Since Saturday 1 October 2022, the international community has been celebrating the 29th edition of Pink October. This event, which ends on Monday 31 October, is dedicated to the fight against breast cancer in women. And to protect women’s health from this disease, specialists recommend several methods of early diagnosis including breast self-examination.
Breast cancer is one of the most common cancers in women. In 2020, there were more than 2.2 million cases of breast cancer worldwide. Statistics also show that almost 1 in 12 women will develop breast cancer in their lifetime. Breast cancer is the leading cause of cancer death in women. Hence the need and urgency for women to use methods such as self-palpation for the early detection of nodules or other abnormalities in the breast for proper management.
Visual breast examination
The visual inspection of the breasts should be done standing, facing a mirror. It consists of observing:
- the breast itself: a deformity, a change in volume (not caused by a hormonal change, such as menopause, pregnancy or the menstrual cycle), a lump visible to the naked eye, the change in appearance of one breast in relation to the other;
- the nipple: a discharge of fluid or blood, a change in appearance, size or shape, retraction or inversion (the nipple retracts into the breast, into the areola), redness, ulceration or persistent eczema;
- the skin of the chest A change in the appearance or colour of the skin, redness or pigmentation, shrinking or thickening of the skin, the appearance of dimples, orange peel skin, cracks or folds, an ulceration or sore, a change in the appearance of the skin of the areola, a new, very visible vein, etc.
The breasts should be inspected in several positions: arms at the side of the body, arms raised, hands on hips, upper body bent forward and lying on the side.
Palpation of the breasts
Breast cancer often appears as a small lump, noticed and felt by the woman herself. There are several methods and techniques for breast self-examination. In general, there are three steps to self-palpation:
- Step 1: Raise your right arm to feel your right breast. To do this, use the pads of the three middle fingers of your left hand. Start palpating the outer part of the breast, using small rotating movements of the fingertips. Gradually work your way around the entire breast using these movements. Palpation should be firm, careful and thorough. As palpation movements are made, three levels of pressure should be applied: first superficial, then average, and finally strong.
- Step 2: Examine and feel the entire breast, especially the area between the curve of the breast and the armpit. Also consider feeling the hollow of your armpit (also known as the axillary hollow). The aim is to identify, or not, the existence of a possible lump or abnormal mass under the skin. This self-examination can be done standing, sitting or lying down. This can also be done in a bath or shower. Soap tends to make palpation easier by improving the precision of touch.
- Step 3: Finally, examine the nipple. Squeeze it gently and see if it causes a discharge (of fluid or blood). If so, contact your GP or gynaecologist immediately.
Once the right breast is finished, repeat the same steps on the left breast. To do this, use the three middle fingers of your right hand. This method is called the circular method. Other techniques can be used in breast self-palpation. The radial method involves palpating the breast from the nipple to the outside of the breast in a straight line and repeating the process until the breast is completely covered. To follow the vertical method, start at the top of the armpit and palpate the breast from top to bottom in very tight vertical lines.
Regardless of the method used (circular, radial or vertical), breast self-examination can detect the presence of a lump or small ball under the skin.
Other advice
Women aged 25 and over should learn about breast cancer self-examination or make a diagnosis with a health professional. However, from the age of 50 onwards, women should have periodic mammograms.
