Breast Self-Examination Guide PDF

Clinical Procedures Breast self Examination Introduction:- Monthly breast self-exams should always include: visual inspection (with and without a mirror) to note any changes in contour or texture; and manual inspection in standing and reclining positions to note any...

Clinical Procedures Breast self Examination Introduction:- Monthly breast self-exams should always include: visual inspection (with and without a mirror) to note any changes in contour or texture; and manual inspection in standing and reclining positions to note any unusual lumps or thicknesses. The best reason for performing monthly breast self examinations is the fact that 90 percent for all lumps and Just under half of all breast cancers are actually discovered by women or by their partners. As with all tumors, early detection leading to early treatment is the single most important factor in successful tumor removal and preservation of the breast. As in all types of cancer, early detection and treatment saves lives. Definition:- Is a method of finding abnormalities of the breast, for early detection of breast cancer? The method involves the women herself looking at and feeling each breast for possible lumps, or swelling. Breast self examination is the only non invasive procedure that can be regularly performed between internal breast imaging and clinical breast examination (CBE). The purpose of a Breast Self-Exam  To learn the topography of the breasts.  Knowing how the breasts normally feel will allow you to notice changes in the future. 44  Clinical Procedures  There is a three-pronged attack one can make in order to detect breast cancer: o Breast Self-Examination: Feeling your breasts. o Mammography: An X-ray of your breast. o Clinical Breast Examination (CBE): When an experienced doctor examines the breasts. Time of performing Breast Self-Examination Women older than 20 years should perform it on a regular monthly basis about 1 week after the onset of each menstrual period, when the breasts are typically not tender or swollen. BSE is most effective when it uses a dual approach incorporating both inspection and palpation. After menopause, BSE should be performed on the same day each month (chosen by the woman for ease of remembrance). Time required: 15 minutes a month Equipments:-  A mirror which lets you see both breasts.  A pillow for your head and shoulders.  Privacy. The Seven Ps methods:- Similar method of self-examination is known as the seven' Ps of BSE:- 1. Position: Inspect breasts visually and palpate in the mirror with arms at with various positions. Then perform the examination lying 45  Clinical Procedures down, first pillow under one shoulder, then with a pillow under the other shoulder, and finally lying flat. 2. Perimeter: Examine the entire breast, including the nipple, the axillary's tail that extends into the armpit, and nearby lymph nodes. 3. Palpation: palpate with the pads of the fingers, without lifting the fingers as they move across the breast.. 4. Pressure: First palpate with light pressure, then palpate with moderate pressure, and finally palpate with firm pressure. 5. pattern: There are several examination patterns, and each woman should use the one which is most comfortable for her.the vertical strip pattern involves moving the fingers up and down over the 46  Clinical Procedures breast.the pie-wedge pattern starts at the nipple and moves outward.the circular pattern involves moving fingers in concentric circles from the nipple outward.don't forget to palpate into the axilla. 6. Practice: practice the breast self exam and become familiar with the feel of the breast tissue, so you can recognize changes. A health care practitioner can provide feedback on your method. 1. Plan: know what to do if you suspect change in your breast tissue.know your family history of breast cancer.have mammography done as often as health care provider recommends. Instructions before doing breast self- examination:- a. Start checking your breasts when you are at 20 years or older. b. Mark your calendar to help you remember to do BSE on a regular schedule. One easy way to remember to do BSE is to do the exam on the same day of each month. 47  Clinical Procedures c. Do your BSE one week after your monthly period. This is the time when your breasts may be the least swollen, lumpy, or tender. d. If you are pregnant or have gone through menopause (change of life), do a BSE on the same day of each month. e. Use your fingertip pads to do the exam. Fingertip pads are the top parts of your fingers. f. Use three types of pressure while you do your BSE. First, press lightly. Second, press with medium pressure to feel a little deeper into the breast. Last, use firm pressure to feel deep within your breast. g. Use small circles to feel your breast tissue. Use your fingertip pads to make overlapping circles on your breast and armpits. h. Examine your entire breast area using up and down lines. Talk to your caregiver and make your own personal decision about doing BSE. (Fig.1). BSE involves the following:-  General Visual Exam (looking) 48  Clinical Procedures 1. Look for changes in symmetry, contour, shape, and overall texture of the breasts. 2. Look for dimpling, scaling, redness, sores, and enlarged pores in the skin. 3. Look for discharge, scaling, sores, puckering, and inversion of the nipples. Change color, size or texture Skin dimpling Nipple discharge  General Touch Exam (Palpation and feelling) Feel for unusual lumps, bumps, thickenings, and tender or enlarged lymph nodes in the breasts, under the arms, along the collarbone, and in center of chest between the breasts. The Five Steps of a Breast Self-Exam Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Breast Self-Exam – Step 1 49  Clinical Procedures Here's what you should look for:  Breasts that are their usual size, shape, and color  Breasts that are evenly shaped without visible distortion or swelling If you see any of the following changes, bring them to your doctor's attention:  Dimpling, puckering, or bulging of the skin  A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)  Redness, soreness, rash, or swelling Step 2: Now, raise your arms and look for the same changes. Breast Self-Exam - Steps 2 and 3 Step 3: While you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood). Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping 50  Clinical Procedures the fingers flat and together. Use a circular motion, about the size of a quarter. Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage. Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage. Breast Self-Exam - Step 4 Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your 51  Clinical Procedures entire breast, using the same hand movements described in Step 4.and press on nipple between fingers Breast Self-Exam - Step 5 Tips for Doing Your BSE 1. Mark your calendar to remind yourself to do your BSE regularly. This is a good way to prevent worry if find a normal cyclic change. 2. Stay relaxed and breathe normally as you do your BSE. Becoming tense will produce some knots that you may mistake for something worrisome. 3. Report any changes or unusual pain to your doctor or nurse practitioner. Keep a log of changes, if that helps you remember. 4. Remember to have an annual clinical exam and a mammogram. 52