Level 1 Exam Instructions

Goal
To know what is normal for your breasts, so you can spot changes quickly and easily.

The most important part of the exam is doing it every month


1. Visual Exam in front of a mirror.

in a large mirror in a well lighted room.

1st Position
 

 

 

 

Arms relaxed by your side.

What to look for
General: any change in size, shape or contour.

Skin Changes:  texture, dimpling, retraction, or scaling of the skin.  soreness, rash, swelling, or flattening.

Nipple Changes:
A nipple that has changed position.
An inverted nipple – pushed inward instead of sticking out.
Redness, swelling or other irregularities.


Important
Repeat the visual inspection as you turn slowly from side to side.  Carefully observe all sides of your breasts.


Important
Lift each breast to check the areas underneath.


2nd Position
Raise your arms over your head.
Repeat the visual exam above.

3rd Position
Rest your palms on your hips.
Repeat the visual exam.

4th Position
Bend forward from the hips with your arms relaxed.
Again repeat the visual exam.


Very Important
Your visual exam has to include all the positions and maneuvers mentioned.


2. Nipple Check
Squeeze each nipple between your finger and thumb.  Check for any discharge.
Report any nipple discharge to your doctor

Push the nipple deep into the hallow beneath it.  Note any unusual resistance, hardness or lump beneath the nipple.


3. Feeling = Palpation

Area to check
Entire breast area.

From armpit to the middle of the chest bone.
From the collar bone to ribs.

Position – Laying Down
Lay flat on your back.
Pillow or folded towel under your right shoulder.
Right arm at a right angle.

Right Breast
Use the left hand for the right breast.
Moisten the pads of your three middle fingertips with body lotion.
Do not use fingertips! They are less sensitive.

Feeling patter – strip or vertical
Move your hand in overlapping small (dime-sized) circular motions, in and up and down pattern.


Important
Never remove your hands from your breast during the examination.
You are feeling for something that varies in size greatly.
It could be from a size of a small pea all the way to much larger size.


Starting place
Start in the underarm area and move your fingers downward little by little, until you reach the ribs below the breast.  Then move your fingers slightly toward the middle, and slowly move back up to the neck or collar bone.


Very Important

Pay special attention to the area between the breast and the underarm, including the underarm itself.

Make sure you include the area beneath the nipple.


Pressure levels
Go over each area using 3 different levels of pressure to feel all the breast tissue.

Light pressure – to feel the tissue closest to the skin.
Soft touch barely move the top layer of the skin.

Medium pressure – feel the middle part of the breast tissue.

Firm pressure – feel the base of the breast tissue closest to the ribs.

Important
Use each pressure level to the feel the breast tissue before moving on to the next spot.

Report any abnormality, lump or thickening found during a breast exam to your physician right away.


Left Breast
Repeat the procedure on your left breast.
Pillow under your left shoulder.
Left hand at the right angle.

Repeat the exam using the finger pads of the right hand.


Congratulations!
Click here to continue to level 2 .