Self breast examination

1. Stand before a mirror. Inspect both breasts for anything unusual, such as any discharge from the nipples, puckering, dimpling or scaling of the skin. The next two steps are designed to emphasize any change in the shape or the contour of your breasts. You should be able to feel your chest muscles tighten while doing these steps.

2. Watching closely in the mirror, clasp hands behind your head and press hands forwards.

3. Next, press hands firmly on hips and bend slightly toward your mirror as you pull your shoulders and elbows forwards.
   Some women do steps 4 and 5 in the shower. Fingers glide over soapy skin, making it easy to concentrate on the texture underneath.

4. Raise your left arm. Use three or four fingers of your right hand to explore your left breast firmly, carefully and thoroughly. Beginning at the outer edge, press the flat part of your fingers in small circles, moving the circles slowly around the breast. Gradually work toward the nipple. Be sure to cover the entire breast. Pay special attention to the area between the breast and the armpit, including the armpit itself. Feel for any unusual lump or mass under the skin. Repeat the exam on your right breast.

5. Gently squeeze each nipple and look for a discharge.

6. Steps 4 and 5 should be repeated lying down. Lie flat on your back, right arm over your head and a pillow or folded towel under your left shoulder. This position flattens the breast and makes it easier to examine. Use the same circular motion, described earlier. Repeat on your right breast.

Monthly breast self-exam (Reference: National guidelines, College of Surgeons Sri Lanka)