What is a breast exam?
A breast exam is a physical examination of your breasts and underarm areas. There are two types of breast exams:
Breast self-examination is a breast check you can perform at home. The usual recommendation for how often to do a self-breast exam is once a month.
Clinical breast exam is a breast screening a healthcare provider performs during a regular health checkup. How often to get a breast exam depends on your medical history. Doctors typically recommend it once a year at your annual exam.
Why is a breast exam performed?
A breast exam is part of breast cancer screening. There are different clinical opinions about the usefulness of breast exams for women at average risk of breast cancer. Some expert organizations recommend them, while others do not. The reason for varying recommendations is there is no clear data showing breast exams reduce the risk of dying from breast cancer. The American Cancer Society reports that most women find lumps during daily activities, such as bathing or dressing. And screening mammograms find many breast cancers before you can even feel a lump. However, there are still benefits to performing these exams.
A self-exam of the breasts is free and they help women become familiar with the normal look and feel of their breasts. This makes it more likely you will notice a change, such as a lump, thickening, or puckering of the skin. It is also possible that self exams can help find cancer early in women who are not yet getting screening mammograms. Report any changes, no matter how small, to your doctor as soon as possible.
Clinical breast exams may find suspicious areas you miss or dismiss as normal. Since it’s usually part of a regular physical exam, it’s easy to include this simple breast cancer check.
Who performs a breast exam?
Where to get a breast exam is pretty straightforward. If you have a gynecologist or primary care doctor, it will be part of your preventive care during an annual exam. A gynecologist specializes in women’s health, while a primary care doctor focuses on your total, overall health. You can also get a breast exam at women’s health clinics. However, there is a specific exam technique that is necessary to properly perform it. Not every healthcare provider has this training. Be sure you are seeing a provider with the right qualifications and training to perform breast exams.
How are clinical breast exams and self-exams performed?
For a self-exam, you feel your breasts and armpits using small circular motions, moving from the outside of the breast to the nipple. You do this in the shower and while lying down with your arm behind your head. You are feeling with the opposite hand for lumps, thickenings, or hard spots or knots.
You also examine yourself in front of a mirror. First, you visually examine yourself with your arms by your side, then with them raised over your head. It’s important to look for any changes between the two positions. Finally, put your hands on your hips and flex your chest muscles. You are looking for dimpling, puckering, or other skin or nipple changes. You should also lightly squeeze your nipples to check for fluid or lumps.
It’s important to know there may be normal differences between your two breasts. Most women have slight mismatches in size or shape. Some women also have normally lumpy breasts—known as fibrocystic breasts. The tissue will feel bumpy throughout the breast. The main point is to note anything that changes from your normal feel or appearance.
Clinical breast exam
To perform a clinical breast exam, your doctor will visually check your breasts while you are sitting up. Like a self-exam, the doctor may ask you to raise your arms over your head and to press your hands against your hips. These posture changes can reveal changes in size or shape of your breasts. A nipple check with a light squeeze may also be part of the exam. Then, your doctor will have you lie down. Your doctor will feel all areas of your breast and underarm area, checking for lumps or texture changes.
What are the risks and potential complications of a breast exam?
A breast exam is a safe exam that carries little risk. However, it is possible to have a false positive result with a breast exam. This means the doctor feels something that needs more testing, but it turns out not to be breast cancer. False positive breast exam results can lead to additional testing, which costs money, can be painful, and can lead to fear and worry. However, the goal of any breast cancer exam is to find cancer early. The ease of the test most likely outweighs the small risk of a false positive result.
What can I expect after a breast exam?
Most breast exams find no evidence of cancer. If your doctor feels a lump or other abnormality, he or she will discuss it with you. There can be differences in the way cancerous and noncancerous lumps feel. However, the only way to know for sure is to run follow-up tests.
Your doctor may recommend a diagnostic mammogram or a breast ultrasound with or without a biopsy to evaluate the area. The results will guide your next steps. Your doctor may clear you until next year, recommend a follow-up exam in a few months, or order more testing right away. If any of these results show cancer, you will go through a complete diagnostic process before assessing your options.