Breast Self-Exam

Breast self-exam (BSE) is not recommended as a screening tool for breast cancer. However, Susan G. Komen for the Cure® recommends that you become familiar with the way your breasts normally look and feel. Knowing what is normal for you may help you see or feel changes in your breasts.

Warning signs of breast cancer

See your health care provider if you notice any of these warning signs of breast cancer (see pictures) [51-54]:

• Lump, hard knot or thickening inside the breast or underarm area
• Swelling, warmth, redness or darkening of the breast
• Change in the size or shape of the breast
• Dimpling or puckering of the skin
• Itchy, scaly sore or rash on the nipple
• Pulling in of your nipple or other parts of the breast
• Nipple discharge that starts suddenly
• New pain in one spot that doesn’t go away

Learn more about the warning signs of breast cancer.   

Breast lumps or lumpiness

Many women find their breasts feel lumpy. Breast tissue naturally has a bumpy texture that varies from one woman to another. For some women, the lumpiness is more pronounced than for others. In most cases, this lumpiness is no cause to worry. If the lumpiness can be felt throughout the breast and feels like your other breast, it is likely just normal breast tissue.  

Lumps that feel harder or different from the rest of the breast tissue (or the tissue of the other breast) or that feel like a change are a concern. This type of lump is more likely to be breast cancer, though some benign breast conditions (such as cysts and fibroadenomas) can cause similar changes. See your health care provider if you:

• Find a new lump or change that feels different from the rest of your breast
• Find a new lump or change that feels different from your other breast
• Feel something that is different from what you felt before

If you are unsure whether you should have a lump checked, it is best to see your provider. Although a lump may be nothing to worry about, you will have the peace of mind it has been checked.  

Learn more about benign breast conditions.

Nipple discharge

Liquid leaking from your nipple (nipple discharge) can be troubling, but it is rarely a sign of cancer. Discharge can be your body's natural reaction when the nipple is squeezed. However, the following may be signs of a more serious condition, such as breast cancer:

• Discharge occurs without squeezing the nipple
• Discharge occurs in only one breast
• Discharge has blood in it
• Discharge is clear (not milky)

Nipple discharge can also be caused by an infection or other condition that needs medical treatment. For these reasons, if you have any nipple discharge, see your health care provider.

What's the evidence for breast self-exam?

As a breast cancer screening tool

Breast self-exam seemed promising when it was first introduced. However, it is not clear that it offers a benefit as a screening test [23]. Results of studies on its effectiveness at finding early stage tumors and improving chances for survival have been mixed.

A meta-analysis combined results from the two largest randomized controlled trials on breast self-exam to date (one in Shanghai, China and one in Russia) [55]. The Shanghai study included about 266,000 women and the Russia study included about 122,000 women. The combined analysis found no difference in breast cancer mortality after 15 years between women who did routine breast self-exam and those who did not [55]. And, the breast self-exam groups had more false positive results, leading to nearly twice as many biopsies with benign (not cancer) results as the other groups [55]. These findings showed breast self-exam does not offer the benefits of other breast cancer screening tests.

Breast cancer screening recommendations

Figure 3.1 lists the breast cancer screening guidelines of some major health organizations. 

Updated 05/20/13