Why are breasts good

Breast exam - what, when and how?

Palpation examination at home and at the doctor's

Every woman should feel her breast at home once a month if possible. In addition to the routine examinations at the gynecologist, this self-examination is advisable: About 80 out of 100 patients have discovered their tumor themselves while palpating their breasts. The best time for this is the first half of the cycle, ideally between the third and seventh day after the start of the menstrual period, when the glandular tissue is particularly soft and changes are easier to feel. Women who consistently take hormone supplements and therefore do not have a monthly bleeding should ask their gynecologist about the most convenient time for the self-examination. He will also be happy to show you the correct technique of scanning if you are unsure. For the early detection of cancer, however, palpation alone does not offer sufficient security, since small tumor cell nests cannot be detected. Therefore, in certain cases, further examinations are useful and necessary.

Here you should see your doctor

While doing a breast self-exam or looking in the mirror, look for the changes described below. If you find one or more of them, have them checked out by your gynecologist.

  • Knotty changes, newly appearing rough spots and hardening in the chest area or in the armpit
  • Skin indentations or protrusions and drawn-in nipples
  • Changes in the skin such as redness, flaking, orange peel or discoloration
  • Changes in the size or shape of the breast
  • Newly occurring side differences of the breasts with regard to, for example, size, shape, position or effect when the arms are raised
  • Fluid leaking from the nipple

Self-examination - the right technique

  • For the self-examination, first stand in front of the mirror and put your arms on your hips. Examine your breasts for the visible changes noted above. Now repeat this with your arms folded behind your head.
  • Then check whether secretion is leaking from the nipples: gently press the nipple between your thumb and forefinger and repeat this on the other side.
  • Now, with your arm hanging down, slowly feel one quarter after the other from the edge of the chest to the nipple. It is important to pay attention to rough spots and knotty changes. Repeat this process with your arm folded behind your head and check the armpit for lumps as well. You should perform this palpation examination again while lying down, as hidden changes may only become noticeable when you change position.

Breast sonography

The ultrasound examination - medical sonography - takes place either in addition to the palpation examination by the gynecologist, or after a mammography. Sonography is uncomplicated and risk-free and allows, among other things, an assessment of cysts and other benign changes. In some cases, breast ultrasound can eliminate the need for further examinations, such as a mammogram. On the other hand, the combination of sonography and mammography can increase the cancer detection rate - for example in the case of very dense mammary gland tissue.

Mammography often brings security

In the event of uncertain or suspicious findings from the palpation examination and any sonography that has already been carried out, a special X-ray examination of the breast, the mammography, is carried out. With their help, the doctor can further narrow down whether a change is benign or malignant. If in doubt - if not already done - an ultrasound examination is then carried out and a tissue sample may be taken, known as a medical biopsy.

In Germany, women between 50 and 69 years of age are entitled to a mammography, the so-called mammography screening, which takes place every two years. This program is used for the early detection of breast cancer and here, exceptionally, mammograms may also be carried out without suspicion of an illness. These X-ray examinations take place in special screening facilities.

Magnetic resonance imaging - MRI for short

An additional imaging method is magnetic resonance tomography, also known as magnetic resonance tomography. If the breast is examined with this, the doctor speaks of breast MRI or MR mammography. It is only performed in certain cases, for example in the case of uncertain diagnoses in mammography, if the extent of the tumor is unclear, in women with very dense breast tissue or with breast implants, and in women for whom a tissue sample, known as a biopsy, is difficult to perform. While X-rays are used in mammography, doctors use MRI to measure energy currents that are generated under the influence of a strong magnetic field.

If in doubt, biopsy

Only when the palpation and imaging examinations do not provide reliable results of a change does the doctor take a tissue sample from the suspicious area and have it examined under the microscope. This so-called biopsy is now performed using various techniques, usually under X-ray or ultrasound control. In some cases, it is also necessary to have a tissue sample removed by surgery - for example, if fluid leaks from the nipple. Ultimately, a biopsy can clearly determine whether a change is benign or malignant.