BREAST SELF EXAMINATION (BSE)

Women older than 20 years should perform monthly breast self-examinations (BSE). If you still have menstrual periods, you should perform the examination a few days after your period has ended. During this time, your breasts are not tender. If you are not menstruating (such as in menopause), BSE should be performed on the same day each month.

Techniques to perform BSE:

• Facing a mirror

Stand before a mirror and compare both breasts for differences in size, nipple inversion (turning in), bulging, or dimpling. Note any skin or nipple changes, such as a hard knot or nipple discharge.

Inspect your breasts in the following 4 steps:

• • With your arms at your sides
  • With your arms overhead
  • With your hands on hips - Press firmly to flex your chest muscles.
  • Bent forward - Inspect your breasts.
  • In these positions, your pectoral muscles are contracted, and a subtle dimpling of the skin may appear if a growing tumor has affected a ligament.

• Lying down

Right breast:

• • Place a pillow under your right shoulder.
  • Put your right hand under your head.
  • Check the entire breast area with the finger pads of your left hand.
  • Use small circles and follow an up-and-down pattern.
  • Use light, medium, and firm pressure over each area of the breast.
  • Feel the breast with the surfaces of the second, third, and fourth fingers, moving systematically and using small, circular motions from the nipple to the outer margins.
  • Gently squeeze the nipple for any discharge.

Left breast:
Repeat these steps on your left breast using your right hand.

• In the shower

A BSE can easily be performed while you're in the bath or shower. Some women discover breast masses when their skin is moist.

• • Raise your right arm.
  • With soapy hands and fingers flat, check your right breast.
  • Use the same small circles and up-and-down pattern described earlier.
  • Repeat on the left breast.

Note: Please click the links below to learn and watch the Breast Self Exam (BSE) on video:

• https://www.youtube.com/watch?v=MipkW8JJ4tI

MAMMOGRAPHY

• What is a mammogram?

Mammograms are x-rays of the breast that may help define the nature of a lump. Mammograms are also recommended for screening to find early cancer. Usually, it is possible to tell from the mammogram whether a lump in the breast is breast cancer, but no test is 100% reliable. Mammograms are thought to miss as many as 10-15% of breast cancers. A mammogram alone is often not enough to evaluate a lump. Your health-care provider will probably request additional tests. All breast lumps need to be clearly defined as benign or should be biopsied. Women should begin having mammogram at the age of 40 for every 2 years and yearly if she falls into high risk group.

• How does it work?

During a mammogram, the breast is pressed between 2 plates to flatten and spread the tissue. The pressure lasts only for a few seconds. Although this may cause some discomfort for a moment, it is needed to get a good picture. Very low levels of radiation are used.

ULTRASOUND

• What is ultrasound?

Ultrasoundof the breast is often done to evaluate a breast lump. Ultrasound waves create a "picture" of the inside of the breast. It can demonstrate whether a mass is filled with fluid (cystic) or solid. Cancers are usually solid, while many cystsare benign. Ultrasound might also be used to guide a biopsy or the removal of fluid.

BIOPSY

Biopsy means to take a very small piece of tissue from the body for examination and testing by a pathologist to determine if cancer is present. A number of biopsy techniques are available.

• Fine-needle aspiration biopsy

Your doctor uses a thin, hollow needle to withdraw tissue from the lump. He or she then sends the tissue to a lab for microscopic analysis. The procedure takes about 30 minutes and is similar to drawing blood. A similar procedure - fine-needle aspiration - is typically performed to remove the fluid from a painful cyst, but it can also help distinguish a cyst from a solid mass.

• Core needle biopsy

A radiologist or surgeon uses a hollow needle to remove tissue samples from a breast lump. As many as 15 samples, each about the size of a grain of rice, may be taken then sent to a pathologist to be analyzed for malignant cells. The advantage of a core needle biopsy is that it removes more tissue for analysis. Sometimes your radiologist or surgeon may use ultrasound to help guide the placement of the needle.

• Surgical biopsy

This remains one of the most accurate methods for determining whether a breast change is cancerous. During this procedure, your surgeon removes all or part of a breast lump. In general, a small lump will be completely removed (excisional biopsy). If the lump is large, only a sample will be taken (incisional biopsy). The biopsy is generally performed on an outpatient basis in a clinic or hospital.

Updated:: 15/03/2023 []