Y our Guide to
One out of seven women in the United States will
develop breast cancer in her lifetime. Thanks to modern
treatments, many women will go on to live full,
productive, and active lives. The key to successful
treatment, however, lies in early detection.
Every woman must depend on herself to do regular
breast self-examinations (BSE). It is important to
know that nine out of ten breast lumps are found by
Eight out of every ten breast lumps are not cancerous,
but this does not reduce the need for you to do a monthly
BSE. By doing regular BSEs, you will get to know what
is normal for your breasts, and be able to detect any
changes more easily. A small visual change may be a
significant early sign of a problem.
Basic Breast Self-Examination
Ideally, you should do a BSE seven to ten days after the
first day of your menstrual period. Your breasts are less
lumpy and tender at this time. If you no longer have
periods, your BSE can be performed at any time, as
long as it is the same time each month. Women who
are pregnant, breast-feeding, or have implants should
also do regular BSEs.
To do a basic BSE, take the following steps:
1. Stand undressed from the waist up in front of a mirror
with your arms relaxed by your sides. Get to know how
your breasts normally look. A small visual change may
be an important early sign of a problem. (Illustration 1)
2. Compare your breasts while turning from side to side.
Look for any change in breast size, shape, skin texture
or color, including redness, dimpling, puckering, or
retraction/pulling-back of your skin.
3. Notice any nipple changes, such as scaliness, a pulling
to one side, or a change in direction.
4. Tightening the chest muscles beneath the breasts can
emphasize changes. Therefore, it is important to assume
5. Place your hands on your waist and press inward, then
turn from side to side to note any changes. (Illustration 2)
6. Place your hands behind your head and press forward.
Again, turn from side to side and look for changes.
Large-breasted women will need to take two fingers of
the opposite hand to lift and look underneath their breast.
7. Place your hands at your waist and bow toward the
mirror, letting the breasts fall forward. Note any change
in breast shape. (Illustration 4)
8. Nipple discharge can also be a sign of a breast
problem. Look for discharge in your bra or clothing.
Do not squeeze your nipple or try to press out any
secretions. Report any discharge to your physician.
9. Feel above and below the collar bone for pea- or bean-
sized lumps or thickening. This may be done while
taking a bath or shower, as some breast changes are
easier to feel when the skin is wet and soapy, or you
may use lotion. (Illustration 5)
10. From the collar bone, rub firmly downward with
a soapy flat hand to the nipple of one breast, feeling
for any lumps, thickening, or changes from previous
examinations. Repeat this sweeping motion, making
sure to sweep the entire breast, including under
the arm and the middle of the chest. Repeat this same
method with the opposite breast. (Illustration 6)
11. Lift the breast and lay it flat in the palm of your hand.
Sandwich the breast by placing the palm down over it. Feel
carefully with the top hand all the way along and across
the breast, feeling the tissue for any thickening or lumps.
Keep the fingers flat and in contact with the skin at all
times, so you do not miss touching all surface areas. Touch
all the way out to the end of the nipple. (Illustration 7)
12. Check for lumps or thickening under your arm while
relaxing your arm at your side. Reach across with your
other hand to feel the area. Check deeply up and down
the inside of the armpit and up and forward toward your
chest. Note any changes from previous examinations.
Repeat on the other side. (Illustration 8)
13. Lie down to complete the exam. Place a pillow or
folded towel under your left shoulder. This will help the
breast tissue be spread evenly across your chest wall. Put
your left hand behind your head and reach across with
your right hand to your left breast. A little lotion or baby
oil on your fingers will make them more sensitive.
14. Begin the exam at the armpit and move your three
middle fingers using light, medium and deep pressures.
15. Your hand should move in straight rows to cover
the breast tissue from the mid axillary line, bra line,
sternum and collarbone. Then repeat on the other side.
Avoid being rushed when you perform the exam.
Choose a time when you will have some privacy and
Remember, finding a lump or change in your breast
does not necessarily mean you have cancer. However,
you should report any changes promptly to your
primary health care provider. Early detection is your
best defense against breast cancer.
Breast Cancer Screening
The Breast Center follows the Breast Screening
Guidelines recommended by the American Cancer
Society ® and the National Comprehensive
Women ages 20 to 39:
• Monthly breast self-examination;
• Clinical breast examination by a trained health
professional every one to three years.
Women ages 40 and older:
• Monthly breast self-examination;
• Annual clinical breast examination by a trained
• Annual screening mammogram beginning
at age 40.
These guidelines apply only to women with no
unusual risks or symptoms of breast problems.
Women with certain risk factors should discuss this
with their doctor. In some cases, mammography
may be started before age 40, and a more observant
schedule of early detection tests may be appropriate.
To make an appointment, call 1-800-826-4673.
Your appointment at the Breast Center will take
about 45 to 60 minutes and includes:
• A breast health history;
• One-on-one breast self-examination instruction
by a specially trained breast care nurse;
• A mammogram.
Our most prestigious designations
and affiliations include:
National Cancer Institute-designated
Comprehensive Cancer Center
National Comprehensive Cancer Network,
National Bone Marrow Transplantation
Research Network, founding member
Association of Community Cancer Centers
National Gene Vector Laboratory
Southern California Islet Cell
One of America’s 50 Best Cancer Hospitals,
2003 & 2004 U.S.News & World Report
Cooper Finkel Women’s Health Center
1500 E. Duarte Road, Duarte, CA 91010 -3000
1-800 - 826-HOPE (4673)
Where the Power of Knowledge Saves Lives ®
MED 6650 5/05