Breast cancer is the second most common cancer and the second leading cause of cancer-related death in women, representing approximately 14% of all new cancer cases in the United States. Treatments for breast cancer have significantly advanced and survival rates have steadily improved since the 1990s. Early detection has contributed greatly, and one of the easiest things every woman can do is to perform regular breast self-exams, which may help identity breast cancer in its early stages.

Following are some tips for performing a breast self-examination as well as what to look for from Cathy J. F. Cole, NP, MPH, CHES, FNCBC, Oncology Nurse Navigator Breast Program at Los Robles Health System.

How often should you perform a breast exam? Monthly. For those with menstrual cycles, exams should be completed five days after the cycle ends. For those who are menopausal, any date of each month.

Who should be performing a breast self-exam? Every woman 18 and over should be familiar with their breast tissue and perform breast exams. Those who are pregnant or lactating can still perform breast exams but recognize that breast tissue may feel different and any change should be reported to their health care provider.

What should you feel for in a self-breast exam? Feel for a lump or thickening, but just as important is looking for skin changes, nipple retraction or nipple discharge.

What’s the best way to perform a breast self-exam? Breast self-exams shouldalways be performed lying down. Using the opposite hand, use the vertical strip method by starting in the armpit and making small circles as you progress toward the nipple. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you’ve reached the deep tissue, you should be able to feel down to your ribcage.

What’s normal and what’s not? There is no “normal” or “standard” breast among women. Breasts differ in size, shape and density, and often one breast will be slightly different from its pair. Pregnancy, as well as monthly cycles, can change the size and tenderness of your breasts. If you feel a hard fixed irregular lump or experience a retracted nipple or clear or bloody discharge, contact your health care provider for further evaluation.

Does a breast self-exam replace mammography if all is clear? Never. Mammograms are still the gold standard for finding abnormalities as well as defining any new change with ultrasound. New 3-D mammography allows the radiologist to see the breast tissue in greater detail as it takes approximately 300 images, as compared to traditional 2-D mammography, which only covers the top and side of the breast. For women with dense breasts, 3-D mammography is particularly valuable.

For more information about 3-D mammography or to schedule a mammogram, contact the Los Robles Imaging Center at 805.523.8062.