c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Breast Self-Examination: 1

A D V E R T I S E M E N T

   
 

The initial diagnosis of breast cancer depends on the combination of breast self-examination (BSE), examination by a qualified health professional and mammography. Examination and mammography are complementary and neither is sufficient alone. Sometimes lumps can be felt (palpated) that are not visible on mammography, and mammographic findings (lesions) can often not be felt.

 Breast self-examination should be done monthly from the teen-years on. Most women have some nodularity or irregularities in their breasts. This is most common in the upper outer quadrants where most of the glandular breast tissue is concentrated. Because the breasts are sensitive to stimulation by the female hormones estrogen and progesterone, they tend to accumulate tissue fluid and become sensitive around the time of the menstrual period. Women with particularly nodular breast tissue (fibrocystic disease) have increased nodularity at this time. For these reasons the monthly examinations should be done 4-5 days after menses, when hormonal influence is reduced.

Many women avoid self-examination out of fear that they will find something, or due to lack of understanding about what they encounter during BSE. The latter is particularly true of women with nodular breasts. It is critical that a woman both be able to identify something that is new and that persists beyond one menstrual cycle, and that she bring it to the attention of a health professional. 

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Breast Self-Examination: 2

A D V E R T I S E M E N T

   
 

Breast self-examination includes inspection of the breasts in the mirror with good light directed from above. Changes in size and shape of the breasts should be noted. The hands are pressed in hard against the waist and raised straight up over the head to accentuate abnormalities.      

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Breast Self-Examination: 3

A D V E R T I S E M E N T

   
 

Fibrous bands (suspensory ligaments) within the breast  (see breast anatomy for background) connect the skin to the underlying chest muscle and support the breasts. An abnormal growth withinthe breast  can shorten these bands and cause dimpling of the skin or retraction of the nipple. This effect is enhanced by stretching the arms up over the head and by pressing the fists inward at the waist.     

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This page was last modified on 7/6/1999.