What, Why, Who, When and How of Self Breast Examination (SBE)  

What is Self Breast Examination?
Whether we call it self breast examination or breast self examination, the process is the same. It refers to examining our own breasts using our own hands and “eyes”. Several studies have shown that women who practise SBE were diagnosed at a significantly earlier stage of the breast cancer than those who did not practise SBE.  

Why do SBE?
To detect changes in your breast, you need to know what is normal for you.

To achieve that, you need to familiarise yourself with your breasts.

This can be achieved through regular (monthly) Self Breast Examinations (SBE).

Who should be doing the SBE?
Every lady from 18-20 years to no upper age limit should benefit from SBE. Even after treatment for breast cancer, you need to do SBE. Persons who have had breast cancer and have been treated may probably find this difficult because it will remind them every month of what they have gone through. SBE should be a routine part of every woman's life.

Men should not ignore their “breasts” because breast cancer is not a “woman’s only” disease. 

Mothers should talk to their daughters (at the appropriate age) about the importance of SBE so it will become a routine part of their lives. This is especially important in mothers who have been diagnosed with breast cancer.   

When is the best time to do SBE?
About 3 days after your period ends, is a good time to perform SBE. This will allow your breast changes in the build up to menstruation to “subside”. If you no longer have periods or are a man, choose a date of the month and do it on the same date every month. The first day of the month is easy to remember. 

If you are on oral contraceptives, do it on the day you start the next cycle of pills.

If you are on Hormone Replacement Therapy (HRT), check with your doctor for the best time. (HRT formulations may vary).
 

How to do SBE? Look & Feel Techniques

Look at your breast
1.Undress to the waist, sit or stand in front of a mirror in good light

2.Look at the size, profile, flow, nipple, colour (skin and nipple) of your breasts

3. Is there a difference in level between nipples, dimpling, puckering of skin, retraction of the nipple (indrawn nipple where it was previously never so)? 

Techniques to detect these are as follows: 

1.Hang your arms loosely by your sides

2.Raise your arms above your head

3.Watch in the mirror as you turn from side to side to see your breasts from different angles

4.Shrug your shoulders and lean forwards and see if the breasts “hang” evenly (change in breast outline)

5.Clasp your hands under your chin and flex your chest wall muscles

6.Place both hands firmly on your hips and press them in hard (chest muscles tense up)

7.Look at your nipples. Squeeze them gently to check for any bleeding or discharge that is unusual for you

Feeling Your breasts (Patterns of Feeling)
1.You may wish to use talcum powder or a baby oil/lotion to help the hand slide smoothly over the breast

2.Lie down on your bed with pillow behind your shoulders and back.

3.Examine one breast at a time.

4.In large breasts, you may need to have 2 pillows but only on one side, so that you lie at an angle to the bed surface

5.Stretch out your arm on the same side as the breast being examined. Place that hand under your head

6.These help to stretch the breast tissue and immobilise it as much as possible, presenting a “thinner” breast for palpation. (Distribute breast tissue more evenly)

7.Use the right hand to examine the left breast and vice versa. 

If you are reluctant to touch your breasts you may not be aware of anything unusual.

Perhaps, your partner can help. Your partner can help by noting changes, and discussing them unemotionally with you later.

More tips:
1.Keep your fingers parallel to the skin of your breast.

2.Feel gently but firmly for any unusual lump or thickening. Superficial pressure (tiny mobile lumps under the skin will move away if the pressure is too firm)

Deeper pressure: search the mid level tissues and to probe firmly all the way to the ribs

With time you will become the expert in knowing your breast!

3.Make sure you cover every part of your breast

4.Examine your armpit. Start right up in the hollow of your armpit and gradually work your way down towards the breast

5.Different systematic ways of feeling your breasts exists: Choose whichever is the most comfortable method for you and take care to use the same pattern.

6. Gently squeeze the nipple, make sure it is not too hard as you may “hurt” your nipples. You can check your bra or clothes for staining if the nipple discharge is spontaneous.

Systematic palpation of the breasts - Concentric circles (round and round)/Spiral

Starting at the top, make a large spiral. Move all around the breast. Make at least 3 smaller spirals until you reach the nipple. Do it once with light and then, with deeper pressure.

(Start with a large outer circle, making smaller circles with your fingers and work your way in towards the nipple) 

Grid method/Up and Down
Examine in an up and down pattern in a series of strips from the collarbone to the bra line and armpit to the breastbone. Make a dime sized circle in each imaginary grid spot, then, move finger-width away and repeat the procedure in the next grid, using light and then, deep pressure.  

Radial Pattern/Wedges
Mentally divide the breast into a clock pattern. Work out towards 12 o’clock, then 1 o’clock and so on.

Make Self Breast Examinations a regular part of
your life!

As each woman's breasts are unique, getting to know your own breasts would allow you to be able to pick up changes the earliest! This won't happen overnight, therefore practising regularly monthly self breast examination is your best bet!