Self Breast Exam

Dear Dr. Bone,

I am a good patient who goes for annual mammograms, but I do not do breast self exam.I am afraid that I won’t know what I am feeling or that I will find something. I feel guilty about it but have heard various things about how important it is to do regularly. What do you think?

M.M.

Dear M.M.

If only I had a nickel for the number of times that I’ve heard those comments! You are not alone. There are many studies pointing stressing the importance of self exam to find cancers, especially ones that do not show up on mammogram and come up between mammograms (called interval cancers). Other studies show that breast self exam does not necessarily improve survival from breast cancer or long term outcomes. My feeling is that you should try to do them, but not beat yourself up about it if you do not do them regularly. There are now kits available to improve your technique by using silicone or other liquids between to layers to improve your skill. While these may be helpful, if you can just start with soap and water in the shower and try to cover all areas of the breast and armpit it is a good start. Remember, almost every woman has some lumps and bumps. Anything hard, stuck, and painless may be important. Try to examine during the week after your period is over when the breasts tend to be less sensitive. If you are postmenopausal, just pick the first of the month or your birthday number. I liken breast self exam to moving to a new city. In the first few months you don’t know your way around, but eventually, you know the streets well and would notice if there is a traffic detour. Once you make breast self exam a habit, any changes, even small ones, will probably stand out without a conscious effort.

Having said all that, don’t cancel your mammogram! Do them both.

Dr. Bone

Please take advantage of the following videos of Dr. Melanie Bone explaining both a stand up and laying down breast self exam.