Hey ladies, it’s always good to check in with your girls. No, not your homegirls. Your other girls. According to the American Cancer Society, breast cancer is the most common cancer among women in America aside from skin cancers; the ACS estimates that 281,550 new cases of invasive breast cancer will be diagnosed in 2021. While that number can seem surprising, survival rates have also risen, in part, due to the fact that more women are taking their breast health seriously. Along with mammograms being a major topic of discussions on daytime shows, podcasts and articles alike, regular at-home breast exams are also being encouraged. For those of us who have stepped into our 30s, breast exams, both at-home and performed by your general practice doctor, are essential. If you were like many of us, you may not have gotten the scoop on the things you should do to check in with your buddies and 21Ninety is here to help. 

Follow these four steps according to suggestions from breast cancer surgeon Susan K. Boolbol. 

*these steps work best if followed during a time of the month when your breasts are not affected by hormonal changes—Boolbol recommends the last day or the week of your period*

Step 1 

Look at your breasts in the mirror. The reason being is that the dimpling and breast changes you are looking for may not be sensitive to the touch but can be visible. Here are some questions to ask yourself as you look at yourself according to Boolbol:

Nipple location: "Is there a change in the location of the nipple? Does it seem like it's being pulled to the side, for instance?"

Breast size: "Has one breast gotten larger than the other breast?"

Skin: "Is there a very scaley portion? Is there a change to the skin of the nipple? Is there a change in the skin color of the breast?”

If the answer to any of these questions is ‘yes’, you should make an appointment with your doctor. 

Step 2

You should continue your visual exam with your arms lifted. "The different arm positions can make changes in the breasts more obvious," Boolbol says. "For instance, if there is a mass in the breast and you put your arms up in the air, it may pull in. It may cause the skin to pull in at a certain region overlying the mass; whereas with your arms down by your side, that may not happen.” You can also look out for nipple discharge that is occurring without applying pressure to the nipple area. 

Step 3

Start the physical part of your breast exam. You want to continue this part in the same location and position as the visual exam and you should also always do the exam the same way. The consistency will help you better identify changes. Here is Boolbol’s advice on how to successfully conduct your physical breast exam: 

Raise one arm. "If you're examining, for instance, the right breast, you should do it with your left hand and have your right arm or hand above your head. The reason for that is it actually helps pulls the breast away from the chest wall [and] allows us to appreciate changes in the breast.”

Feel gently with your fingertips. "The key is you don’t have to press down firmly. It’s a light touch. This should not be a painful experience."

Follow the same pattern every time. "Think of the breast as a clock: 12 o'clock, three o'clock, six o'clock, and nine o'clock, and it just follows around. Start at 12 o'clock, high up on the breast. Use small, circular motions, and go fully around the breast from 12 o'clock, to three o'clock, to six o'clock, to nine o'clock, [and] back to 12 o'clock. When you get back to 12 o'clock, move in a little bit and do the same thing again."

Cover the entire breast. "As you go around and you move in, you do want to feel behind the nipple; but again, not squeezing the nipple. And then you can feel up into the armpit, what we call the axilla.”

Again, if something seems off or different from previous times, reach out to your doctor. 

Step 4

Feel your breasts in different positions—lying down, seated or standing up—as long as you do it the same way. "We want to keep this simple," Boolbol says. "It's a visual inspection of the breast and then the exam. Whether you want to do the exam standing or sitting, it does not matter. The point is do it the same way every month.”

And whatever you do, don’t freak out. The purpose of the exam is to make you vigilant, not fearful, about your breast health. Also, at-home exams are not mammogram replacements so do be sure to still schedule your yearly exam with your doctor. "The majority of [breast] cancers detected in our country are detected on mammograms," Boolbol says. "They are not detected by self breast exams. If they are detected by self breast exams, it means that it's typically a little larger, and we would prefer to diagnose them smaller.”

Take care of your girls, girls! 

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