WOMEN should do regular breast self-examinations to check for any changes in the tissue. First, stand in front of the mirror at home and begin by looking at the breasts in the mirror with shoulders straight and arms on hips. Look for visual signs of dimpling, swelling, or redness on or near the breasts. Check if the nipple has changed position or is inverted. Second, raise your arms and look for the same changes. Third, look for any signs of fluid coming out of one or both nipples. This could be a watery or yellow fluid. Fourth, feel the breasts while lying down, using the right hand to feel the left breast and vice versa. Divide the breast into four quadrants and check each quadrant separately. Use a firm, smooth touch with the first few fingers of the hand, keeping the fingers flat and together. Use a circular motion, moving the fingers in concentric circles from the nipple outward. Cover the entire breast from top to bottom, side to side, from the collarbone to the top of the abdomen, and from the armpit to the cleavage. Be sure to feel all the tissue from the front to the back of the breasts. For the skin and tissue just beneath it, use light pressure. Use medium pressure for tissue in the middle of the breasts, and use firm pressure for the deep tissue in the back. When reaching the deep tissue, feel down to the ribcage. Finally, examine the breasts while standing or sitting. Many women find the easiest way to do this is when the skin is wet, so this step can be done in the shower. Cover the entire breast, using the same hand movements described in step four. Aboul-Nasr said that women from 20 to 30 years old should do breast self-examinations every month. Women over 40 should see a doctor once a year for mammograms and ultrasound scans of the breast tissue.
