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 breast.
Warning signs of breast cancer
If you notice any of the warning signs of breast cancer listed below, see your health care provider.
- 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
Adapted from National Cancer Institute [47-48], American Cancer Society [49] and Centers for Disease Control and Prevention [50].
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. When this type of lump is found, it 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.
- You 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 another 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 [18,51]. Results of studies on its effectiveness at finding early stage tumors and improving chances for survival have been mixed. Some studies supported its value and others did not [18].
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) [52]. 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 [52]. 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 [52]. 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 several major health organizations.
Susan G. Komen for the Cure® recommends that you :
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1. Know your risk
- Talk to your family to learn about your family health history
- Talk to your health care provider about your personal risk of breast cancer
2. Get screened
- Ask your health care provider which screening tests are right for you if you are at higher risk
- Have a mammogram every year starting at age 40 if you are at average risk
- Have a clinical breast exam at least every 3 years starting at age 20, and every year starting at age 40
3. Know what is normal for you and see your health care provider if you notice any of these breast changes:
- 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
4. Make healthy lifestyle choices
- Maintain a healthy weight
- Add exercise into your routine
- Limit alcohol intake
- Limit postmenopausal hormone use
- Breastfeed, if you can
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Updated 08/22/11
