BREAST SELF
EXAMINATION
Mrs.Jayanthi.G
Clinical value and Advantages
a. Experience has verified that 90% of breast cancers are
found by women themselves
b. When women discover lumps in their breasts at very
early stage, surgery can save 70-80% of proven cases
c. Examination should be done every month and at the
end of menses in all menstruating women.
d. Women can use BSE to asses their breasts. When they
perform BSE properly and regularly, they can find
changes in their breasts and seek further evaluation.
Recommendation
1. All women age 20 years and older perform BSE on a
monthly basis. Beginning in their 20’s, women
should be told about the benefits and limitations of
breasts self examination. The importance is prompt
reporting of any new breast symptoms to a health
professional should be emphasized.
2. All women ages 29 to 39 should have clinical
examinations every 3 years preferably be part of a
periodic health examination.
3. All women ages 40 years and older have regular
(every 1 to 2 years) mammograms.
1. Asymptomatic women ages 40 and older should
continue to receive clinical breast examination
preferably be part of a periodic health examination
annually.
2. Screening decisions for older women should be
individualized by considering the potential
benefits and risk of mammography in the context
of the current health status and estimated
expectancy. As long as woman is in good health
and would be candidate for treatment, she should
continue to be screened with mammography.
Barrier to BSE
The major barrier to BSE is the lack of CONFIDENCE
Physical assessment findings in a healthy Adult
A. By inspection
B. By palpation
By inspection the breast should be:
• Symmetrical, full, rounded, smooth in all portions,
without dumpling, retractions or masses
• Faint, even vascular pattern and striae are noted
• Nipples everted, areola even
• Axillae even color, without masses or rash
In palpation the breast should be:
• Firm and without masses, lumps, local areas with warmth,
or tenderness
• Nipples should have no discharges
• Axillae should be smooth and node are nonpalpable
Assessment interview
Sexual health history
Are you currently sexually active? With men, women,
or both?
Describe the positive or negative aspects of your sexual
functioning
Do you have difficulty with sexual desire? Arousal?
Orgasm? Satisfaction?
Do you experience any pain with sexual interaction?
If there are problems, how have they influenced how
you feel about yourself? Have have they affected your
partner? How have they affected the relationship?
Sexual health history
Do you expect your sexual functioning to be altered
because of your illness?
What are your partner’s concern about your future sexual
functioning?
Do you have any other sexual questions or concerns that
have not been addressed?
Breast History
Ask the client about breast pain or tenderness and its
occurrences in relation to menstrual cycle.
Ask whether the woman has had in the past or currently
has breast lumps or masses. If a lump is present, ask the
woman to describe its location, onset and size and
whether it is painful
Determine whether the lump has changed shape, size,
consistency, or degree f redness since it was first
noticed
Ask about nipple discharge, which is abnormal in
women who are not pregnant or lactating. If there is a
discharge, determine the color, consistency, amount
and odor.
Ask whether the woman perform BSE regularly
Note whether the woman include axillary nodes in
BSE.
Ask for her HISTORY of breast cancer in her blood-
related FEMALE relatives – mother, sisters, maternal
grandmother or maternal aunts. It indicates an
increased risk of breast cancer if she has any family
history of breast cancer.
Identifying clients at risk
• Altered body structure or function due to trauma,
pregnancy, recent childbirth, anatomic abnormalities of
genitals or disease
• Physical, psychosocial, emotional, or sexual abuse;
sexual assault
• Disfiguring conditions, such as burns, skin conditions,
birthmarks, scars (e.g. mastectomy) and ostomies
• Specific medication therapy that causes sexual problems
• Temporary or long term impaired physical ability to
perform grooming and maintain sexual attractiveness
• Value conflicts between personal beliefs
and religious doctrines
• Loss of partner
• Lack of knowledge or misinformation about
sexual functioning and expression
SIGNS OF BREAST CANCER
Elevation
Asymmetry
Bleeding
“Orange Peel” skin
Nipple Retraction
WOMEN ARE SCREENED FOR BREAST
CANCER IN 3 WAYS:
1. Mammography
2.Clinical Breast Examination - clinical breast exam
is an examination by a doctor or nurse, who uses
his or her hands to feel for lumps or other
changes
3. Breast self-exam. A breast self-exam is when you
check your own breasts for lumps, changes in size
or shape of the breast, or any other changes in
the breasts or underarm (armpit).
STEPS IN BREAST SELF
EXAMINATION
•Inspection before a mirror
•Palpation: Lying Position
•Palpation: Standing or sitting
Inspection before a mirror
• Stand and face a mirror
with your arms relaxed at
your sides or arms resting
on your hips; then turn to
the right and left for a side
view look. (look for any
flattening in the side view
…continuation
• Bend forward from the waist
with arms raised overhead
• Stand straight with arms
raised over the head and
move the arms slowly up and
down at the sides. (look for
free movement of the breasts
over the chest wall)
• Press your arm firmly
together at the chin level
while the elbows are raised
to shoulder level.
Palpation: Lying Position
• Place a pillow under your right shoulder and place
the right hand behind your head. This position
distributes breast tissues more evenly on the chest.
• Use the finger pads (tips) of the three middle
fingers (held together)on your left hands to feel
the lumps.
• Press the breast tissue against the chest wall firmly
enough to know hoe your breast fells. A ridge of
firm tissue in the lower curve of each breast is
normal.
• Use circular motions
systematically all the way
around the breasts as
many times as necessary
until the entire breast is
covered.
• Bring your arm down to
your side and feel under
your armpit, where breast
tissues are also located.
• Repeat the exam on your
left breast using the right
finger pads of your right
hand.
Palpation: Standing or Sitting
• Repeat the examination of
both breasts while upright with
one arm behind your head.
This position makes it easier to
check the upper part of the
breast and toward the armpit.
• Optional: Do the upright BSE
in the shower. Soapy hands
glide more easily over when
wet
• Report any changes to your
health care provider
Feed Your Faith, Your Fears
Will Starve To Death
