Breast Self-Exam: How to Check Your Breasts for Lumps

What Is a Breast Self-Examination?

A breast self-examination (BSE) is a technique where you visually inspect and manually feel your breasts to detect changes such as lumps, skin changes, or nipple discharge. Performing this examination monthly helps you become familiar with your normal breast tissue, making it easier to notice any new or unusual changes that may require medical attention.

Breast self-examination is a proactive approach to breast health that empowers you to take an active role in monitoring your own body. The examination consists of two main components: a visual inspection where you look for changes in the appearance of your breasts, and a physical examination where you use your hands to feel for lumps or other abnormalities in the breast tissue and surrounding areas including the armpits.

It is completely normal for breasts to have some lumps and irregularities, and for one breast to be slightly different in size from the other. The purpose of regular self-examination is not to diagnose conditions, but rather to help you become familiar with what is normal for your breasts. This familiarity makes it much easier to detect when something has changed, which is the key to early detection of potential problems.

Healthcare organizations worldwide, including the American Cancer Society and the World Health Organization, emphasize the importance of breast awareness as part of comprehensive breast health. While mammography remains the gold standard for breast cancer screening, self-examination serves as a valuable complement that can detect changes between scheduled screenings. Research shows that approximately 40% of breast cancers are initially detected by women themselves who noticed something unusual about their breasts.

Who should perform breast self-examinations?

Breast self-examination is recommended for all adults with breast tissue, regardless of age or gender. While breast cancer is more common in women over 50, it can occur at any age, and early detection improves treatment outcomes. Men can also develop breast cancer, though it is much rarer, accounting for about 1% of all breast cancer cases. Therefore, men should also be aware of changes in their chest area, particularly lumps or changes around the nipple.

If you have breast implants, you can and should still perform breast self-examinations. Your surgeon or healthcare provider can teach you how to distinguish between the implant and your natural breast tissue. The same applies if you are pregnant or breastfeeding, though you should be aware that your breasts will undergo significant changes during these times, making it particularly important to establish what is normal during each stage.

How Do You Examine Your Breasts?

A breast self-exam involves two main steps: first, visually inspect your breasts in a mirror with arms at various positions, looking for changes in size, shape, or skin texture. Second, manually examine your breasts using flat fingers in a systematic pattern, covering all breast tissue from the collarbone to below the breast and from the armpit to the breastbone.

The breast self-examination technique combines visual inspection and physical palpation to thoroughly assess your breast tissue. It is important to develop a consistent method so that you examine the same areas in the same way each time. This consistency helps you notice subtle changes that might otherwise go undetected. The entire examination typically takes between 5 and 10 minutes once you become familiar with the technique.

You can perform the examination while standing or lying down, and many people find it helpful to examine their breasts in the shower when the skin is wet and slippery, making it easier to feel the underlying tissue. Using soap, lotion, or oil can also help your fingers glide more smoothly over the skin. The key is to find an approach that works for you and that you can perform consistently each month.

Step-by-step visual examination

Begin your examination by standing in front of a well-lit mirror where you can see both breasts clearly. Remove your clothing from the waist up and follow these steps:

1. Arms at your sides: Stand with your arms relaxed at your sides and look at your breasts from the front. Turn your upper body from side to side to view the sides of your breasts as well. Note whether your breasts have their usual color, shape, and size. Look for any visible changes such as swelling, dimpling, or asymmetry that is new.
2. Arms raised above your head: Lift both arms above your head and look at your breasts again. Observe whether both breasts and nipples move upward together with the arm movement. This position helps reveal any skin tethering or retraction that might indicate an underlying mass.
3. Turn while arms are raised: With your arms still raised, turn your body from side to side. Look carefully for any dimples, indentations, or puckering of the skin. These changes can sometimes be more visible during movement.
4. Hands on hips: Place your hands firmly on your hips and press down to flex your chest muscles. This position tightens the pectoral muscles beneath the breast tissue and can help reveal changes in breast contour or skin surface.

Step-by-step manual examination

After completing the visual inspection, proceed to the physical examination. Use the flat pads of your three middle fingers rather than your fingertips, as this provides better sensitivity for detecting lumps or changes in tissue texture.

1. Position for examination: Place one hand behind your head. This position spreads the breast tissue more evenly across the chest wall, making it easier to examine. You can stand, sit, or lie down for this part of the examination.
2. Stroke from outer edge to nipple: Using flat fingers from your other hand, stroke gently from the outer edge of your breast inward toward the nipple. Apply light pressure and repeat this motion around the entire circumference of the breast.
3. Circular motion examination: Make small circular motions with your flat fingers, using light pressure. Move in overlapping circles covering the entire breast. Some people prefer to move in concentric circles from the outer edge toward the nipple, while others prefer a vertical up-and-down pattern covering the breast in strips. Either method is effective as long as you cover all breast tissue.
4. Vary pressure levels: At each spot, use three different pressure levels: light pressure to feel tissue just beneath the skin, medium pressure to feel deeper tissue, and firm pressure to feel tissue close to the chest wall and ribs.
5. Examine above the breast: Continue your examination above the breast, covering the area between your breast and your collarbone. Breast tissue extends into this area and should be included in your examination.
6. Examine the armpit: Feel the armpit area using the same circular motion technique. This area contains lymph nodes and breast tissue that extends into the axillary region. Examine thoroughly from the armpit to the breast.
7. Check the nipple: Gently squeeze the nipple to check for any discharge. Note the color and consistency of any discharge that occurs.
8. Repeat on the other side: Switch hands and repeat the entire manual examination on your other breast and armpit.

Can I do a breast self-exam with implants?

Yes, you can and should perform breast self-examinations even if you have breast implants. The examination technique is the same, though you will need to learn to distinguish between the feel of the implant and your natural breast tissue. Implants typically feel smooth and firm with distinct edges, while natural breast tissue has a more varied texture.

Your plastic surgeon or healthcare provider can demonstrate the proper technique for examining breasts with implants and help you understand what to expect. Most implants are placed either behind the breast tissue (subglandular) or behind the chest muscle (submuscular), and the placement affects how your examination will feel. Regardless of implant type or placement, regular self-examination remains important for monitoring your natural breast tissue.

Should I examine my breasts during pregnancy or breastfeeding?

Yes, continue to examine your breasts even if you are pregnant or breastfeeding. However, be aware that your breasts undergo significant changes during these times. During pregnancy, breasts typically become larger, more tender, and may develop visible veins. The areolas often darken and enlarge. During breastfeeding, breasts change in size throughout the day as they fill with milk and are emptied.

Despite these normal changes, it remains important to monitor for unusual changes such as persistent lumps that do not change with feeding, skin changes, or bloody nipple discharge. If you notice any changes that concern you, consult your healthcare provider. While most breast changes during pregnancy and breastfeeding are normal, breast cancer can occur during these times and should not be overlooked.

When Should You See a Doctor After a Breast Self-Exam?

You should see a doctor if you find a new lump, notice skin changes like dimpling or redness, see nipple discharge (especially if bloody or clear), or observe any other changes in breast size, shape, or appearance that are new or different from your normal. If you feel a lump before your period, wait until after menstruation ends and check again before contacting your healthcare provider.

Understanding when to seek medical attention is a crucial part of breast self-examination. While most breast changes are not cancer and have benign causes, any new or unusual change should be evaluated by a healthcare professional. Only a medical examination, and sometimes additional tests like mammography or ultrasound, can determine whether a change is benign or requires further investigation.

The key is to notice changes from what is normal for you. Because breast tissue naturally changes throughout the menstrual cycle, during pregnancy, while breastfeeding, and with age, knowing your baseline is essential. This is why regular monthly examinations are so valuable, as they help you establish and monitor your personal normal.

Signs that warrant medical evaluation

Contact your healthcare provider if you notice any of the following changes during your breast self-examination:

• A new lump or thickening: Any new lump in the breast or armpit area, whether painful or painless, should be evaluated. While many lumps are benign cysts or fibroadenomas, a medical professional should assess any new mass.
• Changes in breast size or shape: Sudden or asymmetric changes in breast size, especially if one breast becomes noticeably larger than the other when they were previously similar, warrant investigation.
• Skin changes: Dimpling, puckering, or indentation of the breast skin may indicate an underlying mass pulling on the tissue. Redness, warmth, or skin that resembles an orange peel (peau d'orange) should also be evaluated.
• Nipple changes: New nipple inversion (turning inward), crusting, scaling, or discharge, especially if the discharge is bloody, brown, or clear and occurs spontaneously without squeezing, requires medical attention.
• A sore or wound that does not heal: Any persistent wound or sore on the breast or nipple that does not heal within a reasonable time should be examined.
• Visible skin pores: An area where skin pores become more visible than on the rest of the breast may indicate inflammation or blocked lymphatic drainage.

Where to seek care

If you notice changes that require evaluation, contact your primary care provider, gynecologist, or a breast health clinic. Many hospitals have specialized breast centers that offer comprehensive evaluation including clinical examination, imaging, and if necessary, biopsy. Some healthcare systems allow direct appointments to breast clinics without a referral. If you are unsure where to seek care, your primary care provider can direct you to the appropriate specialist.

In most cases, breast concerns are not emergencies and can be addressed through routine appointments. However, do not delay seeking care due to fear or anxiety. The vast majority of breast changes are benign, and even when cancer is found, early detection significantly improves treatment outcomes and survival rates.

What Can Cause Breast Changes?

Breast changes can be caused by many factors including hormonal fluctuations during the menstrual cycle, pregnancy, breastfeeding, menopause, benign conditions like cysts and fibroadenomas, infections, medications, or less commonly, breast cancer. Most breast changes are not cancer, but only a healthcare provider can determine the cause through proper evaluation.

The breast is a dynamic organ that changes throughout life in response to hormones, aging, weight changes, and other factors. Understanding the many possible causes of breast changes can help reduce anxiety while also ensuring you remain vigilant about changes that warrant medical attention. The key is distinguishing between normal variations and changes that are truly new or concerning.

Hormonal fluctuations have the most significant impact on breast tissue. During the menstrual cycle, estrogen and progesterone cause breast tissue to swell and retain fluid, often making breasts feel fuller, more tender, and sometimes lumpy in the week or two before menstruation. These cyclical changes typically resolve after the period begins. This is why the ideal time for breast self-examination is a few days after your period ends, when hormone-related changes have subsided.

Benign breast conditions

Several benign conditions can cause lumps or changes that may be detected during breast self-examination:

• Fibrocystic changes: The most common cause of breast lumps, fibrocystic changes cause areas of thickening, lumpiness, and fluid-filled cysts that often fluctuate with the menstrual cycle. These changes are not cancer and do not increase cancer risk, but may feel concerning when first detected.
• Fibroadenomas: Solid, smooth, round lumps that move easily under the skin. These benign tumors are most common in women under 30 and are made up of glandular and connective tissue. They typically do not require treatment unless they grow large or cause discomfort.
• Cysts: Fluid-filled sacs that can develop in the breast tissue. Cysts often appear quickly, can be tender, and may change in size throughout the menstrual cycle. Simple cysts are benign and can be drained if they cause discomfort.
• Fat necrosis: After breast injury or surgery, fat cells can die and form a lump. These lumps may feel firm and can even cause skin dimpling, mimicking cancer. Imaging and sometimes biopsy are needed to confirm the diagnosis.
• Mastitis and breast infections: Particularly common during breastfeeding, breast infections cause redness, warmth, swelling, and pain. These require antibiotic treatment and should be evaluated promptly to prevent abscess formation.

When changes may indicate breast cancer

While most breast changes are not cancer, certain features raise more concern and warrant prompt evaluation. Breast cancer may present as a painless, hard lump with irregular edges that does not move easily, though cancer can also present as a smooth, round mass. Other warning signs include skin changes like dimpling, puckering, redness, or thickening; nipple retraction or discharge, especially if bloody; and swelling of part or all of the breast.

It is important to emphasize that having one or more of these features does not mean you have cancer. Many benign conditions can cause similar symptoms. However, these signs do indicate the need for medical evaluation. Breast cancer detected early, before it has spread beyond the breast, has a 5-year survival rate exceeding 99%. This is why awareness, regular screening, and prompt attention to changes are so important.

Do I Need Breast Self-Exams If I Get Mammograms?

Yes, breast self-examination and mammography complement each other in breast health monitoring. Mammography can detect cancers too small to feel, while self-exams can identify changes that develop between scheduled mammograms. Using both methods provides more comprehensive breast health monitoring than either method alone.

Mammography screening is the gold standard for breast cancer detection and has been proven to reduce breast cancer mortality. However, mammograms are typically performed every one to two years, and breast cancer can develop and grow between screenings. This is where breast self-examination provides value, as it allows you to monitor your breasts continuously and potentially detect changes that arise between mammogram appointments.

The two methods work together because they detect different things. Mammography uses X-rays to visualize the internal structure of the breast and can identify calcifications and small masses that are not yet palpable. Self-examination, on the other hand, allows you to detect changes in how your breasts feel and look, sometimes identifying interval cancers that develop between screenings or cancers that mammography may miss, particularly in women with dense breast tissue.

Research has shown that approximately 15-25% of breast cancers are detected between screening mammograms, often because women noticed a change in their breasts. This highlights the importance of breast awareness and self-examination as complements to, not replacements for, regular mammographic screening. Together, these approaches provide the most comprehensive strategy for early detection.

Understanding your screening schedule

Mammography screening recommendations vary by country and organization, but generally suggest regular screening beginning between ages 40-50 and continuing at intervals of one to two years. Women with higher risk factors, such as family history of breast cancer, genetic mutations, or previous breast biopsies showing certain conditions, may need to begin screening earlier or have more frequent examinations, potentially including breast MRI.

Regardless of your mammography schedule, monthly breast self-examination provides continuous monitoring between these imaging studies. This is particularly important for younger women who have not yet begun mammographic screening, as self-examination may be their primary method of early detection during these years.

How Often Should You Perform a Breast Self-Exam?

You should perform a breast self-examination once a month, on the same day each month. For those who menstruate, the best time is a few days after your period ends when breasts are least tender and swollen. Post-menopausal women or those who do not menstruate can choose any consistent day, such as the first of each month.

Consistency is the cornerstone of effective breast self-examination. By examining your breasts on the same day each month, you create a reliable baseline that makes it much easier to detect subtle changes over time. The monthly frequency is recommended because it is often enough to detect new changes early, while not so frequent that you might miss gradual changes that develop slowly.

For those who menstruate, timing your examination relative to your menstrual cycle is important because hormone levels significantly affect breast tissue. During the luteal phase (the second half of the cycle, after ovulation and before menstruation), elevated progesterone causes breast tissue to retain fluid, leading to swelling, tenderness, and sometimes lumpiness. These changes can make examination more uncomfortable and may cause unnecessary concern about findings that are actually normal cyclical variations.

The optimal time for examination is typically 3-7 days after your period begins or ends, when hormone levels are lowest and breasts are softest and least tender. This timing allows for the most accurate assessment of your normal breast tissue without the confounding effects of hormonal fluctuations. If you have irregular periods, try to examine yourself at a consistent point in your cycle or simply choose a memorable date each month.

Establishing your baseline

The first time you perform a breast self-examination, your goal is to learn what is normal for you. Take extra time during this initial examination to thoroughly map the landscape of your breast tissue. Notice areas that feel more glandular or lumpy, areas that are smooth, the texture and position of your nipples, and any asymmetries between your breasts. This baseline becomes your reference point for all future examinations.

Keep in mind that breasts are rarely identical, and normal breast tissue is not uniformly smooth. The upper outer quadrant of the breast (toward the armpit) typically contains more glandular tissue and may feel more lumpy than other areas. The area beneath the nipple often has a different texture. These variations are normal; what matters is whether they change over time.

Why Is Breast Self-Examination Important?

Breast self-examination is important because it helps you become familiar with your normal breast tissue, enabling early detection of changes that may need evaluation. While most breast changes are benign, early detection of breast cancer significantly improves treatment outcomes, with early-stage breast cancer having a 5-year survival rate exceeding 99%.

Breast cancer remains one of the most common cancers affecting women worldwide, with approximately 2.3 million new cases diagnosed annually according to the World Health Organization. Early detection is crucial because breast cancer found at an early, localized stage has dramatically better outcomes than cancer found at later stages when it has spread to lymph nodes or distant organs. The 5-year survival rate for localized breast cancer exceeds 99%, compared to around 30% for cancer that has spread to distant parts of the body.

While organized screening programs using mammography have significantly improved early detection rates in many countries, breast self-examination provides an additional layer of monitoring. Studies show that between 15-40% of breast cancers are initially detected by women themselves, often between scheduled screening appointments. This highlights the ongoing relevance of breast awareness and self-examination as part of comprehensive breast health.

Beyond cancer detection, regular breast self-examination offers other benefits. It promotes general body awareness and empowers individuals to take an active role in their health. It can also detect benign conditions that, while not dangerous, may benefit from treatment or monitoring. Perhaps most importantly, it creates a habit of regular health monitoring that can extend to other aspects of preventive care.

The role of breast awareness

Modern breast health guidelines emphasize breast awareness alongside formal screening. Breast awareness means knowing what is normal for your breasts at different times of your menstrual cycle, during different life stages, and understanding what changes warrant medical attention. This awareness does not require a formal examination technique, as simply being attuned to your body during daily activities like showering or dressing can help you notice changes.

However, combining general breast awareness with periodic structured self-examination provides the most thorough approach. The structured examination ensures that all breast tissue is systematically assessed, while ongoing awareness catches changes that might occur between monthly examinations. Together, these practices maximize your chances of detecting any significant change as early as possible.