Cancer Breast Cancer Prevention How to Do a Breast Self-Examination (BSE) A Step-by-Step Guide By Serenity Mirabito RN, OCN Serenity Mirabito RN, OCN Serenity Mirabito, MSN, RN, OCN, is a published oncology nurse writer who advocates for those surviving and thriving with cancer. Learn about our editorial process Updated on May 23, 2022 Medically reviewed by Adam M. Brufsky, MD, PhD Medically reviewed by Adam M. Brufsky, MD, PhD Adam M. Brufsky, MD, PhD, is a Professor of Medicine at the University of Pittsburgh who has specialized in breast cancer medical oncology for over 20 years. Learn about our Medical Expert Board Print In the past, breast self-exams (BSEs) were endorsed as a means to check for lumps that may be breast cancer. The thinking has since changed with research showing that BSEs can often lead to unnecessary and invasive breast biopsies for lumps that are benign (non-cancerous). Today, routine mammograms are considered the mainstay of breast cancer screening, while BSEs and clinical breast exams (CBEs) performed by healthcare providers are no longer recommended by most leading healthcare authorities. For its part, the American Cancer Society (ACS) accepts that "some women might still be comfortable doing regular self-exams as a way to keep track of how their breasts look and feel" even though there is little evidence that doing so will improve the odds of early detection of breast cancer survival. This article offers a step-by-step guide on how to perform a BSE and some of the irregularities to report to your healthcare provider if you find them. Despite the lack of evidence supporting their use, BSEs are still used by some as a routine part of their preventive healthcare. If you decide to perform a BSE, it is important to understand the procedure's limitations and that it is not a substitute for screening mammograms. Benign Breasts Changes That Look Like Breast Cancer 1 Step 1: Do a Visual Exam Verywell / Zoe Hansen Start by undressing to the waist. Stand in front of a mirror large enough to visualize both breasts, and place your hands on your hips. Take note of your breasts since your last BSE; they should be their usual shape, size, and color. There should not be any dimpling, puckering, or bulging of the breasts. Your nipples should not be in a different position or unusually inverted (sucked in). There should also not be any redness, soreness, rash, or swelling. If there are, speak with your healthcare provider as soon as possible. 2 Step 2: Lift Your Arms Verywell / Zoe Hansen Next, place your hands behind your head, noting how your breasts move. Both the left and right breast should move in the same way without shifting or pulling. They also should be of more or less the same size, shape, contour, and color. Look under both arms, checking for any swelling or lumps in the armpits. You are looking for swollen lymph nodes, which any number of things can cause, from a simple case of flu to cancer. What Is Breast Asymmetry? 3 Step 3: Check Your Nipples Verywell / Zoe Hansen The next step is to examine your nipples. Start by lowering your left arm. Next, with your right hand's index and middle fingers, gently squeeze the left nipple, pulling it forward and letting it go. The nipple should spring back rather than slowly sinking back into the breast. Check for any unusual bumps, indentations, dimpling, or signs of retraction. Also, note if any fluid is leaking from one or both nipples. A clear or bloody discharge is potentially problematic, especially if only one nipple is involved. The leakage may be due to a blocked milk duct or an infection (mainly if it is green, white, or yellow). Switch sides and repeat. 4 Step 4: Stand and Stroke Verywell / Zoe Hansen Next, raise your left arm overhead. With the fingers of your right hand, slowly stroke your breast from the top to the bottom and then from the inside of the breast all the way into your armpit area. Use firm but gentle pressure. Finally, move your hand in a circular motion, being sure to cover the entire breast area. Take note of any changes in the texture, color, or size of your breast. Switch sides and repeat. You can opt to do this step in the shower. Your fingers will glide more smoothly over wet skin. 5 Step 5: Lie Back and Stroke Verywell / Zoe Hansen Finally, lie down with your left hand behind your head. Use your right hand to stroke your left breast and underarm. The easiest way to do this step is to lie on your bed with your head and shoulders resting on a pillow. Take note of any changes in the texture or size of your breasts. Switch sides and repeat. Summary A breast self-exam (BSE) is a self-care practice used to check for lumps that may be breast cancer. Although BSEs were once commonly endorsed as a form of preventive screening, most leading healthcare authorities advise against their use. Not only is there little evidence that BSE improve early detection or survival in people with breast cancer, but BSEs may also lead to unnecessary and invasive breast biopsies for lumps that are benign. If used, BSEs should never be considered a substitute for screening mammographies. How Breast Cancer Is Diagnosed A Word From Verywell Although the ACS and U.S. Preventive Services Task Force (USPSTF) both advise against the use of breast self-exams, this does not mean that you should ignore your breasts until your next scheduled mammogram. In fact. the ACS states that "women should be familiar with how their breasts normally look and feel and should report any changes to a healthcare provider right away." If you do decide to do a breast self-exam, remember that the lack of lumps or other breast irregularities does not mean that you are "clear" of cancer. Keep to your recommended mammogram schedule or schedule one as soon as possible if you are overdue. Frequently Asked Questions When is the best time to do a breast self-exam? The best time to do a breast self-exam is a few days after your menstrual cycle when your breasts are no longer swollen, firm, or painful. If you do not menstruate, choose the same day each month to perform your BSE. What does a cancerous lump feel like in a breast self-exam? It's normal for breasts to feel lumpy. A breast cancer lump may feel hard like a small rock or pebble. The lump is often irregularly shaped and painless.Other signs of breast cancer include:· Skin redness· Skin dimpling· Fluid leaking from your nipple· A change in the size of your breast 5 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Cancer Society. American Cancer Society recommendations for the early detection of breast cancer. U.S. Preventive Services Task Force. Recommendations: breast cancer screening. Gaddey H, Riegel A. Unexplained lymphadenopathy: evaluation and differential diagnosis. Am Fam Physician. 2018 Jun 1;97(11):702-3. Chen L, Zhou WB, Zhao Y, et al. Bloody nipple discharge is a predictor of breast cancer risk: a meta-analysis. Breast Cancer Res Treat. 2011;132(1):9–14. doi:10.1007/s10549-011-1787-5 Susan G. Komen. Warning signs of breast cancer. By Serenity Mirabito RN, OCN Serenity Mirabito, MSN, RN, OCN, advocates for well-being, even in the midst of illness. She believes in arming her readers with the most current and trustworthy information leading to fully informed decision making. Originally written by Pam Stephan Pam Stephan Pam Stephan is a breast cancer survivor. Learn about our editorial process See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit