reaching the top of the abdomen. At this point, the examination path should be shifted a finger’s width horizontally, and should then progress upwards towards collarbone.
• This up-and-down pattern should be followed all the way to the space between the breasts. It can then be performed on the opposite side of the body.

3. Nipples and areolae

It is important to look for changes when examining nipples and areolae as well. These can include:

• redness or swelling
• if the nipple has turned inward
• scaly or ridged texture
• discharge that is clear, yellow, or contains blood
• tenderness or pain

4. Breast tissue

If a tumor has formed in the ducts or lobules, the cancer may spread to fatty tissue nearby on the breast.

Breast abnormalities that may be signs of cancer include:

a lump in the breast

unexplained change in breast shape

unusual breast shrinkage or swelling

dimpling of the skin or enlarged pores

skin that has become irritated, scaly, or ridged

a thickening of the breast skin

abnormal breast pain

Other unexplained breast changes may also be warning signs, especially if they only appear in one breast.

5. Armpits, collarbone, and breastbone

Swollen lymph nodes may become noticeable even before the original breast tumor is large enough to detect.

For this reason, checking these areas for abnormalities is just as important as examining the breasts and nipples.

When examining these areas, a person should look for:

• a lump in any of these areas
• swelling in any of these areas
• thickening of the skin in the armpit area

6. When to self-examine

Self-examination should be performed once a month, at the same time each month.

Women who have not yet gone through menopause should perform a self-examination a few days after their period ends. This is the time when the breasts are least likely to be swollen or sore.

Each person’s breasts have their own normal texture and appearance. Certain areas might feel sandy or grainy, and others might even have small lumps.

Routine self-examination helps people develop a sense of what’s normal for them. This way, women can differentiate between what is normal for them and any abnormal lumps that appear.

7. What to do if you find a lump

If an abnormal lump has persisted or grown over the course of a full menstrual cycle, a doctor should be consulted.

While it is important to seek further evaluation, this should not be cause for panic.

According to Breastcancer.org, 80 percent of women who have a biopsy when they find a lump turn out to be cancer-free.