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University of Cincinnati Academic Health Center
Publish Date: 10/04/05
Media Contact: AHC Public Relations, (513) 558-4553
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UC HEALTH LINE: Breast Self-Exams Detect Potential Cancer Masses

Cancer experts at the University of Cincinnati say that breast self-exams can be an important—and easy—way for women to detect potentially cancerous breast masses, and avoid becoming one of the more than 40,000 women who die each year from breast cancer.

According to the American Cancer Society, more than 211,000 new cases will be diagnosed this year. Although increased public awareness and education has reduced the number of women dying from breast cancer, the risk of developing the disease is still one in seven.

“Breast self-exams are effective in detecting 90 percent of all breast masses, but not all these masses will be cancerous” said Zeina Nahleh, MD, a medical oncologist and director of the breast oncology program in UC’s Division of Hematology and Oncology. “By becoming familiar with the contours and feel of their breasts, it’s easier for women to proactively check for abnormalities that may indicate breast cancer.”

Seventy-five percent of cancerous breast tumors are found in two areas: behind the nipple (34 percent) and in the outer quadrant of the breast near the armpit (41 percent). Any abnormality detected in the breast, nipple, skin or armpits should be examined by a physician. 

Women should perform a monthly breast self-exam starting at age 20 to check for lumps or tissue thickenings—preferably several days after her menstrual cycle ends—and have a clinical breast exam every three years. Women aged 40 or older should have an annual clinical breast exam and mammogram, an X-ray of the breasts and mammary glands used to screen for breast problems.

Consistency is key, so Dr. Nahleh suggests choosing a day that is easy to remember like the first day of the month or a birth date. She and her colleagues recommend a three-step approach for performing a thorough breast self-exam:
  • In front of a mirror
    Step one is to look for surface changes. Standing undressed from the waist up, visually inspect the breasts for changes in appearance, size, position or shape. You should also examine the border underneath the breasts and check the nipple for discharge. Suspicious changes may include skin puckering, dimpling, discoloration and soreness.

    Repeat visual inspections—from both forward-facing and side angles—with your hands at your side, on your hips and behind your head.
  • In the shower
    Step two involves feeling for unusual masses under the skin. Using soap and the flat part of your fingers to create a smooth surface, feel for lumps and thick tissue masses in your underarm and collarbone areas. Start at the bra line and continue moving up until you reach the collarbone.
  • Lying down 
    In this final step, lie down and place a small pillow under your shoulder, with the corresponding hand behind your head. Thinking of the breast as a clock, place your fingers flat against the upper portion of the breast and continue around the “clock face” until you’ve made a full rotation. After the first rotation, move one inch toward the nipple and repeat the process until you’ve examined the whole breast.

    Lastly, place your flat fingers on top of the nipple and feel beneath it for any changes. 

Dr. Nahleh is one of nearly 150 UC experts who answer health-related questions from consumers on NetWellness, a collaborative health-information Web site staffed by Ohio physicians, nurses and allied health professionals. For more information, visit

NOTE TO EDITORS: UC Health Line contains timely health information and is distributed every Tuesday by the UC Academic Health Center Public Relations and Communications Office.

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