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Self Breast Exam
Aka: Self Breast Exam, Breast Self Exam, Breast Self-Exam
- See Also
- Breast Cancer Screening
- Breast Mass
- Breast Anatomy
- Efficacy
- Study of 266,000 women in Shanghai, China
- Intervention: Intensive self exam instruction
- Control Group: Low Back Pain prevention instruction
- Results
- No difference in Breast Cancers identified
- Twice as many benign growths found in BSE group
- Interpretation
- Insufficient evidence to recommend for or against
- References
- Thomas (1997) J Natl Cancer Inst 89:355 [PubMed]
- Thomas (2002) J Natl Cancer Inst 94:1445-57 [PubMed]
- Meta-analysis findings consistent with Shanghai study
- SBE with no significant impact on mortality
- Increases the number of biopsies performed
- Hackshaw (2003) Br J Cancer 88:1047-53 [PubMed]
- Precautions
- Self Breast Exam is no longer routinely recommended due to low efficacy (see above)
- Does not lead to decreased Breast Cancer mortality
- High risk of False Positives
- Consider a Breast self-awareness protocol as an alternative
- Women 20 years and older recognize normal appearance and feel of their Breasts (without systematic self-exam)
- Women who find new Breast changes should seek prompt medical attention
- McCready (2005) J Clin Nurs 14(5): 570-8 [PubMed]
- Timing
- Perform monthly Self Breast Exam after age 20 years
- Menstruating: Perform 7-10 days after Menses start
- No Menses: Perform on first day of each month
- Step 1: Standing before mirror, observe both Breasts
- Abnormalities to look for in each position
- Nipple Discharge
- Redness
- Puckering
- Dimpling
- Scaling of skin
- Positions of observation
- Arms at side
- Hands on hips leaning slightly forward
- Hands clasped behind head
- Step 2: Examine Breasts with fingers
- Abnormal findings
- New or different Breast Lumps from prior examination
- Technique
- Use arm opposite Breast for examination
- Raise arm on side of Breast being examined
- Use flat surface of three middle fingers
- Press fingers over each area in small circles
- First apply superficial pressure
- Next apply deep pressure
- Pattern
- Imagine Breast as a clock face (left Breast Example)
- Top of nipple to middle of collarbone: 12:00
- Left side of nipple to armpit (includes armpit)
- Bottom of nipple to underside of Breast: 6:00
- Right side of nipple to Breast bone (Sternum): 9:00
- Move fingers around Breast in full 360 degree sweep
- Start at 12:00 at nipple and circle clockwise
- Cover all areas of Breast
- High risk areas on which to concentrate
- Between Breast and armpit (upper outer quadrant)
- Positions for examination
- Standing in shower (apply warm soapy water to Breast)
- Lying down (apply lotion to Breast)
- References
- Austoker (1994) BMJ 309:168-74 [PubMed]
- (1997) How to do a Breast Self-Examination, ACS