Breast self-examination is performed by the woman with the objective of detecting changes or alterations, both visually and physically.
The first thing we have to do is to stand in front of a mirror and, with the arms at the sides of the body, observe if there are changes in the shape or size, if the skin is smooth or has any folds or roughness; if the contour is regular, etc. Do not forget the nipples, areolas and see if there are alterations in the size and shape; if there are wounds, scabs, and if there is fluid secretion.
Next, we raise the arms and compare the breasts and armpits to detect differences. We then interlock the hands in front of the chest and force outward to contract the chest muscles, lifting the arms to observe any alterations in the skin or contour.
Finally, lying on the bed, with the back resting on a cushion or slightly elevated, the left breast is palpated with the right hand, and with the fingers stretched out we gently press the breast. We should never explore by pinching, and it is important to follow a protocol to always do it the same way and not forget any quadrant. With the right breast we do the same but with the left hand, and we must not forget the armpits.
How often should we perform a breast self-examination?
We should take the opportunity to start self-exploration for the first time after a breast check-up, because the breast is not smooth. We have to know what our breast is like; this will take us a few months -a few-, and at the end we will know it and we will know how to detect any change.
Breast self-examination should be done every month, but always after the period, because before (specifically from ovulation to menstruation), it can become congested, swollen or retain fluid, and can give us a scare unnecessarily.
During menopause, we will choose a day of the month so as not to forget.
When to see a specialist in Gynecology
There are several signs and symptoms that should alert a woman to go to her gynecologist:
- The presence of a lump in the breast or armpit. When a lump appears that is new, that does not disappear or change with the cycle, it may indicate pathology and it is necessary to clarify whether it is benign or not.
- Nipple discharge may indicate, especially if it is dark or bloody, a benign entity, such as papilloma, but it may also be a malignant process.
- Sinking or retraction of the nipple or nipple-areola unit; the breast should be evaluated to see if there is something behind the nipple that is pulling.
- Flaking, sores and/or scabs on the nipple; if not due to dermatologic cause, we must rule out Paget’s disease, which is a rare breast cancer.
- Hardening, dimpling, folding of the skin or contour may also suggest breast pathology and should be evaluated.
- Any change in color, temperature, or swelling can almost always be signs of a benign disease called mastitis, but a differential diagnosis should be made with inflammatory cancer, which is also rare.
Breast pain
Finally, I want to make a special section on breast pain, which is the most frequent symptom that scares women the most, being one of the first reasons why women go to the specialist.
As a general rule, and in most cases, breast pain is not indicative of cancer. The breast is innervated by the cervical and intercostal plexus, so any alteration at those levels can give a reflex of pain in the breast. In addition, there is the hormonal factor. We have already mentioned that in the cycles from ovulation to menstruation the breast becomes inflamed (etc.) and can hurt, and a lot!!!
However, if the pain is persistent and is not related either to cycles or to musculoskeletal alterations, we should consult a specialist.
Let us not forget: in addition to worrying, we must take care of it.