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tan253's avatar

How do you exam your breasts correctly?

Asked by tan253 (1805points) December 21st, 2016

Hi Fluther!
I“m 40, getting a mammogram and starting to do breasts exams as I’ve never done them.
Feeling my breasts I can feel so many lumps and bumps, breasts are naturally lumpy are they not?
How do you know what a ‘suspicious’ lump feels like when it’s all lumpy on the breast?
Both breasts feel lumpy I should add, not just one and I had my Dr examine my breasts two days ago and she said they felt fine.
So… what am I looking for??

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10 Answers

tan253's avatar

What does that even mean?? Why would it say it doesn’t think breast examination is good and woman shouldn’t get mammograms at 40?

Earthbound_Misfit's avatar

You will become familiar with your own breasts the more you examine them, and yes, breasts can feel different at various times of your cycle. The recommendation is to check your breasts about a week after your periods. My boobs were sore around the time of my periods. What you’re looking for are any differences. Lumps, thickening, dimpling of the skin (you should look at your breasts in the mirror), check puckering in particular spot and any discharge from your nipples.

Here is a YouTube video that goes through what you should do. If you’re concerned about whether you’re doing it right, ask your doctor to demonstrate how to examine your breasts.

I’m surprised you’re only starting to do this now. Young women can develop breast cancer and breast examination should start when your breasts develop. Mammograms aren’t usually carried out here (in Australia not sure about NZ) until you’re 50. Apparently, breast tissue in younger women is denser and so mammograms are not as accurate at picking up problems (I think that’s why they don’t do them earlier anyway).

I know you can become very stressed about your health, but if you are concerned about anything you fine, talk to your doctor. Better to be safe than sorry. Although, a lump or change in your breasts does not automatically mean you have cancer.

I think what @Rarebear‘s post means is that there isn’t strong medical evidence that breast examination is beneficial as a measure in identifying breast cancer. I can only assume the reason they recommend breast examination should not be taught is that most women don’t do it properly and would either miss problems, do not do it regularly, and/or would present to their doctor with normal breast tissue. He would have to confirm his point.

However, the Cancer Council and Breast Screening Australia are still advising women to carry out self-examinations at this point.

http://www.breastcancer.org/symptoms/testing/types/self_exam/bse_steps

Rarebear's avatar

@tan253 Would you like the short or long answer? I am not interested in debating this if that is what you are after, but I am willing to educate.

tan253's avatar

I“m not up for a debate either as I’m completely uneducated in breast awareness as a woman! So please educate me. – not said with any tone of sarcasm.

I’ve also gone to my DR to get my breasts checked and she’s just said to feel around in a circular motion but I’ve always felt lumps and bumps – so I’m more concerned with what an actual ‘suspicious’ lump will feel like that’s all.

tan253's avatar

@Rarebear – whatever answer you have time to give, long or short. I“m always interesetd.

Rarebear's avatar

Okay. Self Breast Exam or SBE used to be recommended. But studies have shown that they merely increase women’s anxiety and do not increase the number of cases and cures of breast cancer. Does that mean that if you feel a hard lump that you ignore it? Of course not. It just means that doing routine breast exams incur no benefit.

For mammograms, the answer lies in Bayesian statistics. The prevelance and incidence of breast cancer in a general population is low under age 40, and when you run the numbers you find out that a positive test is more likely to be a false positive than a true positive leading to higher unnecessary operations. The incidence and prevelance starts going up at 50, so that’s why that number is picked. Your results may vary. If you have, say, two sisters and a monther and an aunt who all had breast cancer when they were 25, then yes, of course you will get a mammogram early. But if you’re a general population then the risks outweigh the benefits.

What is Bayesian statistic you say? If you take a cohort of 1000 nuns who have never had sex nor shot drugs and tested them for HIV, and one of them come out positive, what is the chance that the test is a true positive? Because the incidence and prevalence (prior probability) is so astronomically low, there is a chance that the test is a false positive (happened to a friend of mind)

Now, lets take the same test and run it on 1000 sexually active gay sex workers who shoot heroin and share needles and don’t use any condoms. The incidence and prevelance is going to be much higher and so the prior probability is going to be much higher. Therefore the test is much more likely to be a true positive.

This doesn’t just happen for women. For prostate cancer there is a test known as a PSA that detects early prostate cancer. Good, right? Well, no, unless you are higher risk. Even if the PSA is positive, the chance that you’ll die of the cancer is less than the chance you’ll die of something else, and you are left with unnecessary procedures with side effects like impotence. Most physician men my age (52) do not take the test. A positive test causes morbidity, but not any mortality benefit.

But I’m an individual person, you say. I’m not a statistic. True. So you are free to do self breast exams—just make sure they are done correctly. You are also free to ask for a mammogram at age 40 (my wife did after hearing my rant on why she shouldn’t and did anyway. It was normal, thank goodness). It all depends on comfort and trust. But if you do it, ask yourself, are you willing to put yourself through a potentially painful surgery for something the statistics say has a greater chance of being benign than malignant?

But down to the meat of your question—what is a specific lump? You’re feeling around for something that feels like a walnut.

Hope that helps.

tan253's avatar

hmmm very interesting thank you @Rarebear and thank you for specifically answering my question as no-one was able to tell me what the lump might feel like. For a woman of my disposition, that being on high alert as a constant – suffering from anxiety I think a mammogram would be good, however, on hearing what you’ve got to say I am seriously reconsidering it.
My Dr examined me and she said all was fine, I’m skinny so it’s easy to feel my tissue so to speak… maybe I should be doing some more self-examing of my peculiar high alert brain ;)
Thank you for your reply.
Much appreciated.
x

Rarebear's avatar

Don’t take my word for it. I’m just an anonymous internet troll. Get the advise from your own doctor.

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