Breast Self Examination
Definition
The most effective programme for early detection of Tumors in the breast
Recommended Schedule
o Monthly BSE, or breast self examination, beginning by age 20
o A breast examination by a health care professional At least
every 3 years starting at age 20
Every year after age 40
o A mammogram every year starting at age 40
If under age 40 with a family history of breast cancer
When to do ?
o The best time for self examination : At the end of the periods - least tender
o Menopausal women on the same day of each month
o Breast feeding mothers - after the breasts are emptied - after suckling the baby
Breast examination
o There are two parts to BSE - looking and feeling
Looking
o Use a mirror
o Check the shape and size of the breasts
o The color and texture of your skin ….
First with the arms down
Then with the arms in the air.
Then pushing down on the hips, to tighten her chest muscles
And bending forward at the waist, with the hands on the hips - spot dimpling
It is not unusual for one breast to be larger than the other.
The woman should learn what is normal for her so that she can spot any changes immediately.
Feeling
o Done most effectively while lying down
o Place a folded towel or pillow under the shoulder and extend the arm out at an angle, to spread the breast tissue more evenly
o Check - from the collarbone to the bra line.
o Using three fingers, make three coin - sized circles.
o One just lightly
o One deeper
o One deeper still.
This will enable the woman to check the full thickness of her breast.
o Use the pads of the fingers. Keep the fingers straight
o Move the fingers down and circle again.
o While moving the hand, it should not be lifted away from the skin to avoid missing a spot.
o The entire area,is palpated spot by spot, going up and down in strips about as wide as the three examining fingers
o Then the armpit is examined.
o Next the other breast is checked.
o Look for a firm lump or area of thickening that is different from the rest of the breast tissue.
Variations
o Women with larger breasts should lie down on their side to check the outer half of the breast.
o Then, keeping the hand on the nipple to mark the midline, roll into the flat position to examine the inner half of the breast.
o If the woman has had breast surgery or breast implants, she has to follow the same steps - looking and feeling
o Conclusion
o Look - in four positions.
o With the arms down at the sides
o With the arms over the head
o Pressing on the hips to tighten the chest muscles
o And bent forward with the hands on your hips
o To feel, prop up with a towel or pillow
o Three finger pads should be used
o Three small circles are made and the whole area is checked.
o To effective the early detection plan must combine monthly BSE with regular clinical breast examinations and mammograms.
Patterns
o Clock pattern
o Circle pattern
o Grid pattern
Introduction of the Examination to the Patient
o Women should begin practising BSE at their late teens or early 20s.
o Breast self examination can be taught to individuals or to groups.
o BSE is best performed after menses (day 5 to day 7. for postmenopausal women once a month.
o Many women have grainy-textured breast tissue, but these areas are usually less nodular after menses.
o The nurse plays a pivotal role in preventive education.
