Breast Self Exam
 
Online Breast Self-Exam
This is an excellent audio/visual tool. It is very thorough and easy to understand. Strongly recommended.
 
Why Do Breast Self-Exams?
If breast cancer is found early, most women can be treated with success. That is why routine breast self-exams, mammography and checkups by your doctor are vital.

How to Do a Breast Self-Exam
The best time to do the breast self-exam is a few days after your period ends each month. It's easier at this time because your breasts are less tender or swollen. There are two parts to a breast self-exam —looking and feeling.

Looking
In the first part of the exam, you are looking in the mirror for any changes.

Feeling
In the second part of the exam, you are feeling for any changes. You can do this lying flat on your back, standing, or when you are taking a shower or bath. It often is easier to examine your breasts when they are smooth and wet with soap and water. It's a good idea to examine your breasts both ways — lying down and standing.
 

How to Examine Your Breasts
Getting Started:
Women are not familiar with breast tissue. No one has ever taught us. It takes time to become familiar with breast tissue - there is no easy way. Therefore, you are encouraged to do your breast exam tonight or tomorrow night and once a week for the next month and then just one time a month. Remember, all breast tissue is lumpy and irregular. When feeling your own breasts if you aren't sure about an area, check the other breast in the same spot. Compare breast to breast, there is usually a similarity. Remember that one breast is usually larger, one breast is more lumpy and one is more sensitive to hormonal changes. If you have a lot of lumpiness - fibrocystic breasts - draw a diagram of each breast and describe to yourself what they look and feel like; as this can be a guide or the next three weeks when doing breast self exams.
 
Part I - Looking:
  1. Stand undressed from the waist up in front of a large mirror in a well-lit room. Look at your breasts. Don't be alarmed if they do not look equal in size or shape. Most women's breasts aren't. With your arms relaxed by your sides, look for any changes in size, shape or texture, or any changes to the skin of the breasts. Look for any skin puckering, dimpling, sores or discoloration. Inspect your nipples and look for any sores, peeling or change in the direction of the nipples.
  1. Next, place your hands on your hips and press down firmly to tighten the chest muscles beneath your breasts. Turn from side to side so you can inspect the outer part of your breasts.
  1. Then bend forward toward the mirror. Roll your shoulders and elbows forward to tighten your chest muscles. Your breasts will fall forward. Look for any changes in the shape or contour of your breasts.
  1. Now, clasp your hands behind your head and press your hands forward. Again, turn from side to side to inspect your breasts' outer portions. Remember to inspect the border underneath your breasts. You may need to lift your breasts with your hand to see this area.
  1. Check your nipples for discharge (fluid). Place your thumb and forefinger on the tissue surrounding the nipple and pull outward toward the end of the nipple. Look for any discharge. Repeat on your other breast.
Part II - Feeling:
  1. Lie down and place a small pillow or folded towel under your right shoulder. Place your right arm behind your head. The exam is done while lying down, and not standing up, because when lying down the breast tissue spreads evenly over the chest wall and it is as thin as possible making it much easier to feel all the breast tissue.
  1. Use the finger pads of the 3 middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-sized circular motions of the finger pads to feel the breast tissue.
  1. Use 3 different levels of pressure to feel all the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. A firm ridge in the lower curve of each breast is normal. If you’re not sure how hard to press, talk with your doctor or nurse. Use each pressure level to feel the breast tissue before moving on to the next spot.
 

Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone (sternum or breastbone). Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone (clavicle). It is recommended to repeat this using all three patterns.

There is some evidence to suggest that the up and down pattern (sometimes called the vertical pattern) is the most effective pattern for covering the entire breast and not missing any breast tissue.

Repeat the exam on your left breast, using the finger pads of the right hand. 

Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel in this area. Raising your arm straight up tightens the tissue in this area and makes it very difficult to examine.

It is recommended to do a complete breast self exam while standing in the shower with your arm slightly raised and with wet, soapy fingers.
 
Information compiled from The American College of Obstetricians and Gynecologists, The American Cancer Society, WebMD.com, Torrance Memorial Medical Center, and Imaginis.