The National Breast Cancer Foundation suggests three steps for an effective breast self-exam:

1. Do a visual exam, including looking in a mirror.
2. Do a physical exam while standing up.
3. Do a physical exam while lying down.

People should pay attention to:

• the breasts
• the underarm area
• the wider chest area, as far as the collarbone, the chest bone, and the top of the abdomen

The following sections explain how to carry out the exam in more detail.

Visual exam

A person can do a visual exam in front of a mirror.

With the arms down, check for changes in:

• shape or size
• skin color and texture
• nipple color, texture, and shape
• vein patterns, especially an increase in the size or number of veins

Repeat these steps with the arms above the head and the body bending slightly forward.

Physical exam while standing up

People often do a standing exam in the shower because the skin is easier to examine when slippery.

Use the following steps to perform a standing check:

1. With the pads of the three middle fingers, check all parts of each breast using circular motions.
2. Move from the sides to the center, checking for lumps or knots.
3. Repeat using light, medium, and firm pressure. With the fingers, perform circular movements, up-and-down movements, and “wedge” shaped movements from the outer breast to the nipple and back again.
4. Repeat for the whole chest area on both sides.

Physical exam while lying down

A lying down exam allows the breast tissue to spread out evenly along the chest wall. In this position, a person can check the whole of both breasts and the wider chest area.

To check the breast while lying down, follow these steps:

1. To check the right side, place a pillow under the right shoulder and raise the right arm above the head.
2. Using the left hand, press on all areas of the breast and underarm.
3. Repeat with light, medium, and firm pressure. Check with the fingers by performing the same movements as with the standing exam.
4. Cover the area from under the arm to the chest bone, collarbone, and top of the abdomen.
5. Squeeze the nipple and check for lumps and discharge.
6. Repeat all of these steps for the left breast.

Some people with breast cancer experience no symptoms. In some cases, however, changes may start to occur from an early stage. People should speak with a doctor about their screening plan if they have any concerns.

It is also worth noting that not all breast lumps are breast cancer, and not every case of breast cancer involves a lump. For these reasons, people should attend regular screening as a doctor recommends.

Checking the breast

Breast changes that may indicate cancer include:

• a lump or thickening in the breast tissue
• an unexplained change in breast shape
• changes in skin color
• unusual breast shrinkage or swelling
• dimpling or puckering of the skin, or enlarged pores
• skin that has become irritated, scaly, or ridged
• a thickening of the breast skin
• pain or a burning sensation

Checking the nipples

Some changes to look for in the nipples and areolae include:

• changes in skin color
• warmth or swelling
• the nipple turning inward
• a scaly or ridged texture to the skin
• discharge that could be clear, milky, or yellow or contain blood
• tenderness or pain

Checking the lymph nodes

Breast cancer can cause changes in the lymph nodes in the early stages.

To check the lymph nodes, look for:

• a lump, swelling, or thickening around the underarm
• a lump or swelling in the collarbone area
• a thickening of the skin in the armpit

Lymph node involvement can also result in a rash on the breast in people with inflammatory breast cancer.

A person should contact a doctor about these or any other unexplained changes, especially if they only seem to affect one breast.

Lymph nodes, breast cancer, and COVID-19 vaccines

It is worth noting that breast cancer is not the only reason for lymph node swelling under the arm. The lymph nodes play a role in the body’s immune response, and swelling can occur as they fight unwanted intruders, such as infections.

The lymph nodes under the arm can also swell in response to a vaccine, such as theCOVID-19 vaccine. This could contribute to a false diagnosis of breast cancer. For this reason, experts suggest scheduling any routinemammogramsat least4–6 weeks Trusted Sourceafter receiving a COVID-19 vaccine.

However, if a person has concerns about possible symptoms of breast cancer, they should not hesitate to contact a doctor. They should also not delay having a COVID-19 vaccine. This is because if cancer is present, they may benefit from the extra protection a vaccine offers.