1) Breast self-examination (BSE) involves visually inspecting and feeling the breasts to check for lumps, thickening, or other changes that could indicate breast cancer. It is recommended that women examine their breasts once a month after age 20. 2) BSE helps detect breast cancer early when it is most treatable. Three techniques - the clock pattern, wedge pattern, and sweeping pattern - are described to thoroughly check the breasts. 3) Abnormal findings that should be reported to a doctor include lumps, skin changes, nipple discharge, or changes in breast size or shape. Regular BSE can improve early detection of breast cancer.

1. BREAST SELF EXAMINATION
(BSE)
PRESENTED BY-
ABHILASHA VERMA

2. DEFINITION
• The breast self examination is the way that
can help in identify changes in breasts such as
lumps, thickening, etc. that may signal breast
cancer in early stages, so chances of surviving
disease are greatly improved
About 80% of all breast lumps are not
cancerous.

3. ADVANTAGE
• If breast cancer detected in early stage, it can
be cured completely.
• A practice of BSE on monthly basis is very
important for early detection of cancer.

4. GUIDELINES
WHEN TO CONDUCT BSE-
• Once a month by all women above 20 years of age.
• Should be conducted on fixed date every month.
• Better to conduct one week after menstrual cycle, if she is not
menstruating conduct BSE on a fixed date every month.
PATTERN-
• Circling, massaging motion and follow a clock pattern
or wedge pattern or sweeping motion ( outer part to
towards nipple).

5. 1) CLOCK PATTERN-
• Visualize breast as face of clock, place left hand behind head
and examine left breast with right hand.
• Place right hand at 12 ‘o’ clock at very top of breast.
• Place pads of three middle fingers firmly on breast in slight
circling massaging motion.
• Move hands down to 1 ‘o’ clock , then2 ’o’ clock and so on
until return to 12 ‘o’ clock .
• Continue same pattern, moving hand in smaller circles
toward nipple.
• Place right hand behind on head and repeat examination on
right breast.
• Check for tissue under nipple and look for discharges.
• Check tissues under armpit and surrounding breast.

7. WEDGE PATTERN:-
• Visualize breast as a circle divided into wedges like
piece of pie.
• Place left hand behind head and examine left breast by
right hand
• Press pads of three middle finger pads firmly in slight
circling and massaging motion.
• Start at the top of breast about half inch below
collarbone and slide fingers in toward nipple.
• Examine breast tissue in entire wedge. Move finger
clock wise to next wedges, until complete breast and
armpit.
• Place right hand behind head and repeat procedure for
right breast with left hand.

8. SWEEPING PATTERN:
• Place left hand behind head and examine left
breast with right hand.
• Instead of circling, massaging motion, sweep
three middle fingers from collarbone to
nipple.
• Clockwise around breast, sweep fingers
outside to inside toward nipple.
• To feel deeper breast tissue repeat process
using walking motion with fingers.
• Place right hand behind head and examine
right breast using left hand.

9. PHYSICAL ASSESSMENT FINDING IN
HEALTHY ADULT
1) BY INSPECTION: Breast should be-
• Symmetrical, full, rounded, smooth in all portions,
without dumping, retraction, masses.
• Nipple everted, areola even
• Axilla even, color normal, without masses or rash.
1) BY PALPATION:
• Firm without masses and lumps.
• No discharges
• Smooth axilla.

10. STEPS IN BREAST SELF EXAMINATION
• Inspection on mirror
• Palpation (Lying position)
• Palpation ( Standing or sitting position)

11. INSPECTION ON MIRROR
• Stand and face mirror with arms relaxed at sides or
arms resting on hips; then turn to right and left for
side view look.
• Bend forward form waist.
• Stand straight with arms raised over head and move
arms slowly up and down at sides.( Look for free
movement of breast over chest wall)

13. SITTING OR STANDING POSITION-
• Examine using clock pattern, or wedge
pattern or sweeping technique.
• Do upright BSE in shower , soapy hands
glide more easily over wet area.

14. PALPATION-
LYING POSITION:
• To examine left breast, Place pillow under
right shoulder and place right hand behind
head . This position evenly distribute breast
tissues.
• Examine in clock pattern, check for
abnormalities. Repeat procedure for right
breast.

15. FINDINGS:
• Redness of skin on breast or nipple.
• Bloody or clear fluids discharge from nipples.
• Changes in feeling or appearance of skin on
nipple or breast like dimples, scaly ,inflammed.
• Marbal like area under skin.
• Mass or lump feel as small as pea.
• Change in size, shape, contour of breast.
• Normal breasts and nipples.

17. SIGNS OF BREAST CANCER
• Elevation
• Asymmetry
• Bleeding
• Orange peel skin
• Nipple retraction
• Discharges

18. BARRIER TO BSE
• LACK OF CONFIDENCE