Breast Exam

Why It Is Done

A clinical breast examination is done to:

• Find a lump or change in the breast that may mean a serious problem is present, such as breast cancer.
• Check other breast problems that may need more treatment, such as mastitis or a fibroadenoma.

How To Prepare

Tell your doctor if you:

• Have a new lump or change in your breasts. This includes a change in the way your nipples look or if you have any nipple discharge.
• Notice that your nipple has become inverted. Some people have nipples that sink into the breast, called inverted nipples. For these people, this is normal. But if you don't usually have inverted nipples and then notice a change where your nipple becomes inverted, tell your doctor.
• Have a personal or family history of breast cancer.

You may want to have your examination 1 to 2 weeks after your menstrual period starts, if you are still menstruating. Your breasts are less likely to be tender at that time.

How It Is Done

A clinical breast examination is done by your doctor. You will need to take off your clothes above the waist. You will be given a gown to wear during the exam.

First, your doctor will ask you questions about any problems you may have, your medical history, and your risk factors for breast cancer. Talk to your doctor about any areas of your breasts you may be concerned about.

Your doctor will then examine each breast, underarm, and collarbone area for changes in breast size, skin changes, or signs of injury or infection, such as bruising or redness. You may be asked to lift your arms over your head, put your hands on your hips, or lean forward and press your hands together to tighten the muscle beneath each breast during this part of the exam. You may also lie flat on the table and put your arm behind your head while your doctor checks your breast tissue.

Your doctor will feel (palpate) each breast for any unusual or painful areas or for a dominant lump. A dominant lump in the breast is any lump that is new, larger, harder, or different in any other way from other lumps or the rest of the breast tissue.

Your doctor will gently press on the breast tissue from about 1 in. (2.5 cm) below the breast up to the collarbone. The doctor also will examine your armpit (axillary area) and your neck for swollen glands (lymph nodes). Your doctor will likely press gently on your nipple to check for any discharge.

Depending on your health history, your doctor may teach you how to examine your own breasts (breast self-examination). This helps you learn how your breasts normally look and feel.

How It Feels

A clinical breast examination normally does not cause any discomfort unless your breasts are tender.

Risks

The risk of a clinical breast exam is that your doctor may find a breast change that may lead to more tests, but the change then turns out not to be cancer (false-positive results). The false-positive results and unneeded tests can lead to distress.

Results

Findings of a clinical breast examination may include the following.

Normal:

• The nipples, breast tissue, and areas around the breast look normal and are normal in size and shape. One breast may be slightly larger than the other.
• A small area of firm tissue may be present in the lower curve of the breast below the nipple.
• Tenderness or lumpiness that occurs in both breasts is normal for many people. Many people have the same lumpiness or thickening in both breasts during the menstrual cycle.
• A clear or milky discharge (galactorrhea) may be present when the nipple is squeezed. This may be caused by nursing, breast stimulation, hormones, or some other normal cause.
• One breast may have more glandular tissue (lumps) than the other one, especially in the upper outer quadrant of the breast.

Abnormal:

• A firm lump or area of thickening may be present in one of your breasts.
• Changes in the color or feel of your breast or nipple may be present. This can include wrinkling, dimpling, thickening, or puckering or an area that feels grainy, stringy, or thickened.
• A nipple may sink into the breast. A red, scaly rash or sore may be found on the nipple.
• Redness or warmth over a painful lump or over an entire breast may be present. This may be caused by an infection (abscess or mastitis) or cancer.
• A bloody or milky discharge (galactorrhea) may occur without stimulation (spontaneous nipple discharge).

If abnormal breast changes are found, you may have other tests, such as a breast ultrasound or a mammogram.

A normal clinical breast exam does not mean that breast cancer is not present. Depending on your age and your personal and family history of breast cancer, your doctor may do other tests, such as a mammogram.