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Teen girls should start self-exams

Breast cancer is the most common form of cancer among women, accounting for 30 percent of all cancer cases among women. Each year, there are approximately 180,000 new cases of breast cancer and 45,000 deaths from it. Only lung cancer causes more cancer deaths among women.

Early detection is essential for best treatment, and monthly breast self-examination starting in young adulthood plus regular mammograms starting at age 40 are the keys to early detection.

Why examine?

It is very unlikely that a teenage girl will develop breast cancer, but the American Cancer Society recommends that all young women practice breast self-exams.

A recommended time to start is once the breasts have finished growing in older adolescence. Why begin in the teen years? First, adolescent girls need to discover what their breast tissue feels like so that any changes will be easier to detect in the future. Second, breast self-exams are an important health habit to learn and a wonderful way a teenage girl can begin taking care of herself.

In addition, there may be other noncancerous breast problems that teen girls will be able to detect by doing breast self-exam, such as infections, cysts, unusual pain, or irritation from sport activities.

When to examine

The best time to do a breast self-exam is during the week after a teenager's menstrual period when the breasts are usually less tender or swollen. If her periods are irregular, then she should choose a day of each month (on the day that matches her birthday, for example) and do the exam each month on that day.

While doing a breast self-exam, young women should remember that it is normal to have some lumpiness or thickening in the breasts, especially during the adolescent years.

How to examine

(Courtesy of the American Cancer Society) Lie down with a pillow under your right shoulder and place your right arm behind your head.

Use the finger pads (where fingerprints are taken) of the three middle fingers on your left hand to feel for lumps in the right breast.

Press firmly enough to feel different breast tissues, using three different pressures. First, light pressure to just move the skin without jostling the tissue beneath, then medium pressure pressing midway into the tissue, and finally deep pressure to probe more deeply down to the ribs or to the point just short of discomfort.

Move around the breast in a circular or up and down pattern. Be sure to do it the same way every time, check the entire breast area, and remember how your breast feels from month to month.

Repeat the exam on your left breast, using the finger pads of the right hand. (Move the pillow to under your left shoulder.)

Repeat the examination of both breasts while standing, with your one arm behind your head. The upright position makes it easier to check the upper and outer part of the breasts (toward your armpit). This is where about half of breast cancers are found. You may want to do the standing part of the breast self-exam while you are in the shower. Some breast changes can be felt more easily when your skin is wet and soapy.

For added safety, while standing in front of a mirror right after each breast exam, you can check your breasts for any dimpling of the skin, changes in the nipple, redness, or swelling. It is normal and common for the breasts to be of different sizes.

If you find any changes, talk with your doctor. Remember, most breast lumps, especially during the teen years, are not cancerous, but if one is discovered, notify your health care provider and arrange for a check-up.The purpose of monthly breast self-exam is to learn what is normal and notice any changes that occur, since breast cancer may be successfully treated if discovered and treated early. And note the advice of the American Cancer Society: delaying the diagnosis of breast cancer does not change the diagnosis, it only worsens the outcome.

Bruce A. Epstein practiced pediatrics in St. Petersburg for 26 years. He edits the Web site

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