Self-examination of the Breasts: When to Pay Attention?


13. 08. 2018

Self-examination of the breasts is one of the simplest methods of ensuring a timely detection of breast cancer. The examination should be carried out each month, between the fifth and tenth day from the onset of menstruation. Let’s explore how breasts should be examined and when you should see a doctor. 


Beginning with self-examination of the breasts

Breasts can be examined once each month, but in case you are just beginning with self-examination, carry it out on a daily basis or once every two days throughout the first month. As a result, you will get to know your breasts and it will easier to quickly detect any undesired changes. From the second month, you can examine your breasts between the fifth and tenth day from the beginning of menstruation, or on the second or third day after it finishes because the breasts are not so tense anymore. If you are not menstruating, you can carry out the self-examination on any day you choose. Self-examinations are most comfortable after taking a shower o a bath. 


Self-examination steps

Let’s explore step by step how you should self-examine your breasts: 

Step 1

At first, examine your breasts with your top off while watching yourself in the mirror. First of all, start with your arms located by your body and check that you do not notice any visual changes in the way the breasts look. The size of the breasts usually varies from side to side, but the difference in size should generally not be significant and certainly should not increase over time. The skin should not be wrinkled, swollen or have an abnormal color to it (for example showing redness). The nipples should be symmetrical, without secretion and should not be inverted.  


Step 2

Put your arms above your head and carefully inspect your breasts in this position. Yet again, pay attention to visible changes in the skin, any growths as well as the inversion of the nipples. 


Step 3

Hold your breast with both palms of the hand. Palpate it in a gliding movement in the horizontal as well as vertical direction. Do the same for the other breast. Pay attention to any lumps or small bumps as well as any other irregularities.  


Step 4

Relax your left shoulder and let it settle down. Let your left arm hang freely. With your right hand, palpate the left nipple, squeezing it gently and look for any milky or bloody secretion. Use the same method to examine the right breast. 


Step 5

Lay down on your back in a way that allows for your breasts to be elevated. You can achieve this by for example placing a pillow or a rolled-up towel under your shoulder blade. First place the pillow under the left shoulder blade and use your right hand to palpate your left breast. Then follow the same approach, using your left hand to examine your left breast. In a circular motion starting from the bottom, work your way towards the nipple. First of all, exert minimal pressure so that you can feel the surface of the breast. Then continue by exerting greater pressure to allow you to detect any changes deeper in the breast tissue. Examine each breast in this manner at least twice. First do it with the free hand behind the head and then with the hand rested by the body. 


Step 6

You are still on your back. Place your left arm under your head and use your right arm to examine (yet again in a circular motion) your left armpit to see if you do not feel a small lump. Repeat the same process for the other side. 


Step 7

While on your back, place your left arm by your body and with your right arm, palpate the indented area above your collar bone (on the left side). Try to see if you can detect a lump. Follow the same on the right side using your left arm. 


Why you should not skip anything during self-examination

As you change the position of your body and hands, the tension of the skin as well as the positioning of the breast on the chest differs. With the help of this, you can detect possible changes that may not have been otherwise apparent at the early stages. Early and timely detection of breast cancer is the key to its quick and successful treatment. Therefore, carry out the self-examination regularly with all its seven steps. In case you have even the slightest doubt, do not hesitate to visit a specialist who will examine you or refer you for further required examinations.  Make sure that you do not forget to examine lymph nodes which represent an important part of examining your breasts (steps 6 and 7). Prevention is particularly important when it comes to cancer yet it is often neglected by women.  


Breast cancer symptoms

Women should take notice when they detect a change in the look of their breasts - one-sided changes of the entire breast or its part, persistent redness of the skin or the skin surface resembling orange peel.  Further, you should suspect any redness, peeling or inversion/swelling of the nipples as well as any discharge from the nipple on one of the breasts. As well as this, any lump or any persistent and localized breast pain should be of concern.  Although symptoms of this disease are non-specific (they can be found in other and often less dangerous diseases), an examination by a doctor is always recommended.

At what age should a woman start self-examinations?

Ideally, you should do so immediately after becoming an adult. The earlier you begin with self-examination, the better. Higher risk groups include women with early onset of menstruation, women in an advanced age, patients who were pregnant at a higher age or those women who have undergone menopause later than is considered normal. Other risk factors include excessive consumption of alcohol, stress, heredity as well as obesity. 

Mammography screening

If you have reached the age of 45, then you are eligible to undergo a mammography breast examination once every two years which is covered by health insurance companies. This screening helps in significantly lowering the number of women who die from breast cancer each year. However, in no way does this mean that women should not undergo self-examinations. Although it is relatively uncommon, the tumor can occur between 2 mammography breast examinations. 


Follow-up question:  Can a patient who has not yet reached the age of 45 undergo a mammography examination?

Women younger than 40 should instead undergo an ultrasound examination because of the characteristics of the mammary gland. This applies to suspected clinical or pathological changes in the breasts or preventive examinations of women who have an increased risk of developing malignant breast cancer (for example when they carry the BRCA gene).  Healthy and women outside of risk groups should not undergo mammography breast examinations prior reaching 40 or 45 years of age respectively. Preventive breast examinations should not be carried out prior to first consulting it with the doctor. 


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