By Michelle Oleson

To do or not to do, that is the question. At least that’s the question some people are asking about conducting breast self-exams to aid in the prevention of breast cancer.

Early detection of breast cancer saves lives. That much is true, even though there might be some debate on whether breast self-exams are effective. Some studies have recently argued that self exams might not be worth doing because some research has shown no decrease in breast cancer deaths in women who perform them, but most health care providers still recommend women conduct them monthly, in conjunction with regular mammograms and clinical exams.

“Although there has been research that suggests self exams may not be helpful, there are other studies that demonstrate that women who regularly perform breast self exams tend to discover cancer when lumps are smaller and less-advanced,” said Dr. JoAnne Biafore, MD, radiologist and breast imaging specialist at Emory Johns Creek Hospital. “When self exams are used with mammograms and clinical exams to screen for cancer, they represent a triple threat in the fight for early detection.”

Biafore added that awareness is also a key factor in detecting the disease early. She said women who conduct self exams are more likely to be aware of changes in their breasts, making it possible to detect cancer earlier, when more treatments are available. To be most helpful, women need to learn what is normal for them, which means self exams should be conducted regularly beginning at around age 20.

Breasts are made up of glands that produce milk, ducts and connective tissue. Most breast cancers begin in the glands and ducts. Keep in mind that while it is normal for breasts to feel a bit lumpy or uneven, a lump is more likely to be cancerous if it is hard and anchored in the breast tissue, meaning it won’t move if pressed on. When conducting self exams, pay attention to warning signs, such as lumps or thickening of the breast; change in size, shape or color of the breast; nipple discharge; and redness or heat.

In order for self exams to most effective, they need to be performed correctly. Here are the five basic steps to a breast self exam, courtesy of Breastcancer.org:

Standing with shoulders straight and arms on hips, face a mirror. Look for any differences in size, shape, color, swelling or bulging of the skin, changes in the nipple, or any signs of redness or rash.

Raise arms, and examine breasts for any of those differences.

Gently squeeze each nipple to check for any discharge.

Lie down, and feel each breast with the hand of the opposite arm. Feel all the tissue, applying pressure to check deep tissue for any lumps or abnormalities.

Examine the breasts while standing or sitting, gently examining the entire breast. This can be done in the shower, while the skin is slippery.

There are many reasons changes in breasts can occur. Aging, pregnancy, timing of menstrual cycle and hormone use are a few examples. And, because a lump can be the size of a pea before it can be detected, it’s important to keep up with regular mammograms and clinical exams, as well.

“Like so many things when it comes to your health, screening begins at home,” said Dr. Biafore. “Self exams are good because anyone can learn to do them, and they’re free. They represent a basic place to start the process of early breast cancer detection.”

Jo Anne Biafore, MD is the breast imaging specia­list at Emory Johns Creek Hospital.