It’s recommended that women—starting in their 20s—perform breast self-exams once a month, two or three days after the menstrual cycle ends (breasts are less swollen and sensitive at that time). For women who are no longer menstruating, performing the self-exam one specific day each month is advised. It’s important for a woman to know what she’s feeling in a self-exam, as breast tissue contains normal lumps and ridges.
A woman performing a breast self-exam is likely to feel both lumps and ridges, and it’s not likely that one breast is just like the other. Within the tissue of the breast, certain lumps and ridges are normal and not a cause for alarm. All women should feel a ridge of tissue at the lower part of the breast, which is the breast tissue that is closest to the ribcage. This is connective tissue, and feels firm yet spongy to the touch. The connective tissue that’s felt (the ridges) are almost rope-like beneath the fingertips. During a breast self-exam, light pressure is applied through the fingertips in an attempt to feel the tissue just beneath the skin (such as around the nipple); medium pressure is used to feel more deeply in the same areas, and strong pressure is applied when feeling around the base of the breast. This is because the area at the breast’s base contains the ridge-like tissue, and it’s possible that in order to feel something unusual within that area, firm pressure is needed.
Normal Breast Tissue
Breasts are composed of tissue, not muscle. A woman’s pectoral—or chest—muscles, lay beneath the breasts. One reason that women are told to perform the self-exam at the same time each month is because breast tissue changes throughout the hormonal cycle. According to lef.org, the normal breast tissue is glandular. This means that the tissue naturally develops and contains lumps and/or nodules. Even normal fibrous tissue can be mistaken for a lump during a self-exam, if it feels especially hard or lump-like—meaning concentrated and perhaps larger—than other ridge-like or lumpy sections of the breast tissue. It may be hard to know whether a lumpy ridge is normal or should be looked at by a doctor.
Lumps or Changes
Even though certain unusual-feeling lumps may in fact be normal, it’s always recommended that a woman consult her doctor if she feels a lump she thinks may not be normal. Breast lumps or nodules can mean any of the following: normal breast tissue—dominant lumps (lumps stand out from surrounding tissue), cysts (benign or cancerous), abscesses of the breast, abscesses of the areolar gland, mastitis and cancer—among other possibilities. Zora K. Brown, author of “100 Questions and Answers About Breast Cancer,” writes that aside from feeling her breasts, a woman should look for visible changes including changes in color, shape or size, and “dimpling, puckering or bulging of the skin.” A rash, red skin or soreness may also be indications of a need for medical investigation.
Outside of the breast’s standard, healthy, glandular tissue, the most common cause for concern are cysts, as cysts commonly cause lumps and/or nodules. Unlike cancer, cystic lumps are mobile, meaning they don’t anchor themselves to the tissue. Because of this, a cystic lump doesn’t cause any dimpling or change in breast appearance. Cysts are most usually found in the same exact place on a breast where a woman feels the ridge-like tissue: the underside of the breast and the upper outside section of the breast. Cysts may change throughout a woman’s hormonal cycle, and she may experience discomfort and symptoms such as a burning sensation. Simple cysts (distinct from complex cysts) are almost always non-cancerous—but should be diagnosed by a doctor.
Women are recommended to perform breast self exams once a month since this is a women's first line of defense against breast cancer.