How to perform a self-breast exam
Know exactly what to do, and what to look for, so you can keep on top of your health.
Dr. Rebecca Jordan, general surgery, breast, Geisinger

Life can get busy, but you’re never too busy to take a moment to check on your health. A monthly, at-home breast exam is just one of the many ways you can keep on top of any changes with your body.

Along with your regular mammogram, monthly breast self-exams give you the opportunity to check for variations in skin texture, bumps or changes in your breasts.

But, exactly how do you do a breast self-exam?

Performing a breast exam at home

It’s a good idea to align these monthly self-exams with your menstrual cycle. Choose a time when your breasts are the least tender or swollen. The best time is often the week after your period ends.

Looking at a mirror, keep your arms at your sides to start. And remember that the key to these exams is to look for any changes compared to the previous month. You’ll begin your self-exam by looking for any visual changes in your breasts’ appearance.

Visual changes in your breast appearance may include:

• Puckering or dimpling of the skin
• Changes in your breast size
• Nipple inversion

Next, lie down to spread out your breast tissue to make it easier to feel for any bumps or lumps. Take your time as you feel around your breast and stick to a pattern — such as moving clockwise or up and down.

Use the pads of your fingers to feel around, use different levels of pressure and gently squeeze your nipple to check for discharge.

Examine your entire breast before moving to your other side and make sure to feel around your armpits, because your breast tissue extends up to that area.

You can also perform a self-exam in the shower, using soap so your fingers glide up and down your skin more easily.

When should you call your doctor to schedule a mammogram?

Remember, just because you feel a lump or have any symptoms doesn’t mean you have breast cancer. But it’s always a good idea to follow up with your doctor to rule it out.

Schedule an appointment with your doctor if you notice any of the following:

• A hard lump in your breast or underarm
• Bloody nipple discharge
• Changes in your breast size
• Nipple inversion
• Pain redness, warmth or swelling in your breast
• Puckering or dimpling
• Scaly skin
• Sores or rashes

At this appointment, your doctor will perform an external breast exam, like the one you get at your annual appointment. In some cases, they may recommend additional testing.

For younger people, we may only recommend an ultrasound. Other times, we may recommend a magnetic resonance imagining test — or MRI — which can help when there have been no findings through other imaging tests but other symptoms present, including nipple discharge.

Your doctor may even recommend a mammogram, especially if you have dense breasts or a lump that requires further testing. A mammogram, or low-dose X-ray exam of your breasts, will allow your doctor to detect any changes in your breast tissue that can’t be detected during a breast exam.

You’ll be scheduled for either a screening mammogram or a diagnostic mammogram to determine the cause of your symptoms and come to a diagnosis.

Remember that keeping on top of your health, including scheduling regular mammograms and self-exams, is important to detecting signs of breast cancer at their earliest stages — when they are easiest to treat.

By following these steps each month, you’re doing just that — taking steps towards your healthiest self.

To learn more about breast cancer care at Geisinger, visit geisinger.org/breastcare.

What can raise your risk of breast cancer?
While you can’t control all your risk factors of breast cancer, you can arm yourself with knowledge. Better-informed health decisions, like taking preventive measures, could reduce your risk.
By: Rebecca Jordan, DO, general surgery, breast, Geisinger

Breast cancer is one of the better-known conditions because it’s relatively common. It’s likely you or someone you know — a friend, family member, neighbor or coworker — will be diagnosed with breast cancer.

Fortunately, you can take charge of your breast health now to help change the direction of your narrative and keep your breast cancer risk as low as possible. While breast cancer can’t always be prevented, regular screenings and healthy lifestyle choices can reduce your risk. 

The important first step is arming yourself with knowledge and the right resources to help prevent breast cancer or catch it in its earliest stages when success rates are higher. When you know your risk factors of breast cancer, you can make informed health decisions and take preventative measures by changing elements in your environment and lifestyle.

Modifiable risk factors of breast cancer

Modifiable risk factors are those you can control. You can modify lifestyle choices like diet, physical activity and alcohol consumption. Scientists don’t know what causes breast cancer. But they do know positive changes in your environment and daily habits can reduce your breast cancer risk.

Maintain a healthy weight and eat a balanced diet

Being overweight or obese is a known breast cancer risk factor. Exercise regularly and eat a balanced diet rich in fruits, vegetables, whole grains and lean proteins to lower your risk. Limiting your intake of processed food, sugar and red meat may also be beneficial.

Stay physically active

Because a sedentary lifestyle increases your risk of breast cancer, aim for at least 150 minutes of moderate exercise (brisk walking, swimming or biking) or 75 minutes of vigorous exercise (running or aerobics) each week.

Limit alcohol consumption

The more alcohol you drink, the greater your risk of breast cancer. If you choose to drink alcohol, limit the amount to no more than one drink a day for women and no more than two drinks a day for men.

Quit smoking

Smoking cigarettes, being around secondhand smoke or using other tobacco products are known risk factors. The harmful chemicals in tobacco can increase your risk of breast cancer, especially when you use or are exposed to them for long periods of time.

Limit exposure to certain chemicals and pollutants

Exposure to harmful substances, such as pesticides — especially DDT — industrial chemicals, plastic that contains BPA and even some beauty products that include parabens, can increase your risk of breast cancer. However, more research is needed in this area.

Understand the impact of your reproductive history

Childbirth can affect your risk, too. Factors that increase your risk of breast cancer include becoming pregnant for the first time after age 30, not breastfeeding and never giving birth at all. 

Avoid hormone replacement therapy

Hormone replacement therapy is used to relieve symptoms of menopause and help prevent osteoporosis. But according to research, taking some forms of hormone replacement therapy, especially those that combine estrogen and progesterone, for more than five years during menopause can raise your risk of breast cancer.

If you’re considering hormone therapy, talk to your doctor about the benefits versus risks to decide if it’s right for you.

Can deodorant cause breast cancer?

Because underarm antiperspirant or deodorant is applied near the breast, some fear that the potentially harmful ingredients in these products, such as aluminum compounds or parabens, might be absorbed into the body, disrupt hormone levels and lead to breast cancer.

Research on this topic is limited, but the American Cancer Society and the National Cancer Institute state there is no convincing scientific evidence to support the claim that deodorant or antiperspirant use increases the risk of breast cancer.

While concerns about deodorant and antiperspirant use persist, focusing on known risk factors and taking appropriate steps to maintain breast health are the most important things you can do to reduce your risk. 

Can birth control cause breast cancer?

Many studies have found consistent evidence that women who use birth control pills that contain both estrogen and progesterone have a slightly higher risk of developing breast cancer. This is especially true if they have used them for longer than 10 years.

We know that estrogen and progesterone stimulate the development and growth of some cancers, but studies vary on the true risk of these medications. Fortunately, research also shows us that once the pills are stopped, the risk for breast cancer seems to return to normal within about 10 years.

If you’re considering oral contraceptives, talk to your doctor. They can guide you based on your medical history, risk factors and birth control preferences. Weigh the risks versus benefits with a healthcare professional to decide what’s best for you.

Nonmodifiable risk factors of breast cancer

Nonmodifiable risk factors are those beyond your control, including your age, gender and family history of breast cancer. Although you can’t change these risk factors, being aware of them can help you and your healthcare provider make informed decisions about screening and risk management.

Nonmodifiable risk factors of breast cancer include:

• Your age, especially if you’re older than 50
• Family history of breast or ovarian cancer
• Inherited genetic mutations, such as BRCA1 or BRCA2
• Dense breast tissue
• Early menstruation (before age 12) and late menopause (after age 55)

Reducing your risk factors of breast cancer

Now you know what changes to make in your environment and daily habits to reduce your modifiable risk factors. But don’t forget about screenings and early detection strategies. They’re crucial in the fight against breast cancer.

Regular breast cancer screenings, such as mammograms and clinical breast exams, can help detect the disease in its early stages when it’s most treatable. If you’re in your 20s or 30s, start getting a clinical breast exam every one to three years when you visit your primary care provider or gynecologist. Before turning 40, talk to your doctor about risk factors that determine how often you should have a screening mammogram. The American Society of Breast Surgeons recommends women of average risk start annual screening mammograms at age 40.

Do you know you have nonmodifiable risk factors for breast cancer, such as a family history or genetic mutations? Your doctor can make personalized recommendations for earlier or additional breast screening and discuss options for risk reduction, such as medications and preventive surgeries.

Early detection is the best protection: The five-year survival rate is highest for early-stage breast cancer. Understanding your unique risk profile, you can work with your healthcare team to develop a personalized plan for early detection and risk reduction — and beat the odds if you’re diagnosed.

To learn more about breast cancer care at Geisinger, visit geisinger.org/breastcare.