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Every woman from the age of 20 years and then for the rest of her life should do a breast examination on herself every month, immediately after her menstrual period (on the 8th day counting the first day of her period), when estrogen levels are low, thus ensuring a more careful and accurate breast examination which is not always possible if breasts are swollen or tender, which is normal when estrogen levels are high.
A breast examination by a qualified Medical person can be carried out every three years, although annually is preferable, between the ages or 20 and 40 years, and then annually after this age group.
Any abnormalities, lumps or discharges you notice and are uncertain about while doing a self-examination, must be reported to your medical practitioner immediately.
It is also a good idea to get a medical doctor, nurse or midwife to check out your technique.
A breast self-examination consists of three important steps:
1. A visual examination
2. Examining the breasts while lying down
3. Examining the breasts while sitting or standing.
The first step consists of standing in front of a mirror that is well illuminated. Stand tall with both arms relaxed and hanging at your sides. Study your nipples carefully and ensure they are both pointing in the same direction. Ascertain that your nipples are not drawn up into the breasts and that your skin surrounding the nipples are not red or dimpled, the pores are not enlarged or coarse, there is no rash or scaling.
Then place both hands on your hips and push down, making sure that your chest muscles contract the same amount on either side and that the skin does not dimple when you apply pressure when pressing down. Press your palms together at heart level and then raise them above your head. Pay attention to ensure that your skin does not dimple and the muscles are contracting evenly.
Finally squeeze both nipples gently, one at a time and ensure there is no discharge. There may be some discharge after the birth of a baby or due to hormonal levels. However anything unusual should be reported to a medical professional.
The second step involves examining the breasts while lying down, this ensures that the breast tissue spreads out over the rib cage making it easier to feel deep tissue layers with the fingers.
Lie down comfortably with a pillow tucked under the shoulder and one arm raised behind the head, with the other hand, starting with the breast on the side of the raised arm, using only the fingertips, examine your breast from the collar bone, around the entire breast, around the nipple, down to the chest, and then all the way till under the arm. Repeat with the other breast.
A variation that can be done is, whilst kneading the outer part of the breast you can keep your arm down by your side, and then raising the arm behind the head while examining the inner part of the breast.
The third step involves the breast examination whilst standing or sitting. During a shower is an excellent time to carry this out, because wet fingers glide more easily over the breast.
Raise one arm over the head, using the other hand, begin with the breast on the same side as the raised arm. Using three or four fingers examine the entire breast. Moving in circles, begin at the outer edge of the breast working your way towards the nipple. Also examine the armpits. Repeat the same procedure with the other breast.
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