How To Do A Breast Self-Exam (BSE)

I am posting this (quick post, haha) because I do get asked this a lot, and I am not always able to explain verbally how to do a proper and effective breast self-examination for lumps.

Why is BSE important? It’s how many breast cancers are detected—sometimes by spouses who are so familiar with their wives’ bodies, they can tell the difference. I learned how to feel my breasts for lumps in my 20s, after my mother had her first experience with cancer. She was a nurse, and taught me how to do it properly, whether lying down (which was fine between the age of 22-31) or standing up facing a mirror (once the kids arrived my boobs began to descend in opposite directions towards my armpits so feeling for lumps in prone position was harder).

The best time to do your BSE is after your period, like a day or 2 days. Apparently the breasts won’t have so many cysts at that time of the month, so you can get a more accurate “reading” of lumps. It’s important to make it a habit, so for me, once my period is down to just a stain, I’ll do my BSE every month (okay, I did miss a month or two but I’d say I remembered 10 out of 12 months).

It’s also pretty important to do your BSE in front of a mirror. Breast cancers may cause some subtle puckering in the skin of the breast (makes it look a bit “orange skin”) or there may be a colour change in the breast, or sometimes you can actually observe a visual difference between right breast and left that could be indicative of an growth.

Standing in front of the mirror, raise your right arm and feel your breast with your fingertips (fold in your thumb and use four fingers). I make small circles with my fingers starting from the outermost part of the breast, moving in towards the nipple.

If you think you feel something lumpy (and many women’s breasts are fairly dense and lumpy-feeling), the way to check if it’s a lump is to feel the opposite breast in the same spot. If you feel a similar “lump” in the same spot, then most likely it is just breast tissue, not a growth.

What does a lump feel like? For me, I didn’t even feel a lump, but there was a “thickening” under the skin that I could faintly detect. It really was because I was so used to feeling my breasts that this subtle change was apparent to me. For other friends who have found cancerous growths, they mostly describe it as a “pea under the skin”.

Here is a diagram I borrowed from Medline Plus that shows you, visually, how to do your BSE. There are different methods — just pick the one that is most comfortable for you.

Three ways of conducting your breast self-exam

I hope this post has been useful! You can ask me anything if what I’ve written isn’t clear enough.

PS Whether you’re high-risk (like me) or not, BSE is still a good habit to form, judging from the calls and emails I am getting from women who don’t have any family history of breast cancer.

Dark Day: Another Friend Diagnosed With Breast Cancer

Yesterday, a good friend SMS’d me.

“Just read your article in Lifewise. Looking good, girl 🙂 I just got diagnosed yesterday evening – “abundant malignant cells”. Doctors says chemo likely. My surgery on Wednesday to discover extent. Will be reading your blog regularly.”

My heart sank like a huge rock. I don’t wish cancer on anyone — but it really breaks my heart when the sweetest, fittest, healthiest people who really have no reason to get cancer, get it. And this friend is just one such. After my surgery, she came over for dinner and brought macaroons from ET Artisan Sweets (they really are artisanal — my favourite is the Black Forest with the brandied cherry in the chocolate ganache filling). She made me laugh out loud with her funny stories, including the one about how she signed up for a 10km run and was so unhappy with herself because she walked some sections of the route. I thought to myself, “I’d be happy if I could run 1km!” And now I can, because she inspired me to think it is possible.

Hers is the fourth case I have heard in two weeks. Two of them, thankfully, have cysts in the breast, which are being removed surgically. Another one hasn’t updated me… I really hope she’s taken my advice.

My best friend Karen had a scare too, about a month ago. But thank God hers turned out to be a fibroid, not cancerous in any way.

I have a feeling more cases of breast cancer are discovered in the month of October, thanks to the fact it is Breast Cancer month. And although it’s terrible to discover it, it’s still better than not discovering it early enough for treatment to be had.

I saw my oncologist two weeks ago (you can read about my latest dilemma soon at this blog). You might wonder why, after my breast surgeon Dr Hoe Ah Leong had basically given me a clean bill, I had to see an oncologist. Dr Hoe said he felt it was safer for me to get an expert opinion as an oncologist is a doctor that deals specifically with cancers, while a breast surgeon may deal with different ailments relating to the breast, whether cysts, fibroids, or cancerous growths.

In short, Dr Tan Yew Oo of Gleneagles concurred with Dr Hoe, based on my histological reports which showed that, given my hormones levels, it would not be profitable for me to go on tamoxifen, which is often prescribed for patients who have had one mastectomy and tested ER+ (estrogen receptor positive). Tamoxifen is understood to help reduce chances of cancer in the second breast. It’s also used in many preventive situations, including male breast cancers. (See here for more on tamoxifen.)

Anyway, Dr Tan gave me some useful literature on breast self-exam. I learned how to do a self-exam when I was 20 — my mom showed me, standing in front of the mirror. I realise that most moms wouldn’t (though I do plan to teach my 2 girls), and so it would be useful for someone who’s trying to find out exactly how to do a breast self-exam (BSE) to download this diagram and practise. I’ve been told the best time to do your BSE is just after your period has ended. I personally use the circular method — mainly because I’ve used it for 22 years!

Ultimately, I have to say that I think BSE saved my life. Even though it wasn’t quite a lump, I was familiar enough with my breasts by this year to know when something didn’t feel quite right.

Breast Self-Exam Diagram

Right now I am praying for my friend, whose surgery happens this Wednesday. She is a real “can-do” lady. I am very sure she’s going to pull out of this and she will have a long, fulfilling life ahead of her. I intend to live as many years as God will give me, and I know she shares my sentiments. So though right now, it seems a tragedy, this is not the end for either of us. We shall live on and fight.