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Breast Self Exam: What You Can Do To Optimize Your Breast Health

The average malignant lump found by regular BSE is 1.5 cm; draw this to see exactly the size on a piece of paper It's about the size of the average blouse button; smaller than a dime. If found at this size (1 to 2 cm), there's a 75%-85% five year survival rate.

The average lump found by the woman who performs "occasional" BSE is 2.5 cm, a little smaller than a quarter. If a cancer is found at this size, there's a 65%--75% five year survival rate.

How does this compare to mammography? The average malignant lump found by a regular mammogram (meaning in a woman who has her mammograms according to the American Cancer Society's recommendations) is 0.3 cm, slightly bigger than a BB gun pellet. If malignancies are treated at this stage-or less than 0.5 cm-there's a 97% five year survival. The average lump found by a first mammogram (all comers) is 0.5 cm. That's about the size of the flat part of a thumbtack.

Ask your doctor if s/he has a breast model that has sample lumps built in so that you can practice feeling these in the waiting room; these are what we use to teach medical students how to properly examine breasts. You may even want to suggest that your physicians leave these in the waiting room in addition to the outdated magazines!

How is the BSE Different Than What Your Physician Does in the Office?

Your physician should do a clinical breast exam (CBE) each year, starting at age 20. If you have identified areas of concern, tell your doctor immediately after s/he examines that breast (i.e. so they have to reexamine that area if they did not catch it the first time). Ideally, a clinical breast exam should take 1-3 minutes per breast; unfortunately, the realities of clinical practice schedules make this length of time the exception rather than the rule.

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 There are many excellent guides to properly performing a proper BSE. Like anything else, it takes practice. 

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