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Normal Breast Structure
Externally, the breast is divided by two lines, at right angles, into four quadrants and a central region consisting of the nipple and areola. The four quadrants are upper outer, upper inner, lower outer, and lower inner. Internally, the breast consists of secretory lobules and fatty tissue stroma. Secretory lobules (15-20) are made up of alveoli, and a group of secretory lobules is organized into lobes. Each lobule is drained by lactiferous ducts. Alveoli > Lobule > Lobe. These secretory lobules of the breast tissue increase and decrease in size depending on hormonal stimulation. Normal breast tissue typically feels firm and somewhat lumpy, with consistent consistency throughout. Breasts are rarely perfectly symmetrical. Normal nipples may protrude or appear flat or inverted, and they may have variations in colour, texture, or size. Healthy breast tissue should not contain any noticeable lumps, masses, or areas of thickening that feel distinct from the surrounding tissue. Healthy breast tissue can move slightly under the skin, particularly when gently pressed or manipulated during self-examination.Breast Self-Examination (BSE) by Visual Inspection
Stand squarely, with your hands by your sides or on your hips, shirtless, in front of a mirror, and look for any changes in size or shape, redness/discolouration, puckering, scaling, swelling, dimpling, nipple inversion, discharge, visible veins, pain, and tenderness. Make sure to check the underside of the breast properly.Sign up for the Connect Nigeria daily newsletter
Breast Self-Examination (BSE) by Palpation
To palpate means to feel with your hands. Here’s how to perform BSE by palpation:- Choose a Comfortable Position: Lie down on your back, preferably on a flat surface such as a bed, with a pillow placed under your right shoulder and your right arm behind your head. This position allows for easier access to the breast tissue.
- Use the Pads of Your Fingers: Use the pads of your three middle fingers (index, middle, and ring fingers) to gently press into the breast tissue in a systematic pattern, in a circular motion or from up to down.
- Apply Light to Moderate Pressure: Apply light to moderate pressure with your fingers, moving them in small circular motions or in a grid-like pattern across the entire breast and into the armpit area.
- Cover the Entire Breast: Make sure to cover the entire breast, including the upper outer quadrant, lower outer quadrant, upper inner quadrant, lower inner quadrant, and the area around the nipple (areola).
- Pay Attention to Sensations: Pay attention to any sensations you feel during palpation, such as lumps, bumps, thickening, or areas of tenderness. Note the location, size, shape, and texture of any abnormalities you detect.
- Repeat on the Other Breast: Once you have examined one breast, repeat the process on the other breast using the same technique.
- Stand Up and Repeat: After examining your breasts while lying down, stand up and perform another round of palpation while standing in front of a mirror.
Recommended Frequency and Timing
- All women are encouraged to conduct breast self-examination (BSE) at least once every month.
- For premenopausal women, the optimal time to conduct BSE is in the week after their period ends, when tenderness and swelling from hormonal causes are minimal.
- Postmenopausal women are encouraged to conduct BSE on the same day of every month.
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The Bottom Line
Breast self-examination (BSE) is a critical practice for the early detection of warning signs that may indicate breast health issues. By performing BSE regularly, women can become familiar with the normal look and feel of their breasts, making it easier to identify any changes or abnormalities that may arise. If anything abnormal is detected during BSE, see your doctor immediately for further evaluation and follow-up care. Early detection not only allows for prompt intervention but also greatly improves the prognosis of any underlying conditions that may be present. Establish a routine for BSE and set reminders to conduct it regularly.Sources😐 who.int| Teachmeanatomy.info| Moffitt.org
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