Breast pains(mastalgia) or other conditions affecting the breast are one of the major reasons for visit to a doctor. Where on one hand, mastalgia affects two out of three women; on the flipside, lack of facilities, higher cost of treatment and investigation procedures, fear of cancer and associated social stigma are factors which cause delay in reporting and consequently the diagnosis of these cases. Awareness campaigns, screening programs and seminars conducted to acquaint people with this problem and its solutions remain confined to the higher socio economic strata, who in fact have easy access to super-specialty hospitals and clinics. Ngos and youth collectives working with the aim of educating women are way beyond the reach of women belonging to the lower socio economic strata – the ones who need it the most. Besides, inestigation techniques and diagnostic procedures like mammograms and sonograms are costly and restricted to private hospitals and nursing homes.
In such a scenario, it is imperative that every woman knows how to self-examine her breast,if she discovers lumps in there. It is recommended that a girl should begin periodical self examination of her private parts soon after puberty i.e around 16 years of age, the best time of check up being a few days after menstruation when the breasts are tender.
HOW TO ‘SELF-CHECK’ YOUR BREAST
STEP 1 : INSPECTION
- Stand straight in front of a mirror with arms at your sides
- Inspect the symmetry of both the breasts (Note that minor differences in size and weight do exist)
- Check if there are changes in the skin of breast – puckering of skin like orange peel( indicative of cancer) or cuts in areola (indicative of eczema/dermatitis)
- Look for any swelling or redness of breast (indicative of mastitis)
- Clasp hands behind your head to check for any changes in the shape of breast
- Now bring your hands to your hips, placing them firmly there and check for any changes in the shape of breast.
- Lean forward and backward and continue the inspection
STEP 2: PALPATION
- Cup your breasts with palms inwards and check for any lumps/nodules in the breast tissue
- Squeeze both nipples one by one to look for discharge (indicative of hormonal imbalances/ sometimes cancer too)
Repeat palpation in different postures like lying on your back and lying on the side.
PATTERNS OF PALPATION
Areas to be checked : underarm, area between underarm and breast, breast proper; area just above the breast upto the collar bone and the apex of shoulder
- pattern 1: LINE
- Start in the underarm area moving downwards until you reach the area below the breast
- Move your palm to the middle and back up
- pattern 2 : Circle
- Begin at the outer edge of breast, moving around whole breast in a circle
- Palpate as if forming circles till you reach the nipple
- pattern 3 : Wedges
- Begin at the outer edge of breast
- Move towards the nipple, then back
- Palpate the entire breast tissue covering one wedge area at a time.
reference : CME on mastalgia