BSE is best performed as the first activity in the morning. That way, if you find a change that worries you, you have a better chance to get this question resolved that day rather than losing a night's sleep. Pre menopausal women should perform this exam when their breasts are the least tender (usually about 1 week after menstruation starts). Post menopausal women should perform this exam on the first day of every month.

Technique:

Before a mirror: Stand before a mirror and examine your breasts with your arms at your side, on your hips, and above you head. Look for dimpling of the skin or inversion of your nipples (some women have nipples that have been inverted from birth). Look for rashes or crusting of the skin particularly about the nipple. Gently squeeze your nipples and look for bloody or rusty colored discharge. If this is present then you should contact your doctor. A drop or two of a clear or milky fluid is normal. A persistent nipple discharge as seen in your bra should be evaluated by our doctor.

Morning shower: Wet and soapy skin reduces the friction between your fingers and the breast. Systematically evaluate each breast perhaps by dividing the breast into imaginary quadrants and mentally memorizing the underlying pattern of the breast. You may start in the center of the breast at the nipple and move around the breast in a circular manner or move across the breast in a horizontal or vertical manner to cover the entire breast and go up into the axilla ( the arm pit).

After bath: Lie down on the bed with a pillow beneath each shoulder blade and examine each breast with the opposite hand. Use light, medium, and deep pressure to again map the entire breast and the axilla.

BSE is an activity that should be done monthly and any changes should be brought to the attention of your doctor.