From Encyclopedia of Sex and Sexuality
Early detection of breast cancer is possible through the use of periodic screening tests of women who display no symptoms of the disease. Women should be taught the technique of self-examination, and the clinical examination of the breasts is recommended at annual check-ups. Breast x-rays (see mammography) can detect breast cancer at an early stage and is recommended on an annual basis for women over the age of forty. Various studies have shown that early diagnosis through screening programs effectively reduces the mortality rate related to breast cancer. However, the frequency of screening and the degree of attention and responsibility taken by the individual woman are key factors affecting the success of screening.
Self-examination of the breast can be done by every woman and it remains one of the most important screening procedures for breast cancer. The majority of breast cancers are first discovered by the patient. Furthermore, tumors discovered by women who regularly practice self-examination are usually smaller and more curable than those discovered in women who do not take the responsibility. Women who practice breast self-examination should focus on three points: timing, visual inspection, and palpation (feeling the breast).
The few days immediately after a menstrual period are the best time to detect changes in the breasts. Postmenopausal women or women who do not menstruate for other reasons should perform breast examination on the same calendar day each month.
The woman should inspect her breasts in front of a mirror, looking for changes in shape, contour, skin or nipples of each breast—in color, retractions, or lumps.
The woman should lie down, initially with one arm at her side and subsequently with the same arm beneath her head. A massaging motion with slight pressure should be applied over the entire breast in a systematic fashion, using the flat part of the fingers (not the fingertips). One of the easier techniques is palpation of the breast in circles, beginning at the nipple and then gradually in larger circles. Many women prefer palpation in the shower, since they have increased tactile sensitivity when the breast is wet.
Any lump should trigger immediate consultation with a physician, even though most lumps in the breast are not malignant. Finally, during self-examination, the woman should gently squeeze both nipples and look for any discharge.
While mammography and other technological approaches to screening can be effective in addition to regular self examination of the breast, an annual breast examination by an experienced physician remains essential.