Ten years ago, OBGYNs frequently spent precious time with patients instructing them on how to put two fingers together and diligently inspect their breasts for lumps and other indications of cancer. But, as is often the case with medical advice, this has now changed.

As it turns out, this focus on lump-monitoring produced anxiety in women of all ages and frequently lead to false positives.

“There have been several studies that have come out that show that breast self-exams don’t really help for average-risk women,” says Dr. Kelly Culwell, an OBGYN and former medical officer at the World Health Organization. “And it can actually be harmful because if you don’t know the difference between normal lumps and bumps and things that can be dangerous; it creates a lot of anxiety and worry, and people may be getting unnecessary biopsies.”

Now, doctors are directing women towards general breast awareness — knowing what their breasts normally feel like and monitoring for any changes. With this in mind, here’s what you need to know, what you should look for, and how frequently you should check.

Check once a month
Women are encouraged to check once a month after their periods because that is when the breast is the least lumpy. “It is important to know that your breast tissue starts at your collarbone and goes all the way up to your armpits and all the way down to the bottom of your ribs,” Culwell says. “You can go in circular motions, you can go in sweeping motions. The key is when you are feeling your breasts, you need to have kind of a light touch because when you press too hard you are going to press all the way down to your rib cage and you will be feeling a rib.”

Some lumps and bumps are normal
Breast texture varies in consistency between women. But, some lumps and bumps in the breast are common, and these can change throughout a woman’s menstrual cycle, Culwell says. “Normal is when they move when you touch them, and they don’t tend to grow other than their normal cyclic changes. Mid-cycle they might get larger, but if you are checking around the same time every month, they really shouldn’t have grown.”

Watch out for hard knots that don’t move
The lumps to be concerned about are ones that are hard. “Abnormal would be something that’s fixed, that doesn’t move,” Culwell says. “If something does hurt I would recommend having an evaluation. When you have a clinical breast exam and the doctor feels something, they can say ‘Has this been there for a while,’ [and] you can say, ‘Actually, I feel that all the time, I know that’s been there for years.’ Sort of like if you have a mole on your arm and you know that has been there for years.”

You can learn more about how to do a breast self-exam here.

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