Philadelphia Philadelphia UniversityUniversity

Faculty of NursingFaculty of Nursing

Breast self Breast self examinationexamination

By :- Yasmin Ali MuslehBy :- Yasmin Ali Musleh

Num :- 200811140Num :- 200811140

Dr :- Aida Abd- ALrazeqDr :- Aida Abd- ALrazeq

Out line:-Out line:-

IntroductionIntroduction

Women high risk for breast cancerWomen high risk for breast cancer

Signs and Symptoms of Breast cancerSigns and Symptoms of Breast cancer

How to do breast self examinationHow to do breast self examination

NotesNotes

Identify Women high risk for breast cancerIdentify Women high risk for breast cancer Know the Sign and symptom of breast Know the Sign and symptom of breast

cancercancer Learn How to do breast self examinationLearn How to do breast self examination Tips for doing breast self examination Tips for doing breast self examination

Objective:-

Breast Self ExaminationBreast Self Examination

All women over the age of 20 should practice All women over the age of 20 should practice regular monthly self breast examinations. The regular monthly self breast examinations. The importance of this can not be over emphasized importance of this can not be over emphasized since an early cancer can be discovered by this since an early cancer can be discovered by this method when mammography is normal. The method when mammography is normal. The examination should be done when the breasts examination should be done when the breasts are least tender, usually 7 days after the start of are least tender, usually 7 days after the start of menstrual period. menstrual period.

If a women detects any changes or lumps, she If a women detects any changes or lumps, she should seek medical attention. Remember that should seek medical attention. Remember that 9 out of 10 women will not develop breast 9 out of 10 women will not develop breast cancer and most breast changes are notcancer and most breast changes are not cancerouscancerous..

Women high risk for breast Women high risk for breast

cancercancer AgeAge. The risk of developing breast cancer . The risk of developing breast cancer

increases with age. The majority of breast increases with age. The majority of breast cancer cases occur in women older than age cancer cases occur in women older than age 50.50.

Age at menarche (first menstrual period)Age at menarche (first menstrual period). . Women who had their first menstrual period Women who had their first menstrual period before age 12 have a slightly increased risk before age 12 have a slightly increased risk of breast cancer.of breast cancer.

RaceRace. White women have greater risk of . White women have greater risk of developing breast cancer than Black women developing breast cancer than Black women (although Black women diagnosed with breast (although Black women diagnosed with breast cancer are more likely to die of the disease).cancer are more likely to die of the disease).

Personal history of breast abnormalitiesPersonal history of breast abnormalities. Two . Two breast breast tissuetissue abnormalities— abnormalities—ductalductal carcinoma in situ carcinoma in situ ( (DCISDCIS) and ) and lobular carcinoma in situlobular carcinoma in situ ( (LCISLCIS)—are associated )—are associated with increased risk for developing invasive breast with increased risk for developing invasive breast cancer.cancer.

Breast cancer among first-degree Breast cancer among first-degree relatives (sisters, mother, daughters)relatives (sisters, mother, daughters). . Having one or more first-degree blood Having one or more first-degree blood relatives who have been diagnosed with relatives who have been diagnosed with breast cancer increases a woman's chances breast cancer increases a woman's chances of developing the disease.of developing the disease.

Breast biopsiesBreast biopsies.. Women who have Women who have had breast biopsies have an increased risk of had breast biopsies have an increased risk of breast cancer, especially if the biopsy showed breast cancer, especially if the biopsy showed a change in breast tissue, known as atypical a change in breast tissue, known as atypical hyperplasia. These women are at increased hyperplasia. These women are at increased risk because of whatever prompted the risk because of whatever prompted the biopsies, not because of the biopsies biopsies, not because of the biopsies themselvesthemselves

Signs and Symptoms of Breast Signs and Symptoms of Breast cancercancer

The most common sign of breast cancer is a The most common sign of breast cancer is a new lump or mass. A mass that is painless, new lump or mass. A mass that is painless, hard, and has irregular edges is more likely to hard, and has irregular edges is more likely to be cancerous, but some rare cancers are tender, be cancerous, but some rare cancers are tender, soft, and rounded. For this reason, it is soft, and rounded. For this reason, it is important that any new breast mass or lump be important that any new breast mass or lump be checked by a health care provider with checked by a health care provider with experience in diagnosis of breast diseases.experience in diagnosis of breast diseases.

Other signs of breast cancer include a Other signs of breast cancer include a generalized swelling of part of a breast (even if generalized swelling of part of a breast (even if no distinct lump is felt), skin irritation or no distinct lump is felt), skin irritation or dimpling, nipple pain or retraction (turning dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast breast skin, or a discharge other than breast milk. Sometimes a breast cancer can spread to milk. Sometimes a breast cancer can spread to underarm lymph nodes that are obviously underarm lymph nodes that are obviously enlarged, even before the original tumor in the enlarged, even before the original tumor in the breast tissue is large enough to be felt.breast tissue is large enough to be felt.

Difficulty:Difficulty: Easy Easy

Time Required:Time Required: 15 minutes a month 15 minutes a month

What You Need:What You Need: A mirror which lets you see both A mirror which lets you see both

breastsbreasts A pillow for your head and shoulders A pillow for your head and shoulders PrivacyPrivacy

11--Make a regular date for Make a regular date for your BSEyour BSE

If you are pre-menopausalIf you are pre-menopausal:: Set a Set a regular time to examine your breasts a few days regular time to examine your breasts a few days after your period ends, when hormone levels are after your period ends, when hormone levels are relatively stable and breasts are less tender.relatively stable and breasts are less tender.

If you are already menopausalIf you are already menopausal (have not had a period for a year or more): Pick (have not had a period for a year or more): Pick a particular day of the month to do the exam, a particular day of the month to do the exam, and then repeat your BSE on that day each and then repeat your BSE on that day each month.month.

22--Visual Exam - Hands on Visual Exam - Hands on HipsHips

In the privacy of your bathroom, strip to the In the privacy of your bathroom, strip to the waist and stand before a mirror. You will need waist and stand before a mirror. You will need to see both breasts at the same time. Stand to see both breasts at the same time. Stand with your hands on your hips and check the with your hands on your hips and check the appearance of your breasts. Look at size, appearance of your breasts. Look at size, shape, and contour. Note changes, if any, in shape, and contour. Note changes, if any, in the skin color or texture. Look at the nipples the skin color or texture. Look at the nipples and areolas, to see how healthy they look.and areolas, to see how healthy they look.

33--Visual Exam - Arms Over Visual Exam - Arms Over Your HeadYour Head

Still standing in front of the mirror, raise your Still standing in front of the mirror, raise your arms over your head and see if your breasts arms over your head and see if your breasts move in the same way, and note any move in the same way, and note any differences. Look at size, shape, and drape, differences. Look at size, shape, and drape, checking for symmetry. Pay attention to your checking for symmetry. Pay attention to your nipples and areolas, to see if you have any nipples and areolas, to see if you have any dimples, bumps, or retraction (indentation). dimples, bumps, or retraction (indentation). Look up toward your armpits and note if there Look up toward your armpits and note if there is any swelling where your lymph nodes are is any swelling where your lymph nodes are (lower armpit area).(lower armpit area).

44--Manual Exam - Stand and Manual Exam - Stand and StrokeStroke

Raise your left arm overhead, and use your Raise your left arm overhead, and use your right-hand fingers to apply gentle pressure to right-hand fingers to apply gentle pressure to the left breast. Stroke from the top to the the left breast. Stroke from the top to the bottom of the breast, moving across from the bottom of the breast, moving across from the inside of the breast all the way into your inside of the breast all the way into your armpit area. armpit area.

You can also use a circular motion, being You can also use a circular motion, being sure to cover the entire breast area. Take sure to cover the entire breast area. Take note of any changes in texture, color, or note of any changes in texture, color, or size. Switch sides and repeat. This is best size. Switch sides and repeat. This is best done in the shower, as wet skin will have done in the shower, as wet skin will have the least resistance to the friction of your the least resistance to the friction of your fingers.fingers.

55--Manual Exam - Check Your Manual Exam - Check Your NipplesNipples

Still facing the mirror, lower both arms. With Still facing the mirror, lower both arms. With the index and middle fingers of your right the index and middle fingers of your right hand, gently squeeze the left nipple and pull hand, gently squeeze the left nipple and pull forward. Does the nipple spring back into forward. Does the nipple spring back into place? Does it pull back into the breast? Note place? Does it pull back into the breast? Note whether or not any fluid leaks out. Reverse whether or not any fluid leaks out. Reverse your hands and check the right nipple in the your hands and check the right nipple in the same way.same way.

66--Manual Exam - Recline Manual Exam - Recline and Strokeand Stroke

This is best done in your bedroom, where you This is best done in your bedroom, where you can lie down. Place a pillow on the bed so that can lie down. Place a pillow on the bed so that you can lie with both your head and shoulders you can lie with both your head and shoulders on the pillow. Lie down and put your left hand on the pillow. Lie down and put your left hand behind your head. Use your right hand to behind your head. Use your right hand to stroke the breast and underarm, as you did in stroke the breast and underarm, as you did in step 4. Take note of any changes in texture, step 4. Take note of any changes in texture, color, or size. Switch sides and repeat.color, or size. Switch sides and repeat.

Tips For Doing Your BSETips For Doing Your BSE Mark your calendar to remind yourself to do Mark your calendar to remind yourself to do

your BSE regularly. This is a good way to your BSE regularly. This is a good way to prevent worry if find a normal cyclic change. prevent worry if find a normal cyclic change.

Stay relaxed and breathe normally as you do Stay relaxed and breathe normally as you do your BSE. Becoming tense will produce some your BSE. Becoming tense will produce some knots that you may mistake for something knots that you may mistake for something worrisome. worrisome.

Report any changes or unusual pain to your Report any changes or unusual pain to your doctor or nurse practitioner. Keep a log of doctor or nurse practitioner. Keep a log of changes, if that helps you remember. changes, if that helps you remember.

Remember to have an annual clinical exam Remember to have an annual clinical exam and a mammogram.and a mammogram.

ReferencesReferences Esserman LJ, et al. Diagnostic evaluation of Esserman LJ, et al. Diagnostic evaluation of

women with suspected breast cancer. women with suspected breast cancer. http://www.uptodate.com/home/index.html. http://www.uptodate.com/home/index.html. Accessed Aug. 4, 2009. Accessed Aug. 4, 2009.

American Cancer Society guidelines for the early American Cancer Society guidelines for the early detection of cancer. American Cancer Society. detection of cancer. American Cancer Society. Accessed Aug. 4, 2009. Accessed Aug. 4, 2009.

U.S. Preventive Services Task Force. Screening for U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task breast cancer: U.S. Preventive Services Task Force Recommendation Statement. Annals of Force Recommendation Statement. Annals of Internal Medicine. 2009;151:716Internal Medicine. 2009;151:716