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Monthly Self-Examination

The earliest detection of symptoms of any malignancy in breasts can be done by a woman herself, by physical self-examination of her breasts, preferably every month, few days after her menstrual cycle.

Breast profile:
   A Ducts
   B Lobules
   C Dilated section of duct to hold milk
   D Nipple
   E Fat
   F Pectoralis major muscle
   G Chest wall/rib cage

   A Normal duct cells
   B Basement membrane
   C Lumen (center of duct)

Breast cancer, in simple terms, is the uncontrolled growth of malignant cells in a breast, as a result of mutations or abnormal changes in the genes responsible for regulating healthy growth of cells. A group of such cells constitute a tumour, which may be either benign (not dangerous to health) or malignant/dangerous. Malignant tumors in breast, unless they are classified as non-invasive, have a tendency to spread beyond original tumor site to other parts of the body. (Refer to image titled Anatomy of breast and MS Word document titled Anatomy of Breast)

Breast cancer is mainly of two types:

   Ductal carcinoma – Cancer which occurs in milk ducts; and
   Lobular carcinoma – Cancer occurs in the milk secreting breast lobules

Breast cancer can further be divided into following types, depending upon its tendency to spread to different parts of body. These types can be classified as:

In-situ breast cancer – The cancer cells remains confined within their place of origin and do not attack surrounding breast tissue; and
Invasive or metastatic breast cancer – The cancer cells, apart their place of origin, spread to different parts of the body.

Breast Cancer Symptoms: Following abnormalities in the breast anatomy are suggestive breast cancer symptoms:

   Unusual swelling of all or one specific part of the breast
   Continuous skin irritation or dimpling
   Persisting pain in breast
   Persisting nipple pain or inversion of nipple
   Inflammation or thickening of the nipple or breast skin
   An unusual discharge from the nipple other than breast milk
   Lump in the breast or underarm area

Breast cancer causes: The definite cause(s) of breast cancer are not known, but primarily the following causes have been attributed to cause breast cancer:

Age factor:
The risk of developing breast cancer increases as a woman gets older. A majority of breast cancer cases are found in women over age 50. 16% of women aged between 40-60 years have breast-related problems, and complain of breast lumps. These breast lumps may carry a potential breast cancer risk.

Genetic factors:
Presence of breast cancer genes BR CA1 and BR CA2 in chromosomes increases the chance of developing either breast or ovarian cancer, or both, by 85%. Do you know that actress Christina Applegate was diagnosed with BR CA1 gene and opted for surgical removal of both her breasts, though malignant tumour was diagnosed in only one of her breasts. She opted for removal of both her breasts to eliminate any chances of recurrence of breast cancer at a later age, which was caused due to this gene.

Family History:
A family history of breast cancer or any other cancer, increases a woman’s risk of developing breast cancer by 3 to 5 times. If a close relative was diagnosed with breast, uterine, ovarian, or colon cancer, the chances of breast cancer are more. About 20 – 30% of women with breast cancer have a family history of disease.

Hormonal disturbances and imbalance:
Woman who do not bear children or bear children at a late age are at increased risk to developing breast cancer. Similarly, women who started their menstrual periods before age 12 and women reached menopause after age 55, are also at an increased risk of developing breast cancer.

Breast Self Examination:

Coming back to detection of breast cancer, every woman from age 20, should herself physically examine her breasts monthly. Breast self examination is a very simple procedure to detect any changes/abnormalities in the breast. We
came across this comprehensive procedure along with graphic images for Breast Self Examination on and we have reproduced the same below:

Step 1:
Begin by looking at your breasts in mirror with your shoulders straight and your arms on your hips. Here’s what you should lookfor:

Breasts that are their usual size, shape, and color.

Breasts that are evenly shaped without ANY visible distortion or swelling.

If you see any of the following changes, bring them to your doctor’s attention:

impling, puckering, thickening or bulging of the skin.

nipple that has changed position or an inverted nipple (pushed inward instead of sticking out).

edness, soreness, rash, or swelling.

Step 2:

Raise your arms and look for the same changes as described in Step 1.

Step 3:

While you’re at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).

Step 4:
Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.

Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you’ve reached the deep tissue, you should be able to feel down to your ribcage.

Step 5:

Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in Step 4

ny changes/abnormalities noticed during Breast Self examination should be immediately brought to notice of a medical practitioner/doctor. However, every lump or any other symptoms above described are not necessarily malignant tumors, but should be immediately examined by a doctor.

Apart from Breast self examination, early detection involves:

Clinical breast exams by a medical professional Screening mammography.
Mammography, Breast MRI and Breast Ultrasound to help identify the breast lump
Breast ultrasound to show whether the lump is solid or fluid-filled

Breast biopsy, needle aspiration, or breast lump removal to remove all or part of the breast lump for closer examination under microscope

   CT scan
   Sentinal lymph node biopsy
   PET scan

Most experts recommend that women of age 20 and above should examine their breasts once a month during the week following the menstrual period. Women between the ages 20 and 39 should have a doctor examine their breasts at least once every 3 years.

After age 40:

Women of age 40 years and older should have a mammogram every 1 – 2 years, depending on their risk factors. Women should call their doctor immediately if they notice in change in their breasts whether or not they do routine breast self-exams.

Note: A lump can be any size or shape and can move around or remain fixed. Of special concern are specific or unusual lumps that appear to be different from the normal varying thicknesses in the breast.

Disclaimer: This article is not intended to provide medical advice in any manner and is meant only to create awareness among readers for early detection of Breast Cancer. A substantial amount of information provided in this article is procured from

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