Tell me what to expect when examining my breasts

The most common type of screening for breast cancer is the physical examination done by your healthcare provider or by yourself.  Although self-examinations are now not recommended by the United States Preventative Services Task Force (U.S.P.S.T.F.), they can be useful when done in the right way.  It is important to know your breasts, because a certain amount of lumpiness is expected. This drawing shows where tenderness and thickening will be caused by an over-the-shoulder purse, or the shoulder strap of the seat belt, especially in women who are under 5’5” and who have a full ‘B’ cup or larger. If there is a difference in the size of your breasts, the bra wire will cause disproportional irritation of the outer edge of the larger breast.  If the one breast is larger it is usually the left.


In women with ‘C’ cups or larger there may be thicken along lower part of the wires (orange lines).  If one breast is larger there may be more thickening along the base of the larger breast, although the smaller side may more tender from the overriding of the bra cup.

There are obvious solutions for these problems. It is important to make an area of thickening improve or go away.  That will show that there is no underlying cancer definitively.  The irritation itself will not cause cancer; no more than an ill-fitting shoe would cause foot cancer.

If the purse is causing the problem, then put the purse on the opposite shoulder.  Also, you would want to wear a soft bra for a few weeks to allow the area in question to heal, since the irritation results from the pressure of the breast above and the tip of the underwire from below.

You can test if the seatbelt is the problem by feeling along the margin of the seatbelt that is closer to your nipple to see if this area is tender.  The maximum tenderness is usually above the level of the nipple on the chest wall.  If so, when you are in the car wash the next time, buy a seatbelt protector to put on the shoulder strap.

Generalized breast tenderness is cause by hormones and some foods such as caffeine and soy products.  These breasts stimulants may also contribute to fibrocystic changes.

The usual hormonal changes that you have every month will cause increased tenderness in the week before your period.  If you have irregular cycles or are in the early stage of pregnancy, your breasts may be more tender than usual.  You may want to check with your physician, if this condition occurs.

The generalized tenderness may be more pronounced in the upper outer portions of the breasts since that is, where most of the glandular tissue is.  If one breast is larger than the other there is probably more glandular tissue in that breast and consequently, it may be the tenderer breast no matter what the cause.

If you have noticed one of these changes, you may want to try one of the solutions described above, but if improvement is not apparent within one month or one cycle, or two at the most, you should see your physician to be certain that the condition is benign.  If you believe that a new mass is truly present, you should ask your physician to have an ultrasound performed since any cancerous mass that is large enough to be felt should be able to be seen by ultrasound.

One last thought should be considered if you think you have a mass.  Rarely, although no outward sign may be present on examination by your practitioner or yourself, you have a feeling of something wrong in a localized area in one of your breasts.  An ultrasound of that area should be performed since rarely a cancer can cause a feeling from inside of the breast, even though it is very small and cannot be felt through the skin.


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