Understanding Breast Cancer: Why Self-Checks Matter

Breast cancer is one of the most common cancers that affect women (and, less commonly, men). In the U.S., about 1 in 8 women (≈ 13.1 %) will be diagnosed with invasive breast cancer in her lifetime.  Sadly, some of those cases will be fatal — though thanks to advances in screening and treatment, survival rates have improved significantly.

Here’s a snapshot of key survival and mortality data:

• The 5-year relative survival rate (which compares people with breast cancer to people without, matched for age, sex, etc.) across all stages is about 91 % in the U.S.

• If breast cancer is diagnosed early (localized, meaning it hasn’t spread beyond the breast), the 5-year survival is ~99 %

• If the cancer has spread to regional lymph nodes or nearby structures, the 5-year survival is approximately 86–87 %

• For distant (metastatic) breast cancer, the 5-year survival drops to around 30–32 %

• Over time, U.S. breast cancer mortality has declined. Between 1975 and 2019, the age-adjusted death rate fell from ~48 per 100,000 to ~27 per 100,000 women.

These numbers tell a compelling story: early detection dramatically improves outcomes. The earlier a cancer is found — before it spreads — the more treatment options exist and the better the chances of long-term survival.

That’s where self breast exams (SBEs) and breast awareness come into play — they don’t replace screening like mammograms, but they help you become familiar with your own tissue and catch changes early.

Self Breast Exam: Purpose, Benefits & Limitations

Why do a self breast exam (or breast awareness)?

• Many breast cancers are first discovered by the person themselves. In fact, some sources estimate that about 40 % of breast cancers are first found by women feeling a lump.

• Regular self-checks help you learn what’s “normal” for YOUR breasts — size, firmness, texture, any lumps that come and go — so when something changes, you notice.

• If you detect a change early — a new lump, thickening, skin dimpling, nipple changes, or discharge — you can bring that to your healthcare provider sooner for further evaluation (clinical exam, imaging, biopsy).

• However, SBEs are not perfect: many self-found lumps are benign, and SBEs can lead to anxiety or false positives. Also, not all organizations recommend formal monthly SBEs as a screening tool for everyone.

The modern approach many experts favor is breast awareness (knowing what’s normal, noticing changes) rather than rigid formal self-exams — but for many people, doing a monthly check remains a practical tool.

When Is the Best Time to Do a Self Breast Exam?

Timing matters, especially for premenopausal women. Hormonal fluctuations throughout the menstrual cycle cause changes in breast tissue (swelling, lumpiness, tenderness), which can mask or confuse what you feel.

Recommended timing:

• If you menstruate: The best time to perform a self exam is approximately 3 to 5 days after your period begins (or ends) — when breasts are least swollen or tender.

• Another common guidance: one week after the period ends (i.e. early follicular phase) is a stable time.

• If you are postmenopausal, or no longer menstruating: choose one consistent day every month (for example, the 1st or 15th of the month) so comparisons over time are easier.

Doing it at the same point each month helps you detect real changes instead of fluctuations related to hormones.

How to Perform a Proper Self Breast Exam

Here’s a step-by-step guide (based on sources like Cleveland Clinic, ACS, StatPearls) to help ensure you cover all areas methodically:

1. Visual Inspection (in front of a mirror)

• Stand bare-chested (or in a bra) with your shoulders straight and arms at your sides. Look for asymmetry in size, shape, or position of the breasts.

• Raise your arms overhead, and inspect again for changes in contour, dimpling, puckering, skin texture (orange-peel/dimpling), or abnormal nipple position (inversion) or discharge.

• Also look for redness, swelling, or skin changes (rash, scaling).

• Place hands on hips or push hands down (pressing) to flex chest muscles and observe subtle changes.

• Use good lighting and a mirror that lets you see from multiple angles.

2. Physical Examination — Standing (often done in the shower)

• With one arm raised (behind your head or resting), use your opposite hand’s three middle fingers (pads) to gently press and feel the entire breast and surrounding areas (armpit included).

• Use a consistent pattern (choose circular, radial/wedge, or vertical “up-and-down”) to cover all areas systematically.

• Use three levels of pressure:

    • Light pressure for tissue near the skin surface

    • Medium for mid-level tissue

    • Firm for deeper tissue (near chest wall)

• Be sure to palpate from the collarbone to the bottom of the breast, and from the center (sternum) out to the side and toward the armpit.

• Also check the nipple and areola: gently press or squeeze to see if there’s discharge.

• Repeat the process on the other side.

3. Physical Examination — Lying Down

• Lie flat on your back; place a pillow under the shoulder of the breast you’re examining.

• Raise the arm of that side behind your head (to spread out breast tissue).

• Use your opposite hand (middle three fingers) and press gently in light → medium → firm pressure, covering all breast areas with the chosen pattern.

• Check toward the armpit, outer edges, and under the breast.

• Repeat for the opposite breast.

Tips & Reminders:

• Go slowly — take time.

• Use the same pattern each time so you don’t miss areas.

• Compare both breasts side-to-side; one breast may be a bit denser, but changes (new lumps, texture differences, thickening) are what matter.

• If you feel something unusual (a lump, persistent thickening, skin dimpling, nipple retraction, discharge, etc.), don’t panic — but don’t ignore it. Schedule a professional evaluation.

What to Look For: Warning Signs and Red Flags

When you examine, pay attention to:

• A new lump or thickening — especially if it feels different from surrounding tissue

• Changes in size, shape, or symmetry of one breast

• Skin changes: dimpling, puckering, or texture like orange-peel

• Nipple changes: inversion (turning inward), retraction, or being pulled inward

• Nipple discharge (clear, bloody, or other fluid)

• Redness, rash, scaling, or crusting of the skin or nipple

• Swelling, warmth, or signs of infection

• Changes in veins: enlarged or more visible

• Swollen lymph nodes in the armpit or collarbone region

Any persistent change that you notice (and that is not clearly cyclical or hormonal) should prompt a visit to your healthcare provider for evaluation.

Integrating Self-Exam Into a Screening Strategy

While self breast exams or awareness are valuable, they do not replace professional screening (clinical breast exam, mammography, MRI in high-risk cases). Many organizations (like the American Cancer Society) no longer mandate monthly formal self-exams for all women, citing concerns about false positives and unnecessary interventions.

However, combining these elements gives you a layered defense:

1. Breast awareness / self-checks: know what’s normal for you and catch changes early

2. Clinical breast exams by trained providers as recommended

3. Mammography or imaging per guidelines (typically starting at age 40, or earlier in those with risk factors)

Early detection of breast cancer — before it spreads — gives access to more treatment options and a much higher likelihood of cure or long-term survival.

Empowerment Through Vigilance

Understanding your body and raising awareness is a powerful step against breast cancer. Monthly self-exams (or regular awareness) help you become your own first line of defense. The more familiar you are with your own tissue and what is “normal” for you, the quicker you’ll spot something that warrants professional attention.

If you or someone you know feels a suspicious change, don’t wait — reach out to your provider. Early detection saves lives.

References

1. American Cancer Society. Breast Cancer Facts & Figures 2024–2025. Atlanta: American Cancer Society; 2024. https://www.cancer.org

2. National Breast Cancer Foundation. Breast Cancer Facts. 2024. https://www.nationalbreastcancer.org

3. Breastcancer.org. Breast Self-Exam (BSE): Step-by-Step Guide. 2024. https://www.breastcancer.org

4. Mayo Clinic. Breast Self-Exam: When and How to Perform One. Updated 2025. https://www.mayoclinic.org

5. Centers for Disease Control and Prevention (CDC). U.S. Cancer Statistics: Data Visualizations Tool. Accessed 2025. https://www.cdc.gov/cancer/dataviz

6. JAMA Network. Trends in Breast Cancer Mortality, 1975–2019. JAMA. 2024;331(3):234-245. https://jamanetwork.com

7. Cleveland Clinic. Breast Self-Exam: How to Check for Changes. 2024. https://my.clevelandclinic.org