Breast Self-Examination Guide: What to Check and How to Do It
A breast self-exam is not a test you pass or fail. It is a simple way to learn what is normal for your body, so you can spot changes early and know when to ask for medical advice.
Breast tissue can naturally feel lumpy, tender, or uneven, especially around menstrual cycles, pregnancy, chest surgery, breastfeeding, menopause, or hormone therapy. That is why the goal is not to diagnose yourself. The goal is to notice new, persistent, or unusual changes.
This guide explains how to do a visual check, a standing breast exam, and a lying-down exam. It also covers what to look out for and when to contact a health-care provider.
This content is for general information only and does not replace medical advice, screening, or care from a qualified health professional.
Why breast self-exams still matter
Breast self-exams are sometimes misunderstood. They are not meant to replace clinical breast exams, mammograms, ultrasounds, or other screening recommended by a health-care provider. They also cannot confirm whether a lump is harmless or serious.
What they can do is help you become familiar with:
The usual shape and feel of your breasts or chest
Areas that normally feel thicker or tender
How your nipples usually look
How breast tissue changes throughout the month
Whether a change is staying, growing, or spreading
That familiarity matters because many people first notice breast changes themselves. A breast self-examination guide can help you check in a consistent way, instead of poking around randomly and feeling unsure about what you missed.
Breast tissue extends farther than many people realize. It is not limited to the rounded part of the breast. It can reach up toward the collarbone, across the chest, down along the rib cage, and into the underarm area. A good self-exam covers all of these areas.
When to do a breast self-exam
Try to choose a time when your breast tissue is least likely to feel swollen or tender.
If you have periods, many people find it easiest to check a few days after their period ends. Hormonal swelling and tenderness are often lower then.
If you do not have periods, choose a consistent day each month. For example, the first day of the month or another date that is easy to remember.
You can also do quick awareness checks at any time, such as while showering or getting dressed. A more complete self-exam is easier when you are relaxed, unrushed, and in a private space with good lighting.
A helpful routine includes three parts:
A visual exam in the mirror
A standing exam, often easiest in the shower
A lying down exam, which helps spread the tissue across the chest
You do not need special equipment. You only need your hands, a mirror, and enough time to check carefully.
Start with a visual breast exam
A visual exam helps you notice changes in shape, skin, nipple position, and swelling. Good lighting makes this much easier.
Stand in front of a mirror and remove your shirt and bra, binder, or any clothing that covers your chest. Keep your shoulders relaxed. Look at both sides from the front, then turn slightly to view each side.
Look with your arms at your sides
Start with your arms resting naturally at your sides.
Look for changes such as:
A new difference in size or shape
Swelling in one area
Skin dimpling, puckering, or pulling
Changes in skin colour or texture
A nipple that has newly turned inward
New crusting, scaling, or rash around the nipple
A breast or chest area that looks unusually lower, higher, or pulled to one side
Many people have one breast that is slightly larger than the other. That can be normal. What matters most is a new change.
Raise your arms above your head
Next, raise both arms above your head.
Look again for changes in shape, dimpling, pulling, or swelling. Raising your arms can make skin changes easier to see because it stretches the tissue differently.
Pay attention to whether both sides move in a familiar way. If one area seems fixed, pulled, or newly uneven, make a note of it.
Place your hands on your hips and flex
Now place your hands firmly on your hips and press inward to flex your chest muscles.
This position can reveal pulling, dimpling, or changes that are not obvious while standing relaxed. Look at the curve of each breast or side of the chest, the nipple position, and the skin around the underarm area.
You do not need to inspect for a long time. A slow, careful look from several positions is enough.
How to do a standing breast exam
A standing exam is often easiest in the shower because wet skin lets your fingers move smoothly. You can also do it in front of a mirror or while getting dressed.
Use the pads of your three middle fingers, not the fingertips. The pads give you better contact with the tissue and make it easier to feel changes below the surface.
Position your arm
Place one hand on the back of your head. This raises the breast or chest tissue and helps you access the full area, including the underarm.
Use the opposite hand to examine the raised side. For example, use your right hand to check your left breast, then switch.
Use small circular motions
Move the pads of your three middle fingers in small circles. Cover every part of the breast or chest area.
You can use one of several patterns, but be consistent:
Work in circles from the outside toward the nipple
Move up and down in vertical rows
Move in wedges from the nipple outward
The exact pattern matters less than covering the full area. Many people prefer small circular motions because they make it easier to check one section at a time.
Increase pressure gradually
Use light pressure first to feel tissue close to the skin.
Then use medium pressure to feel slightly deeper.
Then use firm pressure to feel tissue closer to the chest wall and ribs.
Do not press so hard that it causes sharp pain. The goal is steady, gradual pressure.
Cover the full breast area
Make sure you check beyond the centre of the breast.
Include:
The tissue closest to the armpit
The armpit itself
The area up toward the collarbone
The area below the breast and down along the rib cage
The inner area near the breastbone
The area around the nipple
Breast tissue often extends into the upper outer area near the armpit. Do not skip it.
Check the nipple area
Gently feel around the nipple and areola. Then gently squeeze the nipple to check for discharge.
Discharge can have many causes, and some are not serious. Still, discharge that is bloody, clear, spontaneous, or only from one side should be checked by a health-care provider.
After you finish one side, repeat the same steps on the other side.
How to do a lying down breast exam
A lying down exam changes how the tissue spreads across the chest. This can make some areas easier to feel, especially deeper tissue.
Lie flat on your back. If it feels more comfortable, place a folded towel or small pillow under the shoulder on the side you are checking.
Place your hand behind your head
Place one hand on the back of your head, the same as in the standing exam.
Use the opposite hand to examine the breast or chest tissue. Keep your fingers together and use the pads of your three middle fingers.
Press in small circles
Press gently in small circular movements. Move methodically so you do not skip an area.
Start with light pressure. Then increase to medium pressure. Then use firm pressure to feel deeper tissue near the ribs.
Some breast tissue naturally feels rope-like, thick, or bumpy. That can be normal, especially if it feels similar on both sides. What you are looking for is something that feels new, different, hard, fixed, or persistent.
Check the edges of the tissue
Do not stop at the visible breast shape.
Check:
Up to the collarbone
Across toward the breastbone
Out into the armpit
Along the lower edge near the rib cage
Around the nipple and areola
Again, gently squeeze the nipple to check for discharge. Then repeat the full exam on the other side.
What breast changes should be checked
Most breast changes are not cancer. Cysts, hormonal changes, infections, benign lumps, skin irritation, and injuries can all cause symptoms. Still, it is better to have a change assessed than to wait and worry.
Contact a health-care provider if you notice any of the following.
Changes in the nipple
Get checked if you notice:
A nipple that has newly turned inward
A change in nipple shape
Bloody, clear, or unusual nipple discharge
Discharge that happens without squeezing
Discharge from only one side
Crusting, scaling, or a sore that does not heal
A nipple that has always been inverted may be normal for you. A new change is different.
Skin changes on the breast
Watch for unexplained:
Redness
Swelling
Skin irritation
Discolouration
Itchiness
Rash
Thickened skin
Dimpling or puckering
Skin that looks like an orange peel, feels warm, or changes quickly should be assessed promptly.
Pain or a new lump
Breast pain is common and often linked to hormones. Still, you should ask for medical advice if pain is new, focused in one spot, worsening, or does not go away after your period.
A new lump should also be checked, especially if it:
Does not go away after your period
Feels hard or irregular
Feels fixed in place
Is different from the surrounding tissue
Appears with skin or nipple changes
If you are not sure whether something is new, make a note of where it is and check again after your next period, unless it feels concerning or comes with other symptoms.
Swelling or lumps near the collarbone or underarm
The underarm and collarbone areas are part of a complete breast check. Swelling or a lump in these areas can come from many causes, including infection or swollen lymph nodes.
Still, a new lump, swelling, or tenderness around the collarbone or under the arm should be assessed, especially if it does not improve.
How to keep track of what you notice
If you find something unusual, try not to panic. Write down a few details so you can explain the change clearly.
Helpful notes include:
Which side it is on
Where it is, using the clock method if helpful
Whether it feels hard, soft, smooth, or irregular
Whether it moves or feels fixed
Whether it is painful or tender
Whether there are skin or nipple changes
When you first noticed it
Whether it changes after your period
For example, you might write, “Left side, upper outer area near armpit, pea-sized firm spot, tender before period, less tender after.” Simple notes can make a medical appointment more useful.
Common mistakes to avoid
A self-exam does not need to be perfect, but a few habits can make it more effective.
Do not rush through it
A quick squeeze in one spot is not a full check. Take enough time to cover the breast, armpit, collarbone area, and rib cage.
Do not use only firm pressure
Light, medium, and firm pressure each help you feel different layers of tissue. Start light and gradually press deeper.
Do not compare your body to someone else’s
Breasts and chests vary widely. Size, shape, scars, stretch marks, asymmetry, and texture can all differ from person to person. Your baseline is what matters.
Do not ignore a change because a recent screening was normal
Screening is important, but new changes still deserve attention. If you notice a new lump, nipple discharge, dimpling, or swelling, contact a health-care provider.
Do not skip exams after surgery or during hormone changes
Breast or chest tissue can change after surgery, pregnancy, breastfeeding, menopause, or hormone therapy. Ask your health-care provider how to check your tissue and scars in a way that fits your body.
When to seek medical care
Book an appointment if you notice a new change that lasts, grows, or worries you.
Seek care sooner if you have:
A new lump that does not go away
Bloody or clear nipple discharge
Sudden swelling
Skin dimpling or puckering
A nipple that newly turns inward
Red, warm, painful swelling
A lump under the arm or near the collarbone
If you are in Canada and unsure where to start, you can contact your family doctor, nurse practitioner, walk-in clinic, local public health service, or provincial health line, depending on what is available where you live.
A simple monthly routine to remember
A practical routine can look like this:
Choose a consistent day each month.
Stand in front of a mirror and do the visual exam.
Raise your arms and check again.
Put your hands on your hips, flex, and look for changes.
Do the standing exam with circular finger motions.
Lie down and repeat the exam.
Check the nipple area and underarm area on both sides.
Write down anything new or unusual.
Follow up with a health-care provider if a change persists or concerns you.
The more familiar you are with your body, the easier it becomes to notice changes without fear or guesswork.
The takeaway
Breast self-exams are a body awareness habit. They help you learn what is normal for you and notice changes that should be checked.
Use a mirror for the visual exam. Use the pads of your three middle fingers for both the standing and lying down exams. Move in small circles, increase pressure gradually, and cover the full area from the collarbone to the rib cage and into the armpit.
If you find a new lump, nipple discharge, skin dimpling, swelling, redness, rash, or pain that does not go away after your period, do not wait and wonder. Make a note of it and contact a health-care provider. Early conversations lead to clearer answers.
Schedule an appointment
If you are a rostered patient of Mushkegowuk Health, please contact us at 705-269-6662
Find your nearest screening location: https://www.ontario.ca/page/breast-cancer-testing-and-prevention?gclsrc=aw.ds&gad_source=1&gad_campaignid=24004300531&gbraid=0AAAABEKbr8EjvX5fJi88rqayfM5VGoVWr&gclid=CjwKCAjw0LzWBhBOEiwAKQd0cBjhhDgbM5RKM_nx7WUd4swsD2wU-7kcEfXe4dFGOtW6XCpPZCg6pxoCGKQQAvD_BwE
