Guest Author - A. Maria Hester, M.D.
Breast cancer is the most common cancer in women in the United States. It is second only to lung cancer as a cause of cancer related deaths. The American Cancer Society estimates that in 2007 close to 180,000 women will be diagnosed with breast cancer and over 40,000 women will die from this disease. Fortunately, there are close to 2 million women who have been treated for breast cancer and are still alive. Of further note, breast cancer death rates are decreasing and this is likely the result of early detection and treatment advances.
Close to 1 in 8 women will develop breast cancer at some point in life. While the incidence of this disease is very high, only 1 in 33 will eventually die from the disease.
The American Cancer Society has issued guidelines for early detection of breast cancer –
1. Annual mammograms beginning at age 40
2. Clinical breast exam (by a health expert) every 3 years for women in their 20s and 30s. Starting at age 40, the examination should be yearly.
3. BSE (breast self-exam) is a good option for women starting in their 20s.
How do I do a BSE
Step 1
EXAMINING YOUR BREASTS
Breast exams are best done while you are lying down. This is because when you lie down your breast tissue spreads out over your chest wall and the tissue becomes thinner and easier to examine. Examine the tissue vertically from the collar bone to below the obvious breast tissue AND horizontally from the underarm region to the breastbone.
Method 1 – Put your right arm behind your head and examine your right breast with the pads of your middle three fingers of the left hand. Imagine your breast as a series of circles within each other, like a bulls eye. Starting near the underarm region, examine a small area of breast tissue using a circular motion. Next, move on to the next area of breast tissue making sure you overlap the prior tissue so you do not miss any tissue. After you examine the imaginary outer circle of your bulls-eye, repeat the process with each inner circle until you have examined your whole breast. Do not forget to examine the center of the bulls eye, or your nipple. After you are done, use two fingers to squeeze your nipple to see if any fluid comes out. Note, the presence of nipple discharge does NOT mean you have cancer, but if you notice discharge you should notify your doctor. After you finish one breast, repeat the above steps on the other breast.
OR
Method 2 – Instead of imagining your breasts as a bulls eye, imagine you have on a pin-stripe suit and perform the same circular motions on your breast tissue following vertical lines instead of the circular path used above. Start in the underarm area and remember to overlap tissue so you do not miss anything. Finish by squeezing your nipple.
Step 2
INSPECTING YOUR BREASTS
Do these steps while standing in front of your mirror -
Stand with your arms at your sides and look for abnormalities such as dimpling, redness, abnormal shape, bulges, or scaliness.
Next, push your hands into your sides in order to contract the muscles of your chest wall and see a different view of your breasts.
Finally, raise your arms above your head.

















