October is Breast Cancer Awareness Month – a time when we stand together, remember loved ones, and commit to caring for ourselves. Among the many tools in this fight, regular self‑examination (or more precisely, breast self‑awareness) is one thing you can do. No equipment needed, just time, care, and attention. In this article, I’ll walk you through why self‑checking is important, how to do it in a kind and confident way, and what to do if something seems off. Consider this a gentle companion in your health journey. You deserve to know your body well.
Why self‑checking (or self‑awareness) matters
When it comes to breast cancer, early detection saves lives. The sooner a change is noticed and checked out, the more treatment options are available and the better the outcomes tend to be.
Self‑examination helps you become intimately familiar with how your breasts normally look and feel. That way, if anything changes – a lump you've never felt before, dimpling in the skin, a new nipple inversion – you’re more likely to spot it early and seek medical advice.
In South Africa, where access to advanced imaging and screening is uneven, self‑checking takes on even more value – not as a replacement for clinical services, but as a first line of awareness.
That said, it’s important to be aware of the caveats: large trials haven’t definitively shown that self‑exams reduce breast cancer mortality, and routine instruction in formal monthly breast self‑exams is no longer universally recommended.
What is broadly agreed is that knowing your body and noticing changes is valuable.
When and how often to self‑check
- If you’re still menstruating, the best time is a few days after your period ends, when your breast tissue is less swollen and tender.
- For those who are post‑menopausal, pick a consistent day each month (for example, the 1st or 15th).
- Many experts suggest doing a self‑check once a month.
- Always keep in mind: self‑checking does not replace clinical breast exams or mammograms where indicated.
Step‑by‑step: How to perform a gentle self‑check
Below is a friendly, easy method you can follow. Take your time, go slow, and breathe.
1. Inspect in the mirror
- Stand (or sit) undressed from the waist up before a mirror. Relax your arms by your sides.
- Look for changes in breast shape, size, or symmetry. Is one side sagging more? Puckering? Skin dimpling?
- Raise your arms overhead, or press your palms on your hips and twist slightly – check how the breasts move, whether the contours appear even.
- Gently squeeze each nipple to see if there is any discharge (especially clear or bloody).
- Also glance at the skin around and beneath the breast, up toward the collarbone, and into the armpits.
2. Feel while lying down
- Lie flat on your back with a pillow under your right shoulder. Use your right hand (flat, with fingers together) to examine your left breast, and vice versa.
- Use three levels of pressure – light, medium, firm – and move in a pattern (circular, up-and-down, or wedge/radiating) to cover the entire area from collarbone to below the breast, and side to the sternum.
- Don’t forget the armpit area (tail of Spence) and the area under the breast.
3. Feel while standing or in the shower
- Many people find it easiest to feel when the skin is soapy and slippery.
- Use the same flat‑hand motion, checking the entire breast and underarm area with three pressures.
- Be consistent with the pattern each month so you don’t miss any spot.
4. Note what you feel
As you go, be alert for:
- A new lump, hard knot, or thickening
- Skin changes: dimpling, puckering, redness, scaling
- Nipple changes: inversion, retraction, discharge
- Texture changes: a new firmness or area that feels different
- Swelling or enlargement not typical for your cycle
If you notice anything new, persistent (i.e. doesn’t go away after your period), or unusual, don’t panic — but do make an appointment with your healthcare provider.
Benefits – and limits – of self‑checking
Benefits
- You become familiar with your “normal” baseline – and are more likely to spot changes early.
- It’s free, private, and immediate – no waiting, no special equipment.
- In contexts where access to mammograms or clinical exams is limited, it serves as an empowering tool.
- It encourages women to be proactive about breast health, engage with healthcare providers, and build awareness.
Limitations & cautions
- The evidence is mixed: large trials did not show that formal self‑exams reduce mortality.
- Self‑checks can lead to false positives – benign lumps that cause worry, unnecessary doctor visits, or biopsies.
- Some medical organisations now prioritise self‑awareness over rigid monthly exams.
- Not all cancers are palpable – some develop in areas you can’t feel, or grow between checks. That’s why screening (mammography, clinical exams) is still vital.
In short: self‑checking is a companion, not a replacement, to professional screening and evaluation.
Breast screening in South Africa – when to go further
In South Africa, the Cancer Association of South Africa (CANSA) recommends that women from age 40 consider an annual mammogram, and women 55 and older may shift to a mammogram every two years (or continue annually if preferred).
However, mammography is not universally accessible in the public sector, especially in rural areas.
As a result, clinical breast examinations (by trained healthcare professionals) are often the backbone of public screening programmes.
If you fall into a higher‑risk group – strong family history, known genetic mutation (e.g. BRCA1/2), previous breast disease – your doctor may advise earlier or more frequent imaging.
Tips for making self‑checking a habit (without stress)
- Pick a consistent day each month (e.g. “first Monday”)
- Combine it with another regular routine – after your shower, while you’re applying lotion
- Use a journal, app, or note to record what is normal (size, shape, texture)
- Be gentle with yourself – don’t force or rush
- Share the practice with a trusted friend or in a support group to encourage each other
- If you feel anxious about a finding, remember: many changes are benign. The point is to notice, not to self‑diagnose
- Always pair self‑checking with regular clinical screening and professional guidance.
If you find something – what next?
- Don’t panic. Most lumps are not cancerous.
- Monitor for a cycle (if you're still menstruating) – if the change persists beyond one full cycle, that’s a signal.
- Make an appointment with your healthcare provider (GP, nurse, breast health specialist).
- The doctor may order imaging (ultrasound, diagnostic mammogram) or a biopsy to clarify the nature of the change.
- Stay informed, ask questions, and seek a second opinion if you need reassurance.
A Compassionate reminder
You are more than your physical body. Doing a self‑check is an act of love and care – a way to listen to yourself. If you discover something concerning, you’re not alone. Reach out to a clinician, a friend, a support group.
Breast cancer awareness is more than pink ribbons – it’s about knowledge, early action, and compassion. This October, let’s commit to feeling to heal. Let this be a month where you gift yourself awareness, kindness, and action.