The Best Breast Self-exam

The best breast self-exam involves pressing towards center like the spokes of wheel.

For 30 years, I followed the American Cancer Society breast self-exam guidelines, using a circular motion with little pressure. In 2008, however, my primary care doctor discovered a tumor about 2/3 of an inch, using the Davis method, which I named after him.

The exam involves lying down and imagining the breast like a wheel with the nipple at the center. You move your fingers over the spokes of the wheel, from the outside towards the center. Each spoke is next to each other, so you don’t miss any tissue.

You must press very hard to feel each gland. This pressure might even cause pain, but it is necessary to feel each one individually and get their shape. The breast tissue extends upwards and in the armpit, so you have to start your exam higher up on the chest, and further out towards the under-arm.

Once you become familiar with the glands, you will notice when one seems different than it had been the last time you did the exam. In that case, you have to repeat it a week later. If the gland still feels unusual, you will have to get a mammogram or ultra-sound.

The breast has lobes and ducts. Each lobe is made of lobules and bulbs, where the milk is produced. The ducts connect the lobes, lobules, and bulbs to transport the milk. Most breast cancer is called ductal carcinoma, and is present in these ducts. It starts in glandular tissue.

According to the National Institute of Health, most breast “lumps” are usually not cancer, except in men. They categorize lumps to include cysts, fibroadenomas, and pseudolumps.

The cyst feels squishy, and moves around, like a water balloon. The fibroadenoma is round and hard or firm, found near the surface of the breast. The pseudolump is also hard, and doesn’t change shape during the menstrual cycle.

The adenocarcinoma, the most common breast cancer, has an irregular shape with a pebbly surface. It is also very hard.

Dr. Patricia Joseph, head of the Breast Center at Nyack Hospital, and my surgeon, said it takes 1.5 years for a tumor to reach 2/3 of an inch. It was exactly 1.5 years from a prior mammogram that my cancer was discovered using the Davis method. Another good reason to stay with that mammogram the same month every year.

This method is far superior to the circling method, which my gynecologist had done a month before without discovering the tumor. The cancer was stage I.

Here are some links to organizations that have other self-exam information, in addition to the Davis method: