Unfortunately, many of our lives have been touched by breast cancer - whether personally, through a family or friend, or in the news. It can be scary. We want to do the best we can to be proactive and take care of our health. You may wonder, “Should I do a breast self-exam? Are breast self-exams recommended anymore? Should I do them every month?”
In the past, medical professionals used to advise us to perform regular breast self-exams to screen for breast cancer. However, since 2015, experts seem to disagree whether breast self-exams are necessary or not. We are here to uncomplicate this debate and try to sort out what YOU should do on this important topic.
TLDR: It’s not that simple and it’s all based on your personal risk factor. Most doctors will offer you a personalized recommendation based on your cancer risk. Make sure you speak with a provider so you understand your risk and how to best take care of your health.
Here is everything you need to know about the guidelines surrounding breast self-exams, breast cancer risk, and how to do a breast exam at home.
Do breast self-exams work?
Depending on your breast cancer risk, in most cases they are not recommended. Since 2015, the American Cancer Society (ACS) no longer recommends breast self-exams to screen women with an average risk of breast cancer.
This decision was based on research that studied 400,000 women in Russia and China. The study found that self-exams did not change cancer survival rates and may even lead to unnecessary biopsies.
What is recommended: Get to know your own body
“A self-exam is not considered a screening tool but it can help women improve their breast self-awareness. Breasts undergo so many changes throughout a woman’s life. Regular exams can help keep track of them.” says Dr. Rob Rohatsch MD, Chief Medical Officer at Solv.
Many doctors recommend a monthly breast self-exam so that you know your breasts well. If you know how your breasts feel when they are normal, you may be more likely to detect any changes early.
Before you begin a self-exam, here’s what you need to know:
According to Dr. Rohatsch, there is no medical risk associated with doing a breast examination at home. However, breast self-exams are not a substitute for clinical consultations and mammogram screenings.
Women with an average risk of breast cancer
The ACS considers you an average risk if you do not have a personal history of breast cancer, strong family history of breast cancer, a genetic mutation with an increased risk of breast cancer (BRCA), or have not had chest radiation therapy before 30 years of age.
- Women aged 45 – 54 are recommended a mammogram screening every year.
- Women over 55 can choose to get one every two years or continue their annual mammogram.
Women with a high risk of breast cancer
- Women aged 30 and up: The ACS recommends that women with a high risk of breast cancer get a breast MRI and an annual mammogram screening starting at age 30.
To assess your risk, talk to your doctor. Your medical history, family history, genes, and much more go into assessing your risk of breast cancer and what you may need to do.
Regular breast self-exams will help you know your breasts well. In case of any abnormal changes, you will be better informed when discussing your health with your doctor.
Best way to do your breast self-exam
The Mayo Clinic offers tips for your self-exam. For menstruating women over 40, it is recommended to perform your self-exam a few days after your period ends. If you are not menstruating or have irregular periods, it is recommended to pick one day every month to help you stay consistent.
To start, take your shirt and bra off and stand in front of a mirror. For convenience, many women prefer performing their breast exams before a shower or when they change clothes.
According to the Mayo Clinic, the main steps to performing your breast self-exam are:
Step 1: Use your eyes
- Stand with your arms down in front of a mirror. Look at both breasts and notice any changes like swelling, dimpling (like an orange peel), or in the shape of your nipples.
- Raise arms overhead and look for the same changes.
- Now put your hands on your hips and press firmly to flex (like Wonder Woman). Look for the same changes.
Step 2: Standing, arms down - with touch
- Use the pads of your three middle fingers to press every part of each breast and under your arm.
- A circular motion can help make sure you do not miss a spot.
- In each spot, use three levels of pressure – light, medium, and hard.
- Take note of any lumps, thickness, or changes.
- Squeeze your nipples gently to check for discharge.
Step 3: Lying down - with touch
When you lie down, your breast tissue spreads out, and it becomes easier to feel for lumps.
- Put a pillow under one shoulder and raise that arm above your head.
- Use your other arm to feel your breast.
- Use the pads of your three middle fingers. Repeat the same circular touches (from when you were standing) with a light, medium, and firm touch.
- Repeat with the other breast.
Step 4: Stand or sit, arms raised - with touch
- Stand in front of a mirror or in the shower with soap over the area. Raise your arm (keep it slightly bent, not fully straight).
- Use your other arm to feel your underarm and breasts using the same steps from before (circular with three levels of pressure).
- Repeat with the other breast.
It may be of help to record what you notice during each self-exam. This exercise can help you when you visit a doctor.
What if you find a lump during your self-exam? What does a cancerous lump feel like?
The first thing to do is to try to remain calm and take a moment to breathe. It is important to know that most lumps detected during self-exams are benign cysts or muscle tissue, according to the Dana-Farber Cancer Institute.
According to Dr. Rohatsch of Solv, “Lumps that are potentially cancerous are usually painless, hard with firm edges, and do not move.” He added, “Exceptions do exist. The only way to confirm is to get a professional examination and further screening.”
As a next step, the Dana-Farber Cancer Institute recommends checking to see if the lump moves around as you stand, lie down and raise your arm above your head. Lumpy breast tissue usually spreads out in these postures. If your lump is still rigid, schedule a visit with your provider as a next step.
Remember, even hard lumps can be benign so get it checked out if you’re worried. It is impossible to tell if a lump is cancerous just by touch. The best way to find out if a lump is cancerous is to get it checked by a professional.
How has COVID-19 affected breast cancer screenings?
During the COVID-19 pandemic, many elective procedures, including breast cancer screening, were delayed or canceled. Healthcare professionals were focused on emergencies and urgent needs to help protect patients and staff from infection. The Centers for Disease Control and Prevention (CDC) reports that the total number of breast cancer screening tests for women through their ‘Early Detection Program’ reduced by 87% during April 2020 compared to years prior.
Early detection can save lives and it is important to visit your doctor to start your screenings again. Fortunately, most clinics and hospitals have resumed cancer screening services and follow the CDC’s COVID-19 safety protocols. Healthcare providers, along with Solv Health, strongly urge all Americans to go back to their providers to resume regular cancer screening appointments.
What to do next: How to get your screening back on track?
Consult with a healthcare provider to understand your personal health risk factors. Based on these criteria, your doctor can advise if you need regular breast self-exams and what screening is appropriate for you. Solv offers a hassle-free way to book appointments for doctor’s visits. For your screening, you will need an in-person visit. A virtual visit can be helpful for instructions on how to do a self-exam properly. However, if you feel you may have found a lump, please schedule an in-person visit with your provider for further evaluation.
If you have not had a screening check-up in more than a year, you may also consider scheduling a well-woman exam with a local provider.
A well-woman exam is a series of checks to evaluate your overall health. It offers preventive screening for cancer and gynecological diseases through breast exams, mammograms, and pelvic exams. Some centers also offer the HPV vaccine and pap smears for women who want them. Most insurance plans cover one free well-woman exam every 365 days. So, check to see if you’re eligible for a free wellness exam through your insurance.
The views expressed by authors and contributors of such content are not endorsed or approved by Solv Health and are intended for informational purposes only. The content is reviewed by Solv Health only to confirm educational value and reader interest. You are encouraged to discuss any questions that you may have about your health with your healthcare provider.
Solv has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
- American Cancer Society Recommendations for the Early Detection of Breast Cancer (April 22, 2021)
- Breast Cancer Screening for Women at Average Risk. 2015 Guideline Update From the American Cancer Society (October 20, 2015)
- What Does a Breast Lump Feel Like? (August 18, 2020)
- COVID-19 Impact on Screening Test Volume Through the National Breast and Cervical Cancer Early Detection Program, January–June 2020, in the United States (June 30, 2021)
- Get Your Well-Woman Visit Every Year (July 8, 2021)