1. Breast – Self Examination

2. Self Examination of Breast
By Dr.V.Kasiviswanathan M.S. General Surgeon/ Formerly Sr.DMO/Indian Railways/PGT Visit my website for nursing students at www .examnnotes.com contact me at

3. Introduction
Breast self examination can be taught to individuals or to groups.
BSE is best performed after menses (day 5 to day 7)
For postmenopausal women once a month.
Many women have grainy-textured breast tissue, but these areas are usually less nodular after menses.
Women should begin practising BSE at their late teens or early 20s.
The nurse plays a pivotal role in preventive education.

4. The most effective programme for early detection includes 3 steps
A breast examination by a health care professional At least every 3 years starting at age 20 Every year after age 40
A mammogram every year starting at age 40 If under age 40 with a family history of breast cancer
monthly BSE, or breast self examination, beginning by age 20

5. Bse takes only a few minutes
Breast self examination could be the best time investment of your lifetime
The best time for self examination
At the end of the periods - least tender
Menopausal women on the same day of each month
Breast feeding mothers - after the breasts are emptied - after suckling the baby

7. Breast examination There are two parts to BSE – looking and feeling
Use a mirror
Check the shape and size of the breasts
The color and texture of your skin ….
First with the arms down
Then with the arms in the air.
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.
Then pushing down on the hips, to tighten her chest muscles And bending forward at the waist, with the hands on the hips.
This will help spot dimpling

8. Feeling
Done most effectively while lying down
Place a folded towel or pillow under the
shoulder and extend the arm out at an
angle, to spread the breast tissue more
evenly
Check - from the collar bone to the bra line.
Using three fingers, make three coin – sized
circles.
One just lightly
One deeper
One deeper still.
This will enable the woman to check the full
thickness of her breast.

10. Use the pads of the fingers.
Keep the fingers straight
Move the fingers down and circle again.
, Light medium deep
While moving the hand, it should not be
lifted away from the skin to avoid missing a spot.
The entire area,is palpated spot by spot, going up and down in strips about as wide as the three examining fingers

11. Then the armpit is examined.
Next the other breast is checked.
Look for a firm lump or area of thickening that is different from the rest of the breast tissue.
If it is not sure whether what you’re feeling is normal, visit the doctor and get his opinion.

12. Variations
Women with larger breasts should lie down on their side to check the outer half of the breast.
Then, keeping the hand on the nipple to mark the midline, roll into the flat position to examine the inner half of the breast.
If the woman has had breast surgery or breast implants, she has to follow the same steps – looking and feeling

13. Clock pattern
Circle pattern
Grid pattern

14. Conclusion Look – in four positions.
1. With the arms down at the sides
2. With the arms over the head
3. Pressing on the hips to tighten the chest muscles
4. And bent forward with the hands on your hips
To feel, prop up with a towel or pillow
Three finger pads should be used
Three small circles are made and the whole area is checked.
To effective the early detection plan must combine monthly BSE with regular clinical breast examinations and mammograms.

15. War ning Signs of Breast Cancer
Due to the increased use of mammography, most women are diagnosed at very early stages of breast cancer, before symptoms appear. However, not all breast cancer is found through mammography.
Change in the look or feel of the breast, nipple discharge.
These are listed below: 
Lump, hard knot or thickening
Swelling, warmth, redness or darkening
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

17. Clock pattern

18. Circle pattern

19. Grid pattern

29. Mammogram

45. Warning Signs of Breast Cancer
Due to the increased use of mammography, most women are diagnosed at very early stages of breast cancer, before symptoms appear. However, not all breast cancer is found through mammography. The most common symptoms of breast cancer are a change in the look or feel of the breast, a change in the look or feel of the nipple and nipple discharge. These are listed below: 
Lump, hard knot or thickening
Swelling, warmth, redness or darkening
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