Breast self-examination (BSE) is not a substitute for clinical breast examination or mammography. But as a monthly habit, it is the most practical tool a woman has for detecting new changes in her own breasts — changes that she, knowing her own normal, is uniquely positioned to notice.

Most breast lumps are found by women themselves, not by healthcare professionals during examinations. The difference between finding a lump early and finding one late often comes down to whether a woman was examining herself regularly.

Dr. Shachi Singh, consultant gynaecologist at Prakash Hospital, Sector 33, Noida, explains the correct technique and what to report.

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When to Examine

For premenopausal women: 7 to 10 days after the first day of your period — when the breasts are least hormonally influenced and typically least tender.

For postmenopausal women and pregnant/breastfeeding women: the same day each month — choose a date that is easy to remember.

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The Examination: Two Components

1. Visual Inspection

Stand in front of a mirror with adequate lighting.

• Arms at your sides: look at both breasts for symmetry, contour changes, skin changes, nipple changes
• Arms raised above your head: the same inspection with the breasts lifted
• Hands on hips, pressing firmly (to contract the chest muscles): looking specifically for dimpling or puckering of the skin

What to look for visually:

• Any change in size or shape from your normal (one breast being slightly larger than the other is normal if it has always been that way)
• Skin dimpling, puckering, or an orange-peel texture (peau d'orange) — the skin looks dimpled like an orange skin
• Redness, rash, or skin changes
• Nipple inversion that is new (nipple that has turned inward when it was previously outward)
• Nipple discharge, particularly bloodstained

2. Physical Examination

Lying down and standing in the shower are both effective.

Lying down: Place a pillow under your right shoulder. Raise your right arm above your head. Using the flat pads of your left hand's three middle fingers, make small circular movements in a systematic pattern covering the entire breast — from the armpit across to the sternum (breastbone), and from the collarbone down to the ribs. Use three pressure levels: light pressure (for superficial tissue), medium pressure (for middle tissue), and firm pressure (deep tissue near the ribs). Use a systematic vertical strip pattern — working up and down from the armpit to the sternum in columns — to ensure complete coverage. Repeat for the left breast.

Standing/in the shower: Soapy skin makes it easier for fingers to glide. Same systematic technique as above.

The axilla (armpit): Feel in each armpit for any lumps or enlarged lymph nodes. Lower your arm to your side and then feel with your other hand in the armpit.

The nipple: Gently squeeze each nipple between thumb and forefinger. Note any discharge.

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What Normal Feels Like

Normal breast tissue is not uniform — it typically has areas of lumpiness or nodularity, particularly in the week before a period. Getting to know what is normal for your own breasts through regular examination means you will recognise when something has changed.

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What Always Needs Medical Attention — Without Waiting

• A new discrete lump or thickening — particularly if it is firm, has irregular edges, or feels different from the surrounding tissue
• A lump that does not change with the menstrual cycle (a dominant persistent lump)
• Skin dimpling or puckering — the classic sign of a tumour pulling on the overlying skin
• Nipple inversion that is new
• Bloodstained or unilateral nipple discharge
• Persistent pain in a specific location (not generalised cyclical breast tenderness)
• Any change in the skin — redness, rash, peau d'orange texture
• A lump in the axilla (armpit)

Age to start: Begin monthly BSE from age 20.

Additional imaging: Clinical breast examination by a doctor annually from age 30. Mammogram from age 40 (or earlier if high risk — family history, BRCA mutation).

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Gynaecological Care in Noida and Greater Noida

Dr. Shachi Singh at Prakash Hospital, Sector 33, Noida, performs clinical breast examination as part of annual well-woman care and coordinates appropriate imaging referral for women across Noida and Greater Noida.

To book a consultation with Dr. Shachi Singh, call: +91 97023 46853

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This blog is for informational purposes only. Monthly breast self-examination is not a substitute for clinical examination. Please see Dr. Shachi Singh for annual clinical breast examination.