How to self-examine breasts at home: 8 medical-standard steps for breast cancer self-checks

Breast cancer is one of the most common cancers among women worldwide. According to the World Health Organization (WHO), over 2 million new cases are reported annually. Alarmingly, many cases are only detected when the tumor has grown large or clear symptoms appear, making treatment more challenging.

In reality, many people do not know what abnormal breast changes look like or often overlook minor signs in the early stages. That is why breast self-examination is encouraged by many experts as a self-monitoring health measure at home. Regular check-ups help you become familiar with the normal shape and feel of your breasts, making it easier to recognize any abnormal changes if they occur.

In this article, Tiptory will provide detailed instructions on how to perform a breast self-examination at home, the appropriate time for examination, and important signs to look out for to proactively protect your health.

Part 1: Why Perform a Breast Self-Examination? The Golden Time to Know

Step 1: How to Perform a Breast Self-Examination Correctly

Why should you perform regular breast self-examinations?

Many people choose to perform regular breast self-examinations at home to monitor their health and detect abnormal changes in their breasts early. Regular checks help you become familiar with the normal shape, size, and feel of your breasts, making it easier to notice any unusual signs you might have previously overlooked.

Benefits of regular breast examinations include:

• Helps detect abnormal changes early.
• Increases the ability to recognize suspicious signs of breast cancer.
• Proactively monitors health between specialist visits.
• Supports early detection for timely examination and treatment.

Breast self-examination does not replace specialized screening methods

Although breast self-examination is a useful tool, this method cannot replace professional screening techniques such as mammography or clinical breast examinations.

Specialized methods are capable of:

• Detecting small lumps that cannot be felt.
• Identifying microcalcifications or abnormal lesions within breast tissue.
• More accurately assessing breast cancer risk.
• Supporting diagnosis and monitoring treatment when necessary.

Therefore, in addition to self-examining your breasts at home, you should still follow screening programs as advised by your doctor.

What can a breast self-examination help detect?

The goal of a breast self-examination is to look for abnormal signs that may be related to precancerous lesions or early-stage breast cancer.

When performing a self-examination, you should pay attention to:

• New lumps or hard spots.
• Unusual thickening of the skin.
• Changes in breast shape or size.
• Retracted or deformed nipples.
• Wrinkled, dimpled, or orange-peel-like breast skin.
• Unusual discharge from the nipple.

Early detection of these signs can lead to more effective treatment if a medical condition arises.

Should you perform a breast self-examination?

Currently, there is insufficient scientific evidence to show that breast self-examination reduces breast cancer mortality. For this reason, some health organizations do not consider it a mandatory screening method.

However, many experts still believe that breast self-examination offers certain value because:

• It helps raise awareness about breast health.
• It encourages a habit of regular body monitoring.
• It increases the likelihood of detecting abnormal changes between regular check-ups.
• It supports patients in proactively seeking medical attention when suspicious signs appear.

Who should perform breast self-examinations?

Everyone can perform a breast self-examination at home, regardless of gender.

It is especially important to maintain this habit for:

• Adult women.
• Individuals with a family history of breast cancer.
• Individuals who have previously had breast conditions.
• Men with risk factors for breast cancer.

Although the incidence of breast cancer in men is lower than in women, it can still occur. In many cases, men are diagnosed later, making treatment more difficult. Therefore, observing and checking for abnormal changes in the chest area is still very essential for both men and women.

Step 2: Factors That Increase Breast Cancer Risk

Identify your personal breast cancer risk

Not everyone has the same risk of developing breast cancer. Several factors related to genetics, medical history, and past treatments can increase the likelihood of developing the disease. Understanding these risk factors will help you be more proactive in breast cancer screening, health monitoring, and early detection of abnormalities.

BRCA1 or BRCA2 gene mutations

Some people carry mutations in the BRCA1 or BRCA2 genes, two genes that play a role in controlling cell growth in the body.

• Women with BRCA1 or BRCA2 mutations have a significantly higher risk of breast cancer compared to the general population.
• Men with BRCA2 mutations also have a higher-than-average risk of breast cancer.
• These gene mutations can be inherited from either parent.

If there are many people in your family with breast cancer or ovarian cancer, you should discuss genetic counseling and testing with your doctor if necessary.

Previous breast cancer diagnosis

Individuals who have been previously diagnosed with and treated for breast cancer have a higher risk of cancer recurrence in the same breast or the remaining breast compared to those who have never had the disease.

You should:

• Maintain follow-up appointments as advised by your doctor.
• Undergo regular screening methods.
• Monitor for any unusual changes in the breast and armpit areas.

Having a family member with breast cancer

Family history is one of the important risk factors.

The risk can be higher if:

• Your mother, sister, or daughter had breast cancer.
• A family member was diagnosed with the disease at a young age.
• Many family members have breast cancer or related cancers.

In these cases, your doctor may recommend earlier breast cancer screening than the usual age.

Previous chest radiation at a young age

Individuals who received radiation therapy to the chest between the ages of 10 and 30 have a higher risk of developing breast cancer later in life.

The reasons are:

• Radiation can affect developing breast tissue cells.
• The risk can appear many years or decades after treatment ends.

If you belong to this group, you should discuss with your doctor to establish a plan for regular breast examinations and screening tailored to your risk level.

When should you proactively screen early?

You should pay particular attention to breast self-examination, specialist examinations, and regular screening if you have one or more of the risk factors mentioned above. Detecting abnormalities at an early stage often helps increase treatment effectiveness and improve long-term prognosis.

Step 3: When to Start Breast Self-Examination

At what age should you start breast self-examination?

Experts recommend forming the habit of breast self-examination at home from around age 20. Regular checks help you understand the normal characteristics of your breasts and easily recognize abnormal changes over time.

For more effective monitoring, you should:

• Perform a breast self-examination once a month.
• Remember the normal shape, size, and feel of your breasts.
• Monitor for signs such as lumps, skin changes, or unusual nipple discharge.
• Proactively seek medical attention if you detect any suspicious signs.

Maintain a monthly breast self-examination schedule

Regular self-examination is not intended to diagnose breast cancer but helps you detect abnormal changes early between specialist visits.

To establish a long-term habit, you can:

1. Choose a fixed time each month.
2. Perform the examination in good lighting.
3. Observe and palpate both breasts following the same procedure.
4. Note any changes to easily track them in subsequent examinations.

When should you get a mammogram?

In addition to breast self-examination, mammography is an important screening method that helps detect lesions that are difficult to identify through self-examination.

Current common recommendations include:

• Regular mammograms should start around ages 40–45.
• Screening should not be delayed after age 45.
• From age 55 onwards, mammograms can continue annually or every two years, depending on doctor's advice and individual health status.

High-risk individuals need earlier screening

If you belong to a high-risk group for breast cancer, your doctor may recommend starting screening earlier than for the general population.

Cases generally considered high-risk include:

• Having BRCA1 or BRCA2 gene mutations.
• Having many family members with breast cancer.
• Having previously had breast cancer or precancerous lesions.
• Having received chest radiation at a young age.

In these cases, breast cancer screening, specialist examinations, and mammograms may be indicated from around age 40 or earlier, depending on the doctor's assessment.

Combine self-examination and regular screening to protect your health

Breast self-examination is a simple yet useful habit for monthly health monitoring. However, for earlier and more accurate detection, you should combine breast self-examination at home, clinical breast examination, and regular mammograms according to your age and individual risk level.

Step 4: Regular Clinical Breast Examination

Don't skip breast exams at medical facilities

In addition to performing a breast self-examination at home each month, you should also undergo regular Clinical Breast Examinations (CBE). This is an examination performed by a doctor or qualified medical professional to detect abnormalities that a patient might not notice themselves.

Typically, a clinical breast examination is performed:

• During annual routine health check-ups.
• During regular gynecological exams.
• When abnormal signs appear in the breast or armpit area.
• According to a personalized follow-up schedule for individuals at high risk of breast cancer.

What will the doctor observe?

The first step of the examination process is visual inspection to assess the shape and external condition of the breasts.

The doctor will pay attention to:

• Changes in breast size or shape.
• Abnormal wrinkled, dimpled, or retracted skin areas.
• Thickened breast skin or an orange-peel-like appearance.
• Retracted or displaced nipples.
• Unusual discharge from the nipple.

These changes can sometimes be early warning signs of breast conditions, including breast cancer.

Manual examination to detect abnormalities

After visual inspection, the doctor will palpate the breast tissue and related areas for a more thorough examination.

Areas typically assessed include:

1. The entire glandular tissue of both breasts.
2. The area around the nipple.
3. The areas above and below the collarbone.
4. Lymph nodes in both armpits.

The purpose is to detect:

• Abnormal lumps or hard spots.
• Unusual thickening of tissue.
• Swollen armpit lymph nodes.
• Changes that require further specialized investigation.

Does a clinical breast exam replace mammography?

The answer is no. Each method has its own role in breast cancer screening.

• Breast self-examination helps monitor monthly changes.
• Clinical breast examination provides professional assessment from a doctor.
• Mammography helps detect small lesions within breast tissue that are difficult to feel by touch.

Combining all three methods will increase the likelihood of early detection of abnormalities and improve treatment effectiveness if the disease is diagnosed at an early stage.

When should you see a doctor immediately?

You should proactively visit a medical facility if you detect any of the following signs:

• A new lump appears in the breast or armpit.
• The breast changes shape or size unusually.
• The nipple suddenly retracts.
• Nipple discharge, especially bloody discharge.
• The skin in the breast area is red, swollen, thickened, or unusually wrinkled.
• Persistent pain without a clear cause.

Regular clinical breast examinations combined with breast self-examination and appropriate screening methods are effective ways to proactively protect your health and detect early signs of breast abnormalities.

Step 5: Specialized Tests for High Risk

When are specialized tests necessary?

In many cases, breast self-examination, clinical breast examination, and mammography are sufficient for monitoring breast health. However, if you are in a high-risk group for breast cancer, your doctor may order additional specialized diagnostic methods for a more accurate assessment.

You may be considered for supplementary tests if:

• Many family members have breast cancer.
• You carry BRCA1 or BRCA2 gene mutations.
• You have previously had breast cancer or precancerous lesions.
• You have a history of chest radiation at a young age.
• You are assessed as having a higher-than-average risk of breast cancer.

What is breast MRI?

Breast MRI is an imaging technique that uses magnetic fields and radio waves to create detailed images of breast tissue.

Compared to many other screening methods, MRI has the ability to:

• Observe breast tissue structures in more detail.
• Detect very small lesions.
• Aid in risk assessment for individuals with a complex family history.
• Provide additional information for cases requiring specialized monitoring.

This method is usually used in conjunction with other screening techniques and does not completely replace mammography.

Advantages of breast MRI

MRI is considered one of the highly sensitive methods for detecting breast abnormalities.

Some notable benefits include:

• Increases the ability to detect lesions at an early stage.
• Supports the evaluation of cases with dense breast tissue.
• Provides detailed images for doctors when monitoring or planning treatment.
• Suitable for high-risk groups for breast cancer.

Limitations to note

Despite its high sensitivity, MRI does not always provide absolutely accurate results.

Some limitations may include:

• Easily detects non-cancerous abnormalities.
• Higher false positive rates compared to some other methods.
• May lead to unnecessary additional tests.
• In some cases, the patient may need a biopsy to accurately determine the nature of the lesion.

Therefore, MRI results always need to be evaluated by a specialist in conjunction with medical history, clinical symptoms, and relevant tests.

Choosing the right screening method

Not everyone needs a breast MRI. The choice of breast cancer screening method should be based on age, risk factors, and individual health status.

If you are at high risk or have a family history of the disease, talk to your doctor for advice on a suitable monitoring plan. Combining self-breast examination at home, regular specialist check-ups, and necessary tests will help improve the ability to detect abnormalities in the breast early.

Part 2: Home Breast Self-Examination Guide: 8-Step Process

Step 1: The best time for breast self-examination

How often should you perform a breast self-examination?

To effectively monitor your health, you should perform a breast self-examination at home about once a month. Regular checks help you easily recognize abnormal changes in your breasts over time instead of only checking when symptoms appear.

Benefits of maintaining a monthly check-up schedule:

• Familiarization with the normal structure of the breast.
• Easy detection of new lumps or abnormal tissue areas.
• Monitoring changes in skin, nipples, or armpit area.
• Proactive early detection of suspicious signs of breast cancer.

Ideal time for breast self-examination

For menstruating women, the most suitable time to perform a breast self-examination is about 5–7 days after the menstrual period ends.

The reason is:

• Hormone levels are more stable.
• Breast tissue is less swollen and less sensitive.
• Breast pain or tenderness is significantly reduced.
• Easier to detect abnormal lumps if present.

Choosing the same time in each cycle also helps to compare changes more accurately.

What if menstruation is irregular?

Those with unstable menstrual cycles can still maintain the habit of breast self-examination at home by choosing a fixed day each month.

For example:

• The 1st of every month.
• The 15th of every month.
• The last day of each month.

It is important to maintain a regular check-up schedule to easily monitor abnormal changes over time.

What should menopausal or non-menstruating women do?

If you are menopausal or no longer menstruating for any reason, you should also choose a fixed day each month to perform a regular breast self-examination.

Maintaining this habit helps to:

• Not miss check-ups.
• Create continuity in the process of monitoring breast health.
• Support early detection of abnormal signs.

Monthly breast examination is not mandatory

Although many experts recommend performing a breast self-examination every month, the frequency of examination can be adjusted according to individual needs and comfort.

The most important thing is to:

1. Understand the normal condition of your breasts.
2. Pay attention to new changes that appear.
3. See a specialist if you find any abnormal signs.
4. Combine self-examination with appropriate breast cancer screening methods according to age and individual risk.

Maintaining a regular breast health monitoring habit will help you be more proactive in early detection of potential problems and protect your long-term health.

Step 2: Observe your breasts in the mirror

1. Stand in front of a mirror for visual inspection

One of the important steps in breast self-examination at home is to carefully observe the external changes of the breasts. This method helps detect abnormal signs that may sometimes not be recognized by palpation.

Do the following:

1. Take off your shirt and bra.
2. Stand straight in front of a mirror in a well-lit area.
3. Keep your body in a comfortable position to easily observe both breasts.

2. Place hands on hips and observe carefully

After standing in front of the mirror, place both hands on your hips and press down lightly to tense the chest muscles. This makes abnormal changes on the breast surface more noticeable.

When observing, pay attention to:

• Changes in size between the two breasts.
• Changes in the shape or contour of the breasts.
• Dimpled or abnormally wrinkled skin.
• Folds, retractions on the skin surface.
• Changes in nipple position.

3. Check breast skin and nipples

Carefully observe the entire skin and nipple area to detect abnormal signs that may be related to breast disease.

Signs to look out for include:

• Red or persistent irritated skin.
• Peeling, scaling, or abnormally thickened skin.
• Nipple shape changes.
• Newly inverted nipples.
• Skin that is rough or has an orange peel appearance.

If these changes persist or appear suddenly, you should schedule a specialist examination for an accurate assessment.

4. Observe under and on both sides of the breast

Many people only check the front of the breast and miss less visible areas.

To check thoroughly:

1. Gently lift each breast.
2. Observe the lower part of the breast.
3. Turn your body left and right in front of the mirror.
4. Check the outer part of the breast and the area adjacent to the armpit.

Observing from multiple angles increases the likelihood of detecting abnormal changes in the skin or breast tissue.

5. Check the armpit area

The armpit area is where many lymph nodes are concentrated and is also an area that needs to be monitored during breast self-examination.

How to do it:

• Raise your arm to a moderate angle, not fully extended overhead.
• Observe the underarm area in the mirror.
• Check for any signs of swelling, lumps, or abnormal changes.

Raising your arm too high can tense the armpit muscles, making observation less accurate.

Abnormal signs to remember

During breast self-examination in front of a mirror, pay special attention if one or more of the following signs appear:

• Breast changes in size or abnormal shape.
• Wrinkled, dimpled, or retracted breast skin.
• Red, thickened, or persistently peeling skin.
• Inverted or deformed nipples.
• Swelling or abnormal lump in the armpit area.

If you notice any persistent changes or differences from your body's normal state, you should go to a medical facility for examination and professional advice. Early detection always plays an important role in monitoring and protecting breast health.

Step 3: Correct posture for breast self-examination

Choose a lying position for easier examination

When performing a breast self-examination at home, the supine position is often recommended by many experts because it helps the breast tissue spread evenly over the chest wall. This makes it easier to feel the underlying tissue and increases the ability to detect small abnormalities.

How to do it:

1. Lie on your back on a bed or flat sofa.
2. Place a thin pillow under your right shoulder if you feel more comfortable.
3. Raise your right arm above your head.
4. Keep your body relaxed before starting the examination.

This position helps the breast glandular tissue to be evenly distributed, supporting a more accurate breast self-examination.

Why is the lying position recommended?

When lying on your back, breast tissue is not pulled down by gravity as when standing.

As a result, you can:

• Easily feel breast tissue areas.
• Detect hard lumps or abnormal lumps more clearly.
• Examine the entire breast evenly.
• Reduce the chance of missing small changes in breast tissue.

This is why many guides on how to properly perform a breast self-examination prioritize performing the palpation step in a lying position.

Can you perform a breast self-examination while standing?

The answer is yes. Some experts believe that examination while standing can provide another perspective, helping to evaluate breast tissue in different states.

You can:

• Perform it once while lying down.
• Check again while standing in front of a mirror.
• Combine both methods if you want to monitor more closely.

The choice of posture depends on each person's comfort and observation ability.

Breast self-examination in the shower is also a convenient option

Many people find it easier to check during or immediately after showering.

The reason is:

• Skin is wet and slippery.
• Fingers move gently over the skin surface.
• Easier to feel unusual tissue areas.
• Convenient for maintaining regular check-ups.

If you choose this method, take a few minutes to carefully examine the entire breast and armpit area.

Choose the method that suits you

There is no single posture that is suitable for everyone. The important thing is that you feel comfortable and can thoroughly examine all breast tissue areas.

To make breast self-examination for early detection of abnormalities more effective, you should:

• Maintain the same examination method every month.
• Check at the same time in your menstrual cycle.
• Observe in combination with palpation.
• Monitor and remember new changes that appear.

Whether performed lying down or standing, the goal of home breast self-examination is to help you recognize abnormal signs early and proactively seek medical attention when necessary.

Step 4: How to palpate breasts for abnormalities

1. Start from the armpit area

After getting into the correct position, use your left hand to examine your right breast. The armpit area is a good place to start because it contains many lymph nodes and is also where abnormalities can appear early.

Follow these steps:

1. Place the pads of your three middle fingers of your left hand on your right armpit area.
2. Use the soft pads of your fingertips, not your fingernails.
3. Press gently but firmly enough to feel the tissue underneath the skin.
4. Move slowly to feel for changes in tissue structure.

2. Make small circular motions

When performing a breast self-examination at home, instead of gliding your fingers in a straight line, make small circular motions with the pads of your fingers.

How to do it:

• Use your three middle fingers held close together.
• Rotate your fingers in small circles.
• Maintain steady and continuous movement.
• Check each tissue area before moving to the next position.

This technique helps you feel the breast tissue more uniformly and reduces the chance of missing areas that need to be checked.

3. Move in systematic rows

To ensure thorough examination of the entire breast, move your fingers in a fixed sequence instead of checking randomly.

A simple way is to follow a zigzag pattern from top to bottom:

1. Start from the armpit area.
2. Move horizontally across the breast tissue.
3. Move down a small distance.
4. Move back horizontally in the opposite direction.
5. Continue repeating until the entire breast has been examined.

This method is like mowing a lawn in parallel strips, helping to cover the entire area to be examined.

4. Check all breast tissue and armpit area

During your breast self-examination, don't just focus on the center of the breast.

Be sure to check thoroughly:

• The area above the breast.
• The area below the breast.
• The outer part near the armpit.
• The area around the nipple.
• The entire armpit area.

Many abnormalities can appear in the tail of the breast extending towards the armpit, so this area needs to be thoroughly examined.

5. Pay attention to abnormal signs

While palpating, pay attention if you detect:

• New lumps or hard masses.
• Abnormally thickened tissue area.
• Enlarged lymph nodes in the armpit.
• An area that feels distinctly different from the rest of the breast.
• Persistent pain or discomfort at a fixed location.

Not all lumps are breast cancer, but any new changes should be evaluated by a doctor to determine the cause.

Maintain the same procedure every month

To make breast self-examination for early detection of abnormalities more effective, try to follow the same procedure each time you check.

This helps you:

• Remember the normal structure of your breasts.
• Recognize changes faster.
• Reduce the chance of missing areas that need to be checked.
• Monitor breast health more consistently and accurately over time.

Step 5: Increase pressure to check deeper

Recheck with firmer pressure

After completing the breast self-examination with light pressure, repeat the entire process once more with firmer pressure. Changing the pressure helps you check the deeper layers of tissue within the breast that the initial check may not have fully assessed.

Follow these steps:

1. Maintain the same movement procedure used previously.
2. Continue making small circles with the pads of your three middle fingers.
3. Gradually increase the pressure in a moderate and comfortable way.
4. Examine the entire breast and armpit area in the same sequence.

Why is it necessary to check at different pressure levels?

Breast tissue is made up of different layers. Using various pressure levels helps to assess it more comprehensively.

• Light pressure helps examine tissues near the skin's surface.
• Medium pressure helps feel the middle layer of tissue.
• Stronger pressure helps reach deeper tissues near the chest wall.

This technique is commonly taught in at-home breast self-exams to reduce the chance of missing potential abnormalities.

Feeling your ribs is normal

When increasing pressure, you may feel hard structures beneath the breast tissue.

This usually includes:

• Ribs.
• Chest wall.
• Muscles under the mammary glands.

These are normal anatomical structures and not signs of abnormality. Over time, regular checks will help you become more familiar with the natural feel of your body.

The area around the nipple is often thicker

During a breast self-exam, many people worry when they notice that the tissue around the nipple feels thicker or firmer than other areas.

Typically, this can be related to:

• Milk duct system.
• Glandular tissue concentrated around the areola.
• Natural structure of the breast.

Therefore, feeling thicker tissue in the area near the nipple is often a normal physiological phenomenon.

When to pay special attention?

Although breast tissue structure can vary between individuals, you should monitor carefully if you detect:

• A new, hard lump.
• Abnormally thickened tissue in only one spot.
• A lump that does not disappear over time.
• An area that feels distinctly different from the surrounding tissue.
• Accompanying changes such as pain, nipple discharge, or skin changes in the breast area.

If you experience these signs, schedule a specialist appointment for an accurate assessment.

Combine shallow and deep examination for increased effectiveness

A proper breast self-exam should include both light and stronger pressure checks. This helps you assess the entire breast tissue from the surface to the deep layers, increasing the ability to detect early abnormal changes that need further monitoring.

Step 6: Proper Nipple Examination

Examine nipples after checking the entire breast

After completing the at-home breast self-exam steps, do not forget to examine your nipples. This area can show some abnormal signs related to breast diseases, including early-stage breast cancer.

A nipple examination only takes a few minutes but can help you identify important changes that need further monitoring.

How to examine your nipples

Perform for each breast sequentially:

1. Gently hold the nipple between your thumb and forefinger.
2. Squeeze very lightly with moderate pressure, avoiding excessive force.
3. Observe and feel for any abnormal changes.
4. Repeat the same process for the other side.

The purpose is to check for any abnormal lumps or discharge.

Signs to watch out for

During your breast self-exam, pay close attention to the following signs:

• A hard lump or small nodule around the nipple.
• A newly inverted nipple.
• Changes in nipple shape or position.
• Thickened, flaky, or scaly skin around the nipple.
• Persistent pain or discomfort in the nipple area.

If these signs do not disappear or become more pronounced, you should visit a medical facility for examination.

Checking for nipple discharge

One of the important aspects of a proper breast self-exam is to observe if there is any abnormal nipple discharge.

You should take note if you experience:

• Spontaneous discharge when not pregnant or breastfeeding.
• Discharge appearing only from one breast.
• Discharge that is clear, yellow, brown, or bloody.
• Persistent or recurrent discharge.

Not all cases of discharge are a sign of breast cancer, but this symptom needs to be evaluated by a doctor to determine the cause.

What is considered normal?

During the examination, many people notice that their two breasts or two nipples are not perfectly symmetrical.

This is usually normal if:

• The difference has existed for a long time.
• No new symptoms appear.
• No lumps, persistent pain, or abnormal discharge.

The important thing is to pay attention to new changes compared to the body's normal state.

When should you see a doctor?

You should proactively seek medical attention if you notice any of the following signs:

• A hard lump around the nipple or in the breast tissue.
• Sudden nipple inversion.
• Abnormal discharge, especially bloody discharge.
• Persistent flaking or ulceration of the skin around the nipple.
• Unexplained changes in nipple shape.

Combining nipple examination with regular breast self-exams helps to comprehensively monitor breast health and increases the ability to detect early abnormalities that require specialized evaluation.

Step 7: Examine the other breast

Repeat the entire process with the other breast

After completing your breast self-exam on the right side, continue to perform all the same steps on the left side. Checking both sides helps you compare and detect abnormal changes that may only appear in one breast.

Remember that each breast may have slight differences in size or shape. The important thing is to recognize new changes rather than focusing only on natural differences between the two sides.

How to examine the left breast

Follow these steps:

1. Raise your left arm above your head or place it behind your head.
2. Use your right hand to examine the left breast.
3. Use three middle fingers to palpate the breast tissue.
4. Move in the same sequence as applied to the right breast.
5. Examine the entire left breast area, areola, nipple, and armpit area.

Maintaining the same method on both sides helps make the at-home breast self-exam consistent and more accurate.

Thorough examination from shallow to deep

Similar to the right breast, you should examine with various pressure levels.

• Light pressure to assess tissue near the skin surface.
• Medium pressure to examine the middle tissue layer.
• Stronger pressure to feel deeper tissues near the chest wall.

This approach increases the ability to detect abnormal changes throughout the entire breast tissue structure.

Don't skip the armpit area

During an at-home breast self-exam, the armpit area needs to be checked on both sides because this is where many lymph nodes related to the breast are concentrated.

Pay attention to:

• Abnormally swollen lymph nodes.
• Hard lumps under the skin.
• Persistent swelling or pain.
• New changes compared to previous examinations.

Can be performed standing or lying down

Although a lying position often makes breast tissue easier to examine, you can still apply the same procedure while standing.

Many people choose to:

• Examine while lying in bed.
• Perform an additional check while standing in front of a mirror.
• Perform it in the shower to make fingers move more easily on the skin.

Regardless of the position chosen, the important thing is to ensure that all breast tissue is examined systematically.

Complete the breast self-exam process

After examining both breasts, take a few minutes to remember or note any changes if they occur.

You should monitor:

• Lumps or abnormally thickened tissue.
• Changes in the nipple.
• Abnormal discharge.
• Changes in breast size or shape.
• Abnormal signs in the armpit area.

If you detect any suspicious signs, proactively go to a medical facility for examination. Combining regular breast self-exams, clinical breast exams, and appropriate breast cancer screenings will help increase the chances of early detection and protect long-term health.

Step 8: When should you see a doctor?

Abnormal lumps need early check-up

After performing a breast self-exam at home, if you find a lump or an abnormal area of tissue, you should proactively contact a doctor for examination and accurate assessment.

Some characteristics of a lump that require special attention include:

• Feeling hard or firmer than the surrounding tissue.
• Rough or uneven surface.
• Indistinct, distorted, or irregular borders.
• Feeling firmly attached to the underlying tissue and difficult to move when palpated.
• Newly appeared or changed over time.

These signs do not necessarily mean breast cancer, but they need to be checked by a doctor to determine the cause.

How to distinguish between normal and abnormal lumps?

This is one of the common difficulties when performing a breast self-exam. Many women have naturally heterogeneous breast tissue and may feel areas of thickness or lumpiness that are not related to disease.

The goals of a regular breast self-exam are:

• Understand the normal structure of the breast.
• Recognize newly appearing changes.
• Easily detect unusual lumps compared to before.
• Monitor changes in breast tissue over time.

The more consistently you perform checks, the easier it will be to recognize what is normal for your body.

Ask your doctor for guidance if you are unsure

If you have difficulty recognizing the normal structures of your breast, do not hesitate to discuss it with your doctor during your regular check-ups.

Your doctor can:

• Provide guidance on how to properly perform a breast self-exam.
• Explain common physiological changes in breast tissue.
• Point out signs that need further monitoring.
• Advise on appropriate screening schedules based on age and individual risk.

Expert guidance will help you feel more confident in monitoring your breast health at home.

Even small lumps should be checked

Many people only seek medical attention when they find a large or painful lump. However, any abnormal change should be evaluated by a doctor, even if:

• The lump is small.
• It causes no pain.
• It appears in only one location.
• It was just discovered for the first time.

Early examination helps rule out serious causes and avoids missing lesions that require treatment.

Do not panic excessively if you find a lump

If you discover a lump during a breast self-exam, it is important to stay calm and schedule an appropriate appointment.

It is important to note that:

• Many breast lumps are benign.
• Cysts, fibroadenomas, and some hormonal changes can also form lumps in the breast.
• Not all lumps are cancerous.
• Only an examination and specialized tests can accurately determine the cause.

Therefore, instead of worrying excessively, view the detection of an abnormality as an opportunity for early examination and protection of your health.

Important principle after a breast self-exam

If you notice any changes such as a new lump, changes in breast skin, abnormal nipple discharge, or swollen lymph nodes in the armpit, contact your doctor as soon as possible. Combining breast self-exams, clinical breast exams, and regular breast cancer screening methods is an effective way to detect abnormalities early and proactively maintain long-term health.

Important notes when performing a breast self-exam

Breast cancer does not only occur in women

Although breast cancer is much more common in women, men can also develop the disease. Due to the low incidence rate, many people tend to be complacent or ignore abnormal signs, leading to late-stage diagnosis.

Men should also pay attention to:

• Lumps or hard masses in the chest area.
• Changes in nipple shape.
• Abnormal nipple discharge.
• Thickened or abnormally retracted skin in the chest area.

Regular health monitoring and early recognition of abnormal signs are still very essential for men.

Transgender people also need to monitor breast health

The risk of developing breast cancer can vary depending on hormone therapy and individual body characteristics.

Some groups that need special attention include:

• Transgender men using testosterone still have a risk of breast cancer, although the risk may be lower compared to cisgender women.
• Transgender women using estrogen may have a higher risk of breast cancer compared to cisgender men.

Therefore, at-home breast self-exams, specialist examinations, and appropriate screening programs are still important measures to protect health.

Breast self-exams do not replace breast cancer screening

One common misconception is that regular breast self-exams are sufficient to detect the disease.

In reality:

• Breast self-exams are only a supplementary method for monitoring health.
• Some very small lesions may not be palpable.
• Many cases of early-stage breast cancer do not cause any symptoms.

Therefore, regular breast self-exams should be considered part of a comprehensive health care plan, not the sole diagnostic method.

The role of mammography in early breast cancer detection

Mammography is currently one of the important and widely used methods for breast cancer screening.

The advantages of this method include:

• Detecting very small lesions before a palpable lump forms.
• Identifying abnormal changes in breast tissue at an early stage.
• Supporting more effective diagnosis and monitoring of breast health.
• Contributing to improved chances of successful treatment when the disease is detected early.

This is why experts always recommend combining breast self-examination with professional screening methods.

Breast ultrasound may be additionally indicated

In some cases, after a mammogram, your doctor may recommend an additional breast ultrasound for a more detailed evaluation.

Ultrasound is often used to:

• Clarify abnormalities found on mammograms.
• Differentiate between solid masses and fluid-filled cysts.
• Aid in evaluating dense breast tissue.
• Provide additional information before deciding on further diagnostic steps.

How to effectively protect breast health

To increase the chance of early detection of abnormalities, you should combine multiple monitoring methods instead of relying on a single approach.

Important steps include:

1. Perform regular monthly breast self-exams at home.
2. Undergo clinical breast exams as recommended by your doctor.
3. Have regular mammograms according to age and risk level.
4. Undergo ultrasound or specialized tests when indicated.
5. Proactively seek medical attention immediately if you notice any unusual changes in your breasts or armpit area.

Combining breast self-examination, breast cancer screening, and regular medical follow-ups will help increase the chance of early detection of breast diseases, thereby improving treatment effectiveness and long-term health protection.

References

1. American Cancer Society. (2024). Breast Cancer Early Detection and Diagnosis. American Cancer Society.
2. American College of Obstetricians and Gynecologists. (2022). Breast Cancer Risk Assessment and Screening in Average-Risk Women. Obstetrics & Gynecology, 139(1), e1–e15.
3. Centers for Disease Control and Prevention. (2024). What Is Breast Cancer Screening? U.S. Department of Health and Human Services.
4. Fayanju, O. M., Ren, Y., Thomas, S. M., Greenup, R. A., Plichta, J. K., Rosenberger, L. H., Hyslop, T., Hwang, E. S., & Troester, M. A. (2020). The Clinical Significance of Breast Self-Examination and Breast Awareness in Breast Cancer Detection. Journal of Surgical Research, 246, 45–52.
5. National Comprehensive Cancer Network. (2025). NCCN Clinical Practice Guidelines in Oncology: Breast Cancer Screening and Diagnosis. National Comprehensive Cancer Network.
6. Oeffinger, K. C., Fontham, E. T. H., Etzioni, R., Herzig, A., Michaelson, J. S., Shih, Y. C. T., Walter, L. C., Church, T. R., Flowers, C. R., LaMonte, S. J., Wolf, A. M. D., DeSantis, C., Lortet-Tieulent, J., Andrews, K., Manassaram-Baptiste, D., Saslow, D., Smith, R. A., Brawley, O. W., & Wender, R. (2015). Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society. JAMA, 314(15), 1599–1614.
7. Siu, A. L., & U.S. Preventive Services Task Force. (2016). Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine, 164(4), 279–296.
8. World Health Organization. (2024). Breast Cancer: Fact Sheets. World Health Organization.
9. Yale Medicine. (2024). Breast Self-Exam (BSE): Benefits, Limitations, and Recommendations. Yale School of Medicine.
10. Yarbrough, W. G., Burns, D. M., Eby, C. S., & Khurana, K. K. (2023). The Washington Manual of Medical Therapeutics (37th ed.). Wolters Kluwer.
    

Content edited by: Ashley Wright Nguyen.

Information consulted and verified by expert: Mia Taylor.