How to perform a proper breast self-exam?

So, I think I have a perfect little example here to back up what I was saying earlier about how "certain" doctors just aren't up to the task
you should probably go check out posts 6 and 7

for anyone who doesn't speak German, I'll give you the gist:
This was a post from Isabel R (just a loose translation, really): ...she was only 21; she felt a lump when she was 19 and went to see a doctor
but nobody actually took her seriously, they just kept insisting that you can't get breast cancer that young...
fast forward to now, and she has metastases in her lungs, liver, bones, skin, and maybe even her brain...😢

and honestly, the story about Susanna Kamps is even more intense:
she's 38, and about a year ago she felt a lump and headed straight to the clinic
they did a mammogram, and the doctor insisted everything was totally clear
Susan wanted to just have the lump removed, but the doctor told her:why don't we just take out your appendix too while we're at it, since it might get inflamed someday!!! basically telling her not to panic and that waiting six months for a follow-up would be plenty.
But she pushed for it, especially since her sister had dealt with breast cancer too, and guess what happened in the end??
It was cancer!!

These are just the stories of two young women shared on a forum
and I really don't think they're lying, because they have absolutely nothing to gain from this
and sadly, there are way too many cases just like this
way too many
😢

darkviper5 said:Here is an example that supports my point:the competence of "certain" doctors.
Read posts 6 and 7.

For those who don't speak German:
A post from Isabel R (roughly translated): ...she is 21 years old; at 19 she felt a lump and went to the doctor.
No one took her seriously; they just insisted it was too early to get breast cancer...
Now she has metastases in her lungs, liver, bones, skin, and possibly her brain...😢

And the case of Susanna Kamps is even worse:
She is 38, and a year ago she felt a lump and saw a doctor.
They did a mammogram, and the doctor claimed it was clear.
Susan wanted to have the lump removed, to which the doctor replied:you might as well get your appendix out while you're at it since it could cause inflammation someday!!! She told her not to panic and said a follow-up in 6 months would be enough.
She insisted anyway, especially since her sister had also suffered from breast cancer. And what happened in the end??
Cancer.

These are the experiences of two young women shared on a forum.
I don't believe they are lying, because they have nothing to gain from this.
Unfortunately, there are many examples like this.
Far too many.
😢

Those are extreme cases... by that logic, it’s just as likely that at least one person in the world has died from an allergic reaction to salicylates, yet we still take Aspirin.
Breast cancer is perhaps one of the most researched types of cancer, and we know a great deal about it. Massive studies conducted in the USA, Scandinavia, and Canada involving tens of thousands of patients have led to the constant search for new treatments. We have a very strong understanding of both extrinsic and intrinsic risk factors, as well as the biological behavior of specific tumor types. The fact that one nineteen-year-old developed cancer doesn't mean it's common in young women—peak incidence is actually between ages 54 and 60.
Of course, every patient needs to be evaluated individually. In this specific case, it's even more important given that the girl mentioned had a positive family history...

What are you actually trying to prove here? That all doctors are incompetent or killers?
Are you suggesting every woman should have her breasts surgically removed the moment she feels something?
You're doing harm—you're inciting panic and encouraging distrust toward medical professionals.

nimbleskipper13 said:What exactly are you even trying to prove here? I mean, is your whole point that every single doctor out there is just totally clueless or, like, straight-up dangerous? That seems like a bit of a stretch, don't you think?
So, I mean, do you honestly think every single woman needs to rush out and get her breasts surgically removed the second she feels even the tiniest little lump? I guess it’s just one of those things where people jump straight to the most extreme conclusion, maybe? Like, I don't know, it seems like such a massive leap to go from "oh, wait, what's this?" to "okay, let's just take them off entirely," which feels kind of wild if you really think about it, I suppose.
Honestly, you’re kind of doing a bad thing here—like, I guess you're just totally fueling this unnecessary panic and basically stirring up all this distrust toward doctors... which probably isn't helping anyone at all, really.

I mean, I guess you could say you’ve got a pretty awesome way of putting things, honestly! 🙄
So, like, I was just sitting here thinking about how you could basically prove that... well, nothingness actually exists? It sounds totally wild, I know, and maybe I’m just overthinking things while I drink my coffee, but there's kind of this whole vibe where if you try to point to "nothing," you're actually pointing to a concept, which means it's sort of *something*, right? It's such a head trip, honestly, but I guess if we're really digging into the void, proving absolutely nothing is the ultimate challenge, haha!
I’m only really pushing back here because you told me I was wrong, so I guess I just felt like I had to make my case, you know? 😉
Not that I'm trying to start a massive panic or anything, but honestly, I don't think you need to worry too much about it... I mean, I guess the girls here pretty much know me by now, and they definitely tend to take a little longer when they're reading through stuff like this, so we've got plenty of time to figure it all out together! 🙂
Watch out for those pothole scams, seriously!!
Look, I don't know if it's just me, but I feel like there's this weird thing where people think that if you're rocking an all-white outfit, you've basically ascended to some higher plane of existence or something, but honestly? If you're just wearing white, you aren't exactly gods or anything. 😉!
Hey there! How's it going?

@ darkviper5 :Of course... you're right...
I have no intention of trying to fix your frustrations... or your prejudices... that would be a Sisyphus task.👎

As for everyone else, I still believe people aren't just sheep waiting for a shepherd. They can think for themselves, consult multiple sources, and realize that they need to take their own initiative.

👋

nimbleskipper13 said:@ darkviper5: Oh, sure... you're totally right...
I’m not about to waste my time trying to fix your frustrations... or your biases... that sounds like a Sisyphus job to me. 👎

Look, if you actually know more than I do (or she does), skip the condescension and just teach me.

Honestly, it's hard to believe you're a surgeon when you fold this easily. 😢

🙂

The thing is, here in the States, the choice between a needle biopsy or a core biopsy usually lands on the patient. It's because clinical diagnosis isn't always black and white; some women would rather go straight to a mastectomy just to be safe, while others are willing to take the risk and see how things evolve. But leaving that call up to the patient is exactly why doctors end up facing a mountain of malpractice lawsuits. Letting the patient decide doesn't shield a surgeon or an oncologist from being sued later for a misdiagnosis.

placidfox55 said:If you know more than I do (or more than she does), don't patronize me—just teach me.

It’s hard for me to believe you're actually a surgeon if you lose your cool this easily. 😢

🙂

I understand that in the US, the choice between a needle aspiration and a biopsy often comes down to the patient's own decision. Because clinical diagnosis can be so difficult, some women choose to go straight to a mastectomy, while others prefer to take the risk and monitor how things evolve over time. However, leaving that call entirely to the patient also leads to a massive number of malpractice lawsuits against doctors. When the patient makes the final call, it protects the surgeon or oncologist from being sued later for an incorrect diagnostic or therapeutic approach.

First off, I am not patronizing anyone here. If that’s how you’re perceiving it, then that’s your issue, not mine...
Secondly, I didn't "lose my cool." And whether or not you personally believe I'm a surgeon doesn't bother me one bit...🙂

Let me clarify one fact: the protocol for evaluating breast changes is determined by WHO guidelines and the Department of Health and Human Services, based on decades of breast cancer research. It starts with a physical exam, a mammogram, and an ultrasound. If those methods can't definitively rule out malignancy, the next step is an FNAB or cytological puncture. If cytology proves the growth is benign, we stop there. If the cytology is inconclusive or positive, the next step is a surgical biopsy. If the biopsy confirms cancer, the type of surgery—whether it’s a lumpectomy, quadrantectomy, skin-sparing mastectomy, radical mastectomy, or extended radical mastectomy—is decided based on the stage and histological type.

My responsibility is to provide the patient with a detailed explanation of their condition and all available treatment options.
However, if a patient has a verified benign lesion but still insists on a mastectomy, I will NOT perform it. It is both my right and my duty to treat a patient in their own best interest. A patient isn't a guest at a restaurant, and I am not a waiter; therefore, they aren't always "right." If a patient insists on a procedure that is inappropriate for them after I have explained their condition and the optimal path forward, I will refer them for a second, third, or even fourth opinion... but I will NOT perform a surgery that offers no benefit and only causes harm.

Whether you or anyone else likes that or not...
👋

placidfox55 said:. That’s exactly why it’s so difficult to reach a clinical diagnosis. Because of that uncertainty, some women opt for a mastectomy right away, while others choose to take the risk and just wait to see how things develop over time.

One quick request... when you're debating high-level medical topics like this, please at least try to get the terminology right.
The term "clinical" refers specifically to the physical examination. To actually "find out what's going on," you need radiology and lab work—essentially, full diagnostics. That goes way beyond mere "clinical recognition."

Laypeople should definitely strive to stay informed, but being informed doesn't make you qualified to offer professional opinions. And if you actually *are* a professional, your lack of knowledge here is honestly concerning. 😢

nimbleskipper13 said:The term "clinical" refers specifically to the physical exam. To actually "figure out what's going on," you need lab work and imaging—essentially full diagnostics... which is a much bigger lift than just "clinical recognition."

Thanks for the lesson. I’m not trying to get too deep into the weeds here... but please look over what I wrote... and tell me if I used the terminology correctly.

It’s a shame that American doctors often have to earn respect through sheer aggression. Maybe in a few more years, people will learn how to maintain a professional relationship. I’m not saying you haven't been attacked for no reason before—sometimes you really do have to stand your ground for your own dignity. But honestly, the less you fight back, the less you sink into the quicksand. Save your energy for the actual calling.

And one more thing, let me pose a question: ... once you've had a needle biopsy and a mammogram, how can you be 100% sure an open biopsy wouldn't show malignancy? Basically, the clinical exam and the mammogram are what you base the decision for a puncture or an open biopsy on. Naturally, a mastectomy only happens after the histology comes back. However, mastectomies are performed globally even without proven histological malignancy in cases where there's a strong genetic component.

placidfox55 said:Thanks for the advice. I don't want to get too bogged down in hair treatments... but please look over what I wrote... and let me know if I used the medical terms correctly.

It’s sad that American doctors have to earn respect through aggression. Maybe in a few more years, people will learn how to maintain a professional relationship. I’m not saying you haven't been attacked without cause multiple times—in those cases, you truly have to fight for your dignity. However, the less you fight back, the less likely you are to sink into the quicksand. Save your energy for your demanding profession.

And to add to that, let me pose a question: ... once you've had a needle biopsy and a mammogram, how can you be 100% certain that an open biopsy wouldn't show malignancy? Essentially, the clinical exam and the mammogram are the basis upon which the decision for a needle biopsy or an open biopsy is made. Naturally, a mastectomy only happens after the histological results come in. However, mastectomies are performed (globally) even without proven histological malignancy in cases where there is a strong genetic component.

I’m intentionally going to leave that first part without comment...

Clinically speaking, an exam, ultrasound, and mammogram indicate a cytological needle biopsy... which allows us to obtain and analyze specific cells. If the cells show abnormalities in the sense of malignant alterations or even just metaplasia—meaning, if the finding isn't positive but merely suspicious—then we move to a biopsy. If the biopsy comes back negative, there isn't much else to do because the biopsy removes the entire growth. Women are then monitored at regular, shorter intervals with follow-up ultrasounds and mammograms.
Besides, every woman, regardless of whether she has experienced a breast change before, should have an exam and an ultrasound every year, and for anyone over 40, a mammogram every one to two years...

Certain histological tumor types, which are more aggressive than others, appear bilaterally and multifocally; this usually refers to invasive lobular carcinoma. These tend to occur more frequently in familial lineages following invasive ductal carcinomas, though both are hereditary, as I've mentioned before.
Ideally, for every female relative of a patient, it would be best to check if they are carriers of specific oncogenes, BRCA 1 and BRCA 2. It turns out there is a significantly higher incidence of disease among relatives who carry one, or even worse, both of those genes, whereas for those who don't carry them, the risk is equal to the rest of the population of the same age.
When a woman is a carrier of both genes, it would be advisable to undergo a preventative bilateral mastectomy, which is very commonly done in places like the US and Sweden.
Here, unfortunately, Medicare doesn't cover BRCA 1 and 2 testing, which can be done at the Lawrence Berkeley National Laboratory, and the procedure costs about $1,000. Furthermore, the surgery itself isn't covered by a standard referral...
But I'm not to blame for this; it's the system...
👋

placidfox55 said:Even so, mastectomies are performed globally without a confirmed histological malignancy if there's a strong genetic component involved.

nimbleskipper13:

Here in the States, unfortunately, Medicare doesn't cover BRCA 1 and 2 testing, which you can get done at the Lawrence Berkeley National Laboratory, and it costs about $1,000. On top of that, the surgery itself isn't covered by a standard referral...

I'm glad we agree that in certain situations, the patient decides whether to go through with a mastectomy based on their own anxiety levels and how much they trust current medical methods. That pretty much dismantles your annoyed claim that you aren't just a waitress. (A doctor shouldn't take it personally when a decision is made under the influence of a layperson—their patient).

And for the record, I really didn't appreciate that patronizing smiley face you used to try and maintain a sense of superiority.

placidfox55 said:nimbleskipper13:

I’m glad we finally agree that in certain scenarios, the patient decides whether or not to undergo a mastectomy based on their level of anxiety or how much they trust current medical methods. In doing so, you effectively debunked your own agitated claim about not being a waiter. (A doctor shouldn't take offense at the fact that, sometimes, decisions are made under the influence of a layperson—their own patient.)

And for the record, I really don't care for your choice of patronizing emojis; it feels like you're trying to maintain a tone of superiority.

Once again, you're missing the point!
When discussing preventive mastectomies for BRCA 1 and BRCA 2 carriers, we aren't talking about surgery driven by fear... for these women, breast cancer is a statistical certainty eventually, making a mastectomy an INDICATED procedure. This should not be confused with some wild theory suggesting a woman can choose a mastectomy just because she has a benign cyst (due to "fear levels") and that a doctor MUST honor that request.

Even a terminal patient might want euthanasia, yet ethics and the law still PROHIBIT a doctor from assisting them!

As for how you perceive my emojis or whether you like my tone or not... I ABSOLUTELY DO NOT CARE, HAHA.

👋

nimbleskipper13 said:...You really shouldn't mix this up with those wild theories claiming any woman with a benign cyst can just opt for a mastectomy because of her "fear level," and then insist the doctor HAS to go along with it.

I mean, I think you're kind of doing a "switcheroo" with the facts here,
because nobody was talking about mastectomies when it comes to cysts, but rather removing a nodule based on someone's "level of fear."

I guess you might have skimmed over the details a bit too fast,

darkviper5 said:Well, you're just using a straw man argument here.
I didn't say mastectomy was the standard for cysts; I said removing nodules because of the "fear factor."

You're reading this too superficially.

And what exactly defines a "nodule" to you???
Is it some kind of condensed star nebula? 😕

Before we call something a "nodule," we should probably give it a first and last name by using those various methods mentioned above to determine what we're actually dealing with—whether it's malignant or benign—and then decide how to proceed accordingly...

Look, forgive me if I'm not sophisticated enough to grasp your logic: if we're going to remove every single "nodule" on sight... then there's absolutely no point in having ultrasounds, mammograms, or cytological analysis!
Every woman feels a "nodule"... hop! Straight to the operating table to get it cut out immediately!!!
Decades of medical technology and scientific progress tossed down the drain. It doesn't matter that modern medicine trends toward being minimally invasive... let's just grab an old-fashioned scalpel and revert back to the 19th century...

I’m just wondering, for comparison, which genius invented minimally invasive laparoscopic surgery for gallbladder, uterus, or ovarian issues... when you could just slice the abdomen wide open and see everything clearly right in front of you...

Fortunately, women aren't so "terrified" that they'd neglect their own health and best interests.
I don't know how things are abroad... but American women here at home definitely aren't stupid!
👋

Hey there, my dear doctor lady
Since you apparently didn't have the time to go back and re-read what I already said, let me just lay it all out for you one more time:
-this whole debate started because you insisted that my statement—you know, the one where I said that even a tiny little lump, no matter how benign it seems, could potentially grow into something malicious, though it doesn't necessarily have to—wasn't actually accurate
-well, I sent you a link where you can literally read all about it
I mean, sure, maybe it's just one case out of *who knows how many millions*, but I’m looking at this through the eyes of a patient, not some academic scientist
when it comes down to me, my own body, and my health, I really don't care about the statistics
I want, and I'm honestly searching for, the absolute best treatment possible

And anyway, I gave you those examples (just two out of like, infinity squared) where doctors were being totally negligent or incompetent, and on top of that, super arrogant (kind of like you, if I'm being honest!) rather than what you took it to be, which was examples of young girls getting sick:
in that first instance, the poor girl's illness got so far along that she couldn't be saved because the doctors failed to properly examine her, despite a palpable lump being right there
and in the second case, this one doctor kept telling her that the lump in her breast was nothing but a cyst (based on a mammogram, no less!!) and told her not to panic, saying she could just get it removed whenever she wanted, along with her appendix just in case it decided to inflame one day!!!! Like, seriously!!!
But in the end, she did get that lump removed, and it turned out it wasn't a cyst at all, but cancer!

These aren't even extreme outliers, they are, unfortunately, just way too common a reality!
You can read so much about this online, and it's definitely one of the reasons why women decide to just have lumps removed! Obviously not everyone does, but plenty of them do

Two people I know actually went ahead with bilateral mastectomies without even having any lumps (one was only 24 and the other was 29) strictly because of the high frequency of cancer in their families (maybe they should've tested for the BRCA gene, I guess, but who knows?) and they did it upon their own request, following doctor's orders, of course!!

Four of my coworkers decided to have breast lumps removed even though they were just FA

purely out of fear!

And no, the decisions made by those six women don't represent the entire world
but then again, I don't know the entire world either!

So, that's it from a primitive immigrant girl who hasn't graduated from medical school or earned a PhD, but does have access to the internet😁

I have no intention of engaging in debates with people on an ego trip, those fueled by a hatred for an entire profession, and likely much more...
While some people stubbornly try to prove they’re better Catholics than the Pope, the reality is quite different. Fortunately, the world is full of intelligent men and women, so having a few misfits like this just proves that nothing in nature is perfect—not even Mother Nature herself...

To those who claim belonging to a world they escaped while fleeing the Middle East in flames, only to now try and dictate our fates from a distance—all while voting for OUR government and OUR president—I say this: you clearly lack any basic understanding of how to conduct a civilized debate or discussion.

:2up:

nimbleskipper13 said::2up:

love ya too! 😘

I’m not trying to scare anyone here. My point is simply that nobody can give you a 100% guarantee when they say, "you don't have breast cancer." Even if your mammogram, ultrasound, and biopsy all come back clear—even after a lumpectomy where they've removed a suspicious mass—there's still a chance a malignancy could be hiding in another part of the tissue that didn't look suspicious at all.

The reality is that we still don't know everything there is to know about breast cancer. It’s only really in recent years, following massive awareness campaigns, that research funding has actually started to surge. Before that, discussing breasts was practically taboo in our otherwise incredibly conservative United States.

Now, we’ve swung to the opposite extreme. People toss the phrase "breast cancer" around casually, and many women view it as the single most terrifying threat to their health.

In truth, breast cancer still ranks relatively low on the list of actual causes of death. The number one killer remains heart disease and cardiovascular issues. And honestly? There is a lot more you can do to prevent those.🙂

I don't know how things work elsewhere, but in the United States, the patient's own perspective is a huge factor in deciding the next steps. You have some women who are perfectly fine living with a certain level of risk if it means preserving their bodily integrity—because let's face it, breasts are a massive part of a woman's identity. Then you have others who would rather sacrifice that part of themselves just to get a good night's sleep. As it stands, no doctor should be forcing one choice over the other.

Of course, you'll always deal with people who rush into a decision, maybe because they're already spiraling from irrational anxiety. That’s where a doctor comes in—to help identify the psychological side of things and talk someone down if they're just panicking for no reason.

I’ve got a question for someone from the coast or maybe a medical professional who can make sense of this ultrasound report. Since this info is actually from two years ago, please point me toward anything more recent regarding cystic breasts... this is the only thing I could dig up.🙂

The diagnosis says:

Physical inspection shows no pathological changes in the breasts.
No isolated masses felt during palpation.
Ultrasound shows a hypoechoic area in the right breast at the 9 o'clock position, measuring roughly 1x1 cm. Back in 2005, this was about 4x2 cm and had the characteristics of a cyst.
Given how much it has shrunk, today's hypoechoic area in that same spot might be a cyst with thicker contents, but a surgical consultation is recommended along with all previous findings and mammogram images to determine if further testing is needed.
The parenchymal structure in the rest of both breasts indicates fibrocystic changes.
In the left breast, there's a cluster of small cystic formations.

So, my questions are:
Why would they recommend seeing a surgeon specifically?
What kind of next steps might they suggest?
And honestly, what’s the risk level if I don't go see them immediately?

hey ladies 🙂
quick question—do you guys actually do regular breast self-exams?
I've had a few doctors walk me through the process, and I spend way too much time scrolling through sites like http://www.mayoclinic.org/diseases-conditions/breast-cancer/in-depth/breast-self-exam/art-20044124, but honestly? I still can't tell if everything feels "normal" or not.
My breasts change texture so much depending on where I am in my cycle—at least that's how it feels under my fingers—so there are always these "weird" lumps popping up. And I put "weird" in quotes because maybe it's all just in my head, but the whole concept of this famous "self-exam" thing sounds like straight-up science fiction to me. 🤷
So, yeah, I want to hear from you. Do you actually do it? How often? Any tips on the easiest way to check, or what's actually considered normal versus when you should actually freak out?

Yes, I make sure to stay on top of my checkups. My grandmother had breast cancer, so I’ve made it a point to be incredibly proactive about it. To be honest, even when you're being vigilant, it can be hard to tell what's actually "normal" and what isn't. As you mentioned, there are so many strange little lumps and bumps out there that if you aren't getting regular screenings, it becomes almost impossible to distinguish a minor irregularity from something serious.
I remember one time I felt a lump that was distinctly different from anything else I'd ever noticed, and it turned out to be a fibroadenoma. My takeaway from that experience is that if something truly suspicious is going to happen, you'll likely feel it.
That said, I still think it's highly recommended to go in for an annual ultrasound just to be safe.