pain
lump or swelling
tenderness
skin irritation or dimpling
nipple pain or retraction (turning inward)
redness or scaliness of the nipple or breast skin
a discharge other than breast milk

If you have any of these symptoms please consult your gp as soon as possible. Any abmornality should be reported to the gp for a professional opinion. Ask a friend to go with you if you're worried.

Breasts change throughout your monthly cycle to a certain extent but you should learn this pattern of yourself as you practice your self-examination and by checking at the same time every month you should feel the same.

When should you do it?

breast self-examination should be done after your period so there is less tenderness and swelling.

Visual Examination

How to start

Put on a light, get naked from the waist up (remember to shut the curtains!), stand in front of a mirror. Have a look.

Is anything different from last time?

Shape
Size
Contour or symmetry (is there a difference in the level between your nipples? Do both breasts look symmetrical?)
Skin discoloration or dimpling
Bumps/lumps – NOTE: normal lumpiness, like in the week before and of your menstrual cycle, will appear as very small and separate lumps like the texture of an orange.
Sores or scaly skin
Discharge or puckering of the nipple

Look for changes -- is everything the same?

Next, put your hands on your hips and push down with your arms while pushing your chest out. (Think of Barbara Windsor to get this one right )
Do you see anything unusual? Your breasts should look the same without any unusual dimpling or puckering.

Squeeze each nipple gently to check for discharge. A clear discharge is normal - as is none. If the discharge is tinged with blood, contact your doctor.

Stand in front of a mirror and look for the above changes in your breasts (from both a frontal and profile view) in 3 different positions:

1. With your arms up behind your head
   
2. With your arms down at your sides
   
3. Bending forward
   -- with your hands on your hips and shoulders turned in
   -- with your arms relaxed hanging in front of you

Tactile Examination -

Don't be shy, this is the part of the examination when you need to feel your breasts for any changes. Whether your boobs have been compared to melons or mosquito bites, the examination is the same. The only exception is that large breasted-women should be sure they see and feel the entire breast and surrounding region, while very thin women should figure out whether the hard lump they've been feeling is just a rib bone or something of concern. You will find you get to know what you feel like anyway.

Begin by looking for the changes listed above while standing up. Some women find it useful to do this part of the BSE in the shower, since soap or bath gel will aid in the ease of feeling your breasts.

The first thing you have to do is pick a pattern. For the BSE, you need to pick a pattern to feel your breasts and surrounding areas, which include:

the breast itself
between the breast and underarm
the underarm itself
the area above the breast up to the collarbone and across to your shoulder
It is important to check surrounding areas because breast cancer may be found in the lymph node tissue around your breast and underarm.

You use the pads (where your fingerprints are) of your three middle fingers on your right hand pressed together flat to check your left breast, and do the opposite for the right breast. You should press on your breast with varying degrees of pressure:

light (move the skin without moving the tissue underneath)
medium (midway into the tissue)
hard (down to the ribs "on the verge of pain")
When using any of the 3 patterns, you should always be using a circular rubbing motion (in dime-sized circles) without lifting up your fingers.

Patterns:

1. Spiral (concentric circles): begin with a large circle around the perimeter of your breast and make smaller and smaller circles as you work your way toward the nipple.

2. Pie shape wedges: pretend your breast is divided into sections like pieces of a pie, begin in the nipple area and feel your breast in a small circular motion within one pie shape section, then move on to the next wedge starting in the nipple area again.

3. Up and down: pretend your breast is divided into vertical stripes, begin on one side and feel your breast in a small circular motion up and down in a zig zag pattern.

Then repeat the process for the other breast.

Once you've performed the tactile examination while standing up in front of a mirror, you should do the whole examination again, this time while lying down. Here's how to do so:

Put your left arm behind your head and use your right hand to examine your left breast.

Put a small pillow or towel under your left shoulder to aid you.

Again, use the pads of your 3 fingers of your right hand to check your left breast in the pattern of your choice (spiral, pie shape wedges, or up and down).

Be sure to always use the same pattern (it's the best way to know if there are changes).

And again, don't forget to feel your breast using light, medium, and hard pressure.

After you're finished, you must repeat the procedure again for your right breast.