breast examThe medical community debates whether breast self-exams are worth the time.

Just how effective are self breast examinations when it comes to early detection of breast cancer and improving the mortality rate for women who contract it?

It’s a topic that’s been hotly debated over the past few years, according to the nonprofit breastcancer.org that works to educate women on the deadly disease, so much so that the American Cancer Society has even labeled self breast exams as an “optional” tool for screening breast cancer in women. The nonprofit website cites a 2008 study done on roughly 400,000 women in Russia and China that concluded self examinations not only did nothing to decrease the mortality rate, they also added complications to breast cancer patients by urging biopsies that may have been unnecessary.

But Women’s and Children’s Hospital breast surgeon Dr. Tyshaun James-Hart is quick to counter that “knowing your body and being able to identify any changes and address them as soon as possible is never optional.”

“My colleagues and I don’t consider it optional,” says James-Hart, who generally recommends monthly self exams for her patients. “It’s about being proactive and knowing what the changes are. Every change doesn’t mean cancer. There are a lot of benign issues that can be addressed and resolved. If the doctor says to you, ‘I feel this’ or ‘I see this. How long has it been there?’ You don’t want to have to say, ‘I don’t know. I never noticed it before.’ That’s important for everyone.”

Like James-Hart, breastcancer.org stands behind the assertion that self exams play a critical role in battling the disease, maintaining that 20 percent of breast cancer cases are found through a physical examination rather than a mammogram. To coincide with national Breast Cancer Awareness Month, the following are the five steps of a self breast examination, as outlined through breastcancer.org:

  1. Begin by looking at your breasts in the mirror with your shoulders straight and your hands on your hips. Look for breasts that are their usual size, shape and color and breasts that are evenly shaped without visible distortion or swelling. The following changes should be brought to your doctor’s attention: Dimpling, puckering or bulging of the skin; a nipple that has changed position or an inverted nipple (pushed inward instead of sticking out); and redness, soreness, rash or swelling.
  2. Raise your arms and look for the same changes as noted in Step 1.
  3. Use the mirror to look for any signs of fluid coming out of one or both nipples (this could be a watery, milky or yellow fluid or blood).
  4. 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. 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.
  5. Feel your breasts while standing or sitting, using the same hand movements described in Step 4.

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