Examining Your Breasts 101

Photo by Dyanna.

How often do you do examine your own breasts? Monthly? Quarterly? Never? Don’t feel guilty if your answer is never, just read on! The most common answer I hear is actually, “I’m not sure what I’m feeling for anyway,” or, “It’s always lumpy bumpy in there.”

Let’s talk breast tissue so you can learn how to distinguish lumps from bumps and know when to see a doctor.

Breast tissue is made up of collagen, elastin, ligaments, glands and fat tissue. Milk glands, called lobules, are connected by the milk ducts to the nipple. This means that a lot of the masses you’re feeling are just the glands and ducts (which can be prominent even if you aren’t breastfeeding).

Some women have nipples that are ‘inverted’ or inward facing, while others stand out. When doing your self-exam, look at your breasts in the mirror to see if there is any puckering of the tissue, difference in skin color, or change in your nipple position. If there is, have your health care provider do a follow-up exam.

Breast tissue is hormone sensitive, which means you might experience swelling and pain around your menstrual cycle. Women who are high in estrogen, especially in the second half of their cycles, may notice it the most. I advise women to do their monthly breast exam after their period when the swelling and pain diminishes.  No need to contribute to the tenderness!

When doing your exam, start in the upper-outer quadrant of your breast up by your armpit at the end of your collar bone.  I know it seems far removed from your nipple, but your breast borders actually go from your collar bone, down your sternum, along your bra line and then up the side of your body into your armpit.

The great thing about breasts is that you have two of them! If you feel something in one side, double check to see if it’s in the other as this is a good sign. Also remember that breast tissue is generally thick and full of ducts and such so a ‘lump’ or ‘bump’ may actually be normal. Plus, common normal lumps include cysts, fibroadenomas, and fibrocystic changes.

Check for nipple discharge which you can sometimes elicit on the exam.  This can be normal even if you aren’t anywhere near breastfeeding but check in with your health care provider. You may need a prolactin level run which is the hormone that tells your body to make milk (hence pro-lactation, get it?). In some women, this hormone rises with stress.

Lastly, run your hands along the top of your collar bone and into your armpit feeling for lymph nodes just like the ones in your neck.  Breast tissue and the lymphatic system are very intimately connected and we’re looking for lumps or bumps there too.

Remember that not everything in the breast is cancer and it’s important to periodically check in with your breast tissue and compare sides.  It may take you a couple of times to really understand what all is going on in there but on the chance you do develop something new, you’ll know right away.

For more information, check out 5 Ways to Reduce your Breast Cancer Risk or get basic breast facts from the Komen Foundation.

Dr. Carrie Jones has practices in Tigard and Sherwood, Oregon where she focuses in all aspects of women's health. She is an adjunct professor at the National College of Natural Medicine, and writes and speaks regularly on the subject of women's medicine.