Teaching Your Daughter How to Do A Self-Exam

Hello, Warriors! How are you doing today? We here at The Breast Place hope you’re enjoying the long days of constant sunshine midsummer has to offer. Whether you’re at the beach with your family or basking in your backyard, remember to slather on a thick layer of your favorite sunscreen! 
 
Today, our aim is to impress upon each of our readers the importance of teaching your daughters how to perform a breast self-exam and how you might go about having such a conversation. We understand these sorts of things can be tricky. It’s our professional opinion: preparation is the pangea to anxiety in situations such as this one. Equipped with knowledge, you can answer any questions your daughter might have about why breast self-exams are necessary and how to perform one herself. This exchange doesn’t have to be awkward. In fact, we hope with the information in this article, both you and your daughter will walk away from the conversation feeling confident and empowered. 
 
On the Importance of Self-Examination
 
A breast self-exam (BSE) is, as the name suggests, a self-performed examination of one’s own chest area. The area underneath one’s armpits is also included in a self examination. 
 
Early Awareness
 
The chief benefit of self-exams are their potential to alert women to the presence of lumps and masses in their breasts which might be cancerous. Forty percent of diagnosed breast cancer cases are first detected by women who felt a lump. Early awareness is a key factor in determining survival rates in cases involving non-metastatic invasive breast cancer. Sixty-three percent of women are diagnosed while the cancer is still contained within the breast and of these women, the five-year survival rate is ninety-nine percent. However, young women—ages 15 to 39—are less likely to be diagnosed within this early stage because regular breast cancer screenings don’t begin until age forty for most. 
 
The chance of women under forty developing breast cancer is only five percent. However minimal this risk factor may seem, it is still a risk. Therefore, teaching your daughters how to perform self-exams is vital. 
 
Knowing One’s Own Body
 
The secondary benefit of performing regular self-exams might be the more universal of the two. We all need to have at least a basic understanding of our bodies. Performing regular breast self-exams can help your daughter to become familiar with her own physicality. Doctors recommend young women conduct self-exams less for the chance they’ll find a cancerous mass and more to have a solid understanding of what’s “normal” for them. Only by having a baseline of what your breasts look and feel like can young people identify when something has changed. 
 
The Talk
 
Now, you’re ready to have “the talk.” You don’t necessarily have to plan out what you’re going to say. In fact, it’s better if you don’t! You don’t want anything to sound too scripted. This is a natural topic of conversation between you and your daughter. Therefore, it’s always better to keep things casual. 
 
            When and Where
 
As with any in-depth conversation, you want to choose your moment. On a broader scale, this comes down to when—in your daughter’s timeline of development—you choose to have this conversation. While some doctors don’t recommend starting breast exams until you’re at least twenty and fully developed, others recommend beginning self-exams as soon as puberty. In this aspect, you must gauge the maturity of your child. Will they participate in this sort of conversation or plug their ears and run away? If it’s the latter, you might want to wait until they’re a bit more mature to have this conversation. 
 
On a smaller scale, when to have this conversation depends on external factors. Environment. Time-of-day. Even whether or not your child has eaten. For the optimal retention of information, you’ll want to choose a day when your child is well-rested. Choose a private location for this conversation, as well. Though there’s nothing to be embarrassed about, no one wants an audience when they're talking about intimate parts of their bodies. 
 
            Do Your Research
 
Knowledge is your friend. Don’t go into the conversation unprepared. Chances are, your daughter will have questions about things. If you’re confused about certain aspects of the self-exam, you’ll only transfer your confusion onto her. Make sure you’re able to answer the most common questions. 
 
How often should I be performing a self-exam? Once a month. 
 
When should I perform the exam? At least a week after your last period. This allows any swelling of the breasts to lessen before the exam. 
 
Where should I perform an exam? Self-exams can be performed standing up or lying down. They’ll want to add in the assistance of a mirror (when standing) in order to visually inspect the breasts. Doctors no longer recommend performing self-exams in the shower. 
 
What should I be looking for? You’re looking for any lumps, bumps, hard masses, dimpling, discoloration, changes in texture, or discharge. 
 
What’s normal? Everyone’s body is different. Therefore, there is no basic definition for normal. You’ll have to develop your own definition after multiple self-exams. Uneven breasts aren’t necessarily an indication of something being wrong. Likewise, stretchmarks (lighter or darker toned striations where the skin has stretched) are no cause for concern. What you want to keep an eye out for is major differences between the breasts (i.e. deformations or dimpling) and other sudden changes in the feel and appearance of your breasts.
 
How do I perform a self-exam? 
 
            Demonstrate
 
This part of the conversation depends on your level of comfortability. You can either verbally explain what to do or physically demonstrate using hand motions or combine a mixture of both methods. You can also print out a self-exam guide on the National Breast Cancer organization website. 
 
Written Instructions
 
Standing Self-Exam
 
Stand in front of a mirror. With your arms by your side, visually assess your chest area. You’re looking for noticeable changes in contour, dimpling, discoloration or strange texture. Next, raise your arms above your head. Continue your visual examination. Next, place your arms on your hips and press to flex your pectoral muscles. Continue your visual examination, searching for major differences in the usual appearance of your breasts.
 
Lying Down Self-Exam
 
Lie down with a pillow placed under the shoulder of the breast you’re examining. Lift the arm on the side of the breast you’re examining until your bicep is beside your ear. Use the three middle fingers of your opposite hand (i.e. ring, middle, index) to make a flat surface. Using the flat surface of the pads of your fingers, palpate the entire breast area, including the armpit. You can use varying degrees of pressure. You can use an up-down motion, make circles, or radiate your palpitation outward from the nipple. Finally, squeeze each nipple to check for blood or discharge.
 
After the Talk
 
What happens after the talk is just as important as the actual conversation. At this point, your child will go off to process the information and perform a self-examination alone. Especially in the beginning, self-examinations can be the catalyst of worry. This next section will help you handle the emotions which might come up as a result of a self-exam.
 
Managing Fear
 
Self-exams shouldn’t be a source of anxiety. In fact, they’re a wonderful tool for assuaging anxiety. Self-exams cannot rule out the possibility of having breast cancer. To rule out any foreign masses, you or your child would need to have a mammogram performed by a doctor. However, self-exams give us a small amount of power in the knowledge they imbue. With an understanding of our own body and what’s “normal” for us, we’re equipped to notice when something goes awry. 
 
And, even when something does go awry, it’s not always a reason to panic. Eight out of ten lumps are not cancerous. They can be cysts or benign tumors or even just particularly dense sections of breast tissue. 
 
Self-exams take five to ten minutes and only need to be completed once a month. As women, we have a responsibility to ourselves to check in with our own bodies. This is how we manage our health. Fear is most often born out of a lack of knowledge. With regular self-exams, we’re collecting knowledge about ourselves and managing our fear.
 
Assuage and Anticipate
 
Even equipped with the proper knowledge and relevant statistics, self-exams can bring up a lot of guessing and wondering. In the weeks or months following your conversation, check-in with your daughter. Of course, gauge her willingness to continue the conversation first. You might ask her how she’s feeling about her self-exams. Does she have any questions? Even if you’re not able to answer her questions and concerns, you can both take a trip to the doctor’s office and learn about breast health together. 
 

 
Discussing your daughter’s health care concerns doesn’t have to be done alone. Consulting with a healthcare professional can help assuage any fears which might arise after beginning self-exams. That’s why The Breast Place offers consultations concerning breast pain, breast lumps or masses, abcesses and nipple discharge. Our physicians can show you and your daughter how to properly perform a self-exam and run family history risk assessments to see if you’re genetically predisposed to certain forms of breast cancer. 
 
If you or your daughter do encounter a lump, don’t panic. Instead, schedule an appointment as soon as you’re able. The Breast Place offers several breast imaging services, including: mammograms, ultrasounds, and MRIs. Whether you have dense breast tissue or have had an abnormal mammogram, we can assist you in deciding what the next step in your healthcare journey should be and facilitate the necessary care. We’re here to help!