Breast Self-examination (BSE) for the Filipino Females


Breast Self-examination (BSE) for the Filipino Females

Reynaldo O. Joson, MD

What is Breast Self-examination (BSE)?

Breast Self-examination (BSE) is an examination done by a person on one’s own breasts.

Why is it being strongly recommended for Filipino females to do regular BSE?

Breast cancer is very common among the female population in the Philippines.  All Filipino females are at risk of having breast cancer.  There is NO definite way of prevention.  At present, the most practical thing to do in the fight against breast cancer is to detect it early enough and to have it treated as soon as possible.  BSE is a simple cost-nothing procedure that can assist Filipino females in the early detection of breast cancer in case they will have one. This is as long as they do BSE properly and regularly.

What are the two essential parts of BSE?

  1. Visual inspection of one’s own breasts to LOOK for anything unusual that may be present on the breasts!
  2. Palpation of one’s own breasts to FEEL for anything unusual and a dominant mass that may be present on the breasts!

What are the minimum essential parts of the body to examine in BSE?

The breast proper and the armpits.

What is a simple step-by-step technique of doing BSE? (see illustrations for better understanding of instructions)

Visual Inspection (LOOKING)

Expose the upper body.

In a standing position, face a mirror to view entire chest and breasts.

With both arms down and then raised over the head,

Look for anything unusual on the breasts!

Look for changes in the contour of the breasts and armpits, such as bulge, skin dimpling, and flattening!

Look for unusual changes on the skin of the breasts, such as redness and lesions!

Manual Palpation (FEELING)

In a standing position, with one arm raised over the head, using the flats of 2 to 3 fingers (2nd to 4th fingers) of the other hand, gently but firmly palpate the entire breast on the side where the arm is raised.

Feel for anything unusual in the breast and feel for a possible presence of a dominant mass!

A dominant mass is an unusual density distinct from the surrounding breast tissue with a felt margin or border which connotes a three dimensional lump.

Cover the entire area of the breast by going one quadrant at a time until all four quadrants of the breast are palpated.

Before palpating the armpit, gently squeeze the nipple for possible presence of discharge.

When palpating the armpit, put the arm down to have a lax or slack skin fold. Place the palpating fingers initially at the uppermost portion of the armpit.  Then, gently but firmly press against the chest wall in the armpit and slowly glide the fingers downward to feel for anything unusual and to feel for a possible presence of a dominant mass!

Repeat the same procedures for the other breast, nipple, and armpit.

When and how frequent to do the BSE?

Monthly, starting at age 25.

  • For menstruating women, after 5 to 7 days after menstruation when the breasts are usually not sensitive and tender anymore.
  • For non-menstruating women, last day or first day of the month.
  • For women on oral contraceptive pills, before start of new package of pills.

What is a quality BSE?

A quality BSE is one that is done completely, accurately, regularly, and effectively.

Criteria for a completely done BSE consist of the following:

1.    Visual inspection and manual palpation done.

2.    Breast proper and armpits examined.

3.    Entire areas of the breasts and armpits covered during examination.

Criterion for an accurately done BSE consists of concurrence by a breast specialist in the detection and recognition of something unusual or a dominant breast mass.

Criterion for a regularly done BSE consists of a monthly performance of BSE starting at age 25.

Criterion for an effectively done BSE consists of an early detection of breast cancer, if it occurs, at a size of less than 2 fingerbreaths, preferably less than 1 fingerbreadth.

What to do when something unusual or a dominant mass is detected in BSE?

Consult a breast specialist as soon as possible for checking and treatment, if necessary!

What is Physical Examination of the Breast (PEB)?

PEB is essentially the same as BSE except that the former is done by a person other than the self, done by a person trained to do examination of the breast by visual inspection and palpation.  This person may be a physician, allied medical professional, or any lay person such as caregiver or a husband trained to do breast examination.

How can BSE and PEB be used in reducing the magnitude of the breast wellness problems in the Philippines?

There are currently three groups of breast wellness problems in the Philippines.  These are, breast diseases; symptoms (such as breast pain and nipple discharge) on the breast but without a breast disease; fear and anxiety even in the absence of a breast disease because  a relative or a friend got one; because of scary media campaign; and because of alarming readings on diagnostic tests.

Both BSE and PEB are initially educational tools before being technical tools in detecting and recognizing breast wellness problems.  People doing quality, complete, and accurate BSE and PEB and accomplishing them at the recommended frequency will have greater chances for earlier detection and recognition of breast cancer and other breast diseases than those who are not doing them properly and accomplishing them longer than the recommended frequency.  With earlier detection, recognition and treatment, there will be reduction in the magnitude of complications and premature deaths that are usually associated with advanced breast diseases.

With proper understanding of the breast conditions and allayment of fear that come with BSE and PEB, there will be reduction of the complaints and symptoms on the breasts but without a breast disease and the unwanted fear and anxiety.

For details on Breast Self-examination, visit: https://sites.google.com/site/rojosonbreastselfexam

ROJ@12jun1; ROJ@14jul11 (same as 2014 version)

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