What Is Breast Self-Examination: What Is It For, Breast Cancer, Observation, Palpation

Self-examination is an examination that every woman can perform on her own, one week after the end of her period . This periodic check should be done once a month, starting from the age of 20 .
If performed correctly and regularly, breast self-examination can limit the risk of diagnosing advanced stage cancer.

What Is It For

Periodic self-examination allows you to know the normal appearance of your breasts and to notice any changes and any irregularities.
The signal that most frequently leads to the discovery of a tumor is, in fact, the presence of a nodule . Usually, this lesion is not painful, but palpable or even visible.
To identify unusual changes early, attention must also be paid to the appearance of the nipple (which may retract, become more protruding or secrete fluid) and skin , especially when these concern only one breast.
This simple gesture therefore allows you to keep the breast tissue under control and to check regularly whether it is homogeneous or has nodular hardenings never found in previous self-examination.

Breast Cancer

• Breast cancer (or mammary carcinoma ) is the most common neoplasm in the female population.
• The neoplastic process derives from the uncontrolled and anomalous growth of some breast cells , in which the genetic material is “damaged”; all of these “clones” form a tumor mass inside the mammary gland.
• The nature of the tumor can be benign ( fibroadenomas or cysts ) or malignant (carcinomas). The latter lesions are the most dangerous, as they can progress and become “infiltrating” or “invasive”, i.e. they can involve the tissues close to the breast or other parts of the body.
• Early diagnosis is possible mainly due to the large-scale diffusion of mammography screening programmes . Furthermore, it is advisable to undergo regular tests indicated by your doctor based on your age and personal history.
• The possibilities of treatment and recovery depend, in fact, on the stage in which the neoplasm is found at the time of diagnosis (localized, diffuse or metastatic ) and on its biological characteristics (benign or malignant nature): different types of breast cancer , in fact have different growth rates and responses to therapies.
• Treatments for breast cancer currently available include surgery (such as Quadrantectomy), chemotherapy , radiation therapy , hormone therapy, and biological therapies. These therapeutic approaches can be used alone or in combination, depending on the characteristics of the patient and the disease.

When You Run

From the age of 20, breast self-examination should be performed once a month, between the seventh and fourteenth day of the menstrual cycle (if the latter is regular, it is advisable to set a stable day).
In fact, the structure of the breast is susceptible to changes in hormone levels that occur on a monthly basis: knowing your body allows you to distinguish which changes are to be considered “normal” and avoid, in some cases, confusion or false alarms.
About a week after the end of the cycle, the breasts are less sore and turgid, therefore certain changes in the breasts are more easily perceptible; if you are pregnant or menopausal, the moment in which it is indicated to perform the self-examination is indifferent.
It should be remembered that other signs such as contractions or changes in the skin , liquid discharge from the nipple or changes in the shape of the breast should also lead to medical attention.
There are also cases in which the disease is not associated with obvious signs and recognizable changes. Therefore, self-examination must be combined with regular breast examinations and more precise instrumental examinations , such as breast ultrasound (generally recommended from the age of 30) and mammography (from the age of 40).

How It Is Done

Self-examination takes place in two stages: observation and actual palpation.

Observation

During this phase it should be observed if there are any irregularities in the shape of the breast, changes in skin colour, cracked nipples, skin ulcerations or dimples; the two breasts are rarely identical in every detail, but are usually symmetrical and have a regular profile.
Self-examination begins in front of a mirror, in a well-lit environment. With the torso erect, the shoulders relaxed and the arms along the sides, the shape of the breast and the nipple can be observed, both from the front and from the side.
The observation should be repeated with the arms raised, stretched over the head, looking for any irregularities in the breasts. The operation must be performed again by joining the hands in front of the forehead and contracting the pectoral muscles .

Palpation

The palpation phase is performed in an upright position, bending the arm corresponding to the breast to be examined behind the neck. The breast is examined by sliding the inside of three joined fingertips of one hand (index, middle and ring fingers) with small concentric movements. These “spiral” maneuvers must be repeated for each quadrant of the breast.
By moving the fingers in a circular direction, with gradually increasing pressure , it is possible to grasp any lumps or hardening of the breast tissue.
Then, movements are made with the hand from top to bottom and, again, in a radial direction (from the outside towards the nipple, drawing a sort of star). Palpation from the axilla continues around the curve of the sinus,.
The same maneuvers are repeated in the supine position , with the arm corresponding to the breast to be examined up, bent under the head.
In the last phase, the nipple is gently pressed between forefinger and thumb, to check for possible liquid leakage ( serum or blood ); during this evaluation, it is possible to use a handkerchief to possibly check the color of the secretion.

Note : If a lump, dip or discharge is found during the self-examination, do not be alarmed as it may be a harmless finding. In any case, it is important to inform the doctor who can indicate the appropriate instrumental tests to ascertain the real state of health.

What To Pay Attention To

During breast self-examination, attention should be paid to:

• Changes in shape and size of one or both breasts
• Thickening or bumps in the breast or underarm area ;
• Leaks of blood or liquid from the nipples , not related to pregnancy or breastfeeding (serous or bloody secretions);
• Lumps, wrinkles, bumps, or dimples on the skin surface;
• Strange sensations (especially if they affect only one breast).

Other possible changes and unusual signals that should not be underestimated are:

• One or more breast lumps (taking into consideration that the breast is lumpy by nature and that, nine times out of ten, these formations are not worrying);
• Changes in the appearance of the nipple (contours, size or position) or retraction of the same;
• Inflammations or rashes of the skin and areola ( orange peel skin, swelling , redness or warmth);
• Unexplained pain in the breast or armpit.

Self-examination does not in any way replace the breast examination or instrumental tests, such as mammography (useful for detecting the presence of nodules, micro-calcifications or other indirect signs of a possible neoplasm) and ultrasound (indicated for confirming the presence and the solid or liquid nature of a nodular lesion).
However, it should be noted that breast self-examination, performed correctly and regularly, can allow early diagnosis of cancer, limiting the risk that it may be in an advanced stage.
Therefore, in case one or more of these symptomsare evident to the eye or present to the touch, it is advisable to contact your doctor or a breast specialist, to receive as soon as possible reassurances or indications regarding the diagnostic tests deemed most suitable to dispel any doubts.