Breast Health

Clinical breast exam

The examiner will look at your breasts while you are sitting and while you are lying down. You may be asked to raise your arms over your head or let them hang by your sides, or to press your hands against your hips. The examiner checks your breasts carefully for changes in the skin such as dimpling, scaling, or puckering; any discharge from the nipples; or any difference in appearance between the two breasts, including differences in size or shape. The next step is palpation: Using the pads of the fingers to feel for lumps, the examiner will systematically inspect the entire breast, the underarm, and the collarbone area, first on one side, then on the other.

A lump is generally the size of a pea before a skilled examiner can detect it. Lumps that are soft, round, and smooth tend not to be cancerous. An irregular, hard lump that feels firmly anchored within the breast tissue is more likely to be a cancer. However, these are general observations, not hard and fast rules.

~ The only sure way to know if a solid lump is cancer is to have some tissue removed and examined under the microscope. ~

A breast exam by a doctor or nurse can find some cancers missed by mammography, even very small ones. In addition to the skill and carefulness of the examiner, the success of a physical exam can be influenced by your monthly cycle and by the size of your breast, as well as by the size and location of the lump itself. Lumps are harder to find in a large breast.

Currently, mammography and breast exams by the doctor or nurse are the most common and useful techniques for finding breast cancer early. Other methods such as ultrasound may be helpful in clarifying the diagnosis for women who have suspicious breast changes. However, no other procedure has yet proven to be more effective than mammography for screening women with no symptoms; thus, most alternative methods of breast cancer detection are used primarily in medical research programs.

Source: The National Cancer Institute (NCI)

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