A breast self-exam is an examination of your breasts that you do yourself. It's a way for you to notice any changes, lumps, or abnormalities in your breasts. It's also a chance for you to become familiar with what is normal for your breasts. 

When breast cancer first develops, there may be no symptoms at all but as the cancer grows, it can cause the following changes:

• Lumps: The breast is naturally lumpy and regular. Monthly breast checks allow you to become familiar with the natural lumps and changes in the breast. A new lump or change or a hard, firm lump, not noticed before, is the kind of change to check for and if this is found and persists you should be bring this to the attention of your doctor immediately. Cancer changes can occur throughout the breast but common sites/areas for breast cancer is the upper outer quadrant of the breast and underneath the nipple of the breast.
  
• Nipple discharge or thickening can be a sign of breast cancer. If discharge from the nipple is new and is only coming from one breast and is bloody or occurs for the first time in an individual who is post-menopausal, prompt evaluation by a provider is recommended. Some discharge from the nipple is due to benign causes including certain medications such as birth control pills. Infections can be another cause of breast discharge and you should check with your doctor.
• A new thickness or fullness may be another indicator of breast cancer.
• A change in the breast size or shape may be another indicator of a breast change that should lead to an evaluation by your provider.

When should I conduct a breast self-examination?
If you are still having monthly cycles/periods, the best time to perform this examination is during day 1-5 of the cycle.

If you are older or have stopped having cycles/periods, it is suggested that you select one day out of each month (a day that you know you routinely perform some task on such as the day that you pay your electric bill) and perform the examination on that day.

Mammography is a type of imaging that is designed to find changes in the breast that might suggest cancer. It is currently recommended that women of average risk should begin undergoing screening mammograms annually starting at age 40. Mammograms are pictures of the breast and usually 2 pictures/images are taken during a screening evaluation.

What do radiologists look for?
When evaluating a mammogram for breast cancer, a radiologist carefully inspects the pictures/images for differences between your breasts and studies them carefully for signs of densities/lumps and/or calcifications.

Some breast cancers will appear as a density on an x-ray with a rounded or an irregular spot that shows up as a white area on the film. To better characterize these changes, another mammogram and/or ultrasound will be requested to determine if this changes is one that should be removed or tested with a biopsy.

Calcifications are deposits of calcium in the breast-they appear as small white spots on a mammogram. In the early development of mammograms, calcifications with certain features were found to occur more commonly with changes that suggest breast cancer. There are several forms of calcifications that can occur and be seen on mammography, however, not all calcifications suggest cancer but may require more testing.

By: Dr. Sharon T. Wilks, MD, FACP 
Cancer Committee Chair, Baptist Health System