Introduction
Especially at the beginning of breast cancer, when the tumor is still very small and in its early stages, there are often no great noticeable signs. Often the tumour is discovered by chance during a woman’s self-scanning or during routine examinations by a gynaecologist. The nodular changes that can be palpated are usually hard and blurred.
Often it can also no longer be displaced too well in the tissue because malignant tissue tumours have a tendency to grow together with the surrounding tissue. If the tumour is located behind the nipple, retraction of the nipple and the surrounding skin may also be noticeable. Furthermore, in some cases, a change in the skin in the area above the tumour in the form of an orange-peel texture can be noticed.
In advanced stages it can even lead to real ulcerations. In the case of so-called inflammatory breast cancer – a special form of breast cancer – all signs of inflammation may be present (redness, swelling, overheating, pain) and thus often difficult to distinguish from inflammation of the breast (mastitis). In the following, methods for examining the female breast are described.
The order is chosen according to the “invasiveness” (in medicine, methods that penetrate the body are called invasive) and the complexity of the examination. The self-examination, which is at the beginning, is in no way stressful and easy to perform for the body. In the following, methods for examining the female breast are described. The order is chosen according to the “invasiveness” (in medicine, methods that penetrate the body are called invasive) and the complexity of the examination. The self-examination, which is at the beginning, is in no way stressful and easy to perform for the body.
Self examination
The simplest method to examine the female breast is to palpate it. Still 80% of breast cancer cases are detected by the women themselves. Part of the statutory early detection programme for breast cancer is a palpation of the breast from the age of 30.
However, in view of the simplicity of this “method”, the low cost and the complete absence of side effects, younger women should also take advantage of this possibility and examine themselves. However, not every palpable hardening or change in the breast always means breast cancer. In 80% of the cases the palpable nodular structures are benign changes.
About once a month a woman should look at her breasts in the mirror and palpate them at rest. Stand in front of the mirror with your arms hanging down. Look at her breasts from the front and from the side.
Look for unilateral changes, e.g. on the skin surface, bulges, wrinkles or retraction of the nipples. Then place your arms behind your head on both sides. The breasts should follow the movement and move upwards as well.
Here too, attention should be paid to retractions or one-sided changes in the shape of the breasts. Newly occurring changes in the skin surface, protrusions or retractions are always a reason to make an appointment with your gynaecologist. The best time for breast palpation is approximately one week after the start of the last menstrual period.
At this time the breast is particularly soft, later in the cycle the breast tissue becomes harder and knottier under the influence of the hormones. After the onset of the menopause, the breast can be palpated equally well at any time. If you are examining your breast for the first time, do not be alarmed!
The breast tissue consists not only of fat, but also of the mammary glands. Palpable bumps and small lumps are normal. Changes over time are especially important.
Therefore, pay particular attention to whether you feel lumps that were not there a month ago. Palpation of the breasts is usually a simple procedure that allows a fairly accurate overview of the nature of the breast tissue. To palpate the breast, it is best to take the arm on the same side behind the head.
Another possibility is to place your hand under the breast and raise it slightly to create a resistance during palpation. The breast is divided into four quadrants by imagining a cross with the nipple as its centre. Start, for example, at the upper inner quadrant and work your way from outside to inside, from quadrant to quadrant, with slightly circular movements.
Use the fingertips of the index, middle and ring finger to feel from the outside towards the nipple, always in the form of slightly pressure-bearing, small, circular movements. Then you should examine the middle of the breast around the nipple. Change the pressure exerted by your fingers and feel the surface and depth of the tissue.
Also feel your armpit and feel along the edge of the pectoral muscle and see if you notice any changes, such as knots or lumps that cannot be moved, for example, by applying light pressure. Finally, you should take your nipple between your thumb and forefinger and squeeze it gently. If you experience severe pain or observe the leakage of fluid or blood, you should arrange a check-up appointment with your doctor.
You should also palpate the area of the breast directly under the nipple and under the areola with light pressure. In order to be able to detect changes more easily, this procedure should be repeated while lying down, just so that the lower quadrants can be examined more easily. – Viewing the breast with hanging arms
- Viewing the chest with both arms behind the head
- Slowly scan all four quadrants with the arm behind the head or hand under the chest
- Palpation of the armpit and the edges of the chest muscle
- Compression of the nipple and palpation of the deeper tissue
- Repetition while lying down
