I am concerned about those breast lumps that my doctor always talks about. What is the best way to check for these in a breast self-examination?

It is very important to examine your breasts regularly, ideally from an early age. Most women do have slightly different-sized breasts, especially as a teenager. Here are some instructions on how to examine yourself. Remember that your nurse or doctor can also show you how to give yourself an examination.

• Lying in bed, place a pillow or folded towel under your left shoulder and your left hand behind your head. Your shoulder should be raised high enough for your left breast to be centered on top of your chest. If the breast is not properly flattened against the chest, it can be difficult to feel a lump.
  
• Careful and systematic feeling of your breasts will give you a 'touch picture' of their normal structure. Always use your right hand to examine your left breast and vise-versa. Use two or three fingers, keeping the thumb extended. Do not use your fingertips, use the flat inner surfaces of your fingers, they're more sensitive. Never compress your breast between thumb and fingers as this may cause you to feel a 'lump' that doesn't exist.
  
• Use small rotary motions, press gently but firmly. Starting from the outermost point on your breast and moving inwards towards the nipple, proceed in a clockwise direction around the entire outer rim of the breast, returning to the starting point. Move an inch towards the nipple and repeat.
  

Sometimes lumps are more easily detected in the shower with wet soapy skin. Place one hand on your head and examine the breast on that side wih your opposite hand using the same technique as above. When examining yourself, take notice of any lump or other change found in one breast only. See your doctor if you have any of the following:

• breast lump
• nipple discharge that leaves a stain on clothing
• breast pain
• nipple scaling
• skin puckering/dimpling
• any unexplained changes in how the breast looks or feels