6 Physical Examinations for Breast Cancer Screening

Breast cancer in its early stages does not cause symptoms. Sufferers tend to present at an advanced stage. In fact, this cancer can be detected early by recognizing changes in the breast. Early detection can be done in three steps: breast self-examination (BSE), physical breast examination (CBE/Clinical Breast Examination), and mammography.

Breast self-examination (BSE), including:

1. 1. Examination in front of a mirror. Note the symmetry of both breasts.
   2. Raise both arms over your head, noting changes in the shape of each breast, swelling, indentation, or changes in each nipple.
   3. Touch examination in a standing position. Examine the right breast, raise your right arm behind your head, and use the fingers of your left hand to perform the examination. Make a vice versa or change.
   4. Check all parts of the breasts and armpits. Move the breasts in a circular, up-down (vertical) or “wedge” pattern. Use a pattern that is easy to do, then do the same pattern every month.
   5. Gently massage the nipple and see if there is any blood or fluid coming out.
   6. Lie down on a hard surface. Place a pillow under your right shoulder and your right arm behind your head. Flatten the fingers of your left hand on your right breast, and press gently all over the breast, including the nipple.
   7. Do the same thing on the left breast.

Breast physical examination (CBE/Clinical Breast Examination) includes:

1. components

• position, perimeter
• patterns of search
• palpation
• pressure, practice

2. Infection:

• Pay attention to the presence of masses, skin changes (erythema/inflammation of the skin located in the fat layer of the skin, retraction/inflammation in the breast tissue, peau d'orange/orange peel), and nipple changes (discharge +).
• (arms at sides, raised up, hands on hips, bent).

3. Palpation:

• Use the flat of the palm and the proximal knuckles of the middle three fingers.
• Palpation can be done methodically with a pattern of wheel spokes (wedges), concentric circles, or vertically.

4. Axillary examination

• Relax the pectoralis muscle, then examine the right axilla (the patient's right lower arm is supported by the right hand), then the fingertips of the left hand begin to examine from the bottom of the axilla, then the patient's right arm is pulled medially, then move the left hand higher into the axilla.

5. Examination of the Areolar Nipple Complex
   • You must lie straight.
   • Inspect for nipple retraction, fissure desquamation or redness, and inversion.
   • Is there any discharge? (Place each hand on both sides of the nipple gently, then press the nipple, then pay attention to the nature of each fluid that comes out.).
6. Mammography:

• To look for changes in the breasts of women who do not show signs of breast cancer on physical examination;
• Using X-rays (breast tissue is pressed between two discs or plates), a picture is taken and assessed to see if there are any abnormalities in the picture.

Breast cancer sufferers in Indonesia only find out about their condition after it is in an advanced stage. In fact, this cancer can be detected early by changes in the breast. This early detection can be achieved through three steps, namely breast self-examination (BSE), physical breast examination (CBE), and mammography. Women are advised to have their breasts checked every month (BSE) starting around the age of 20 to get used to the appearance of their breasts, so they can detect early signs of cancer. Clinical Breast Examination (CBE) is carrying out inspection and palpation of the breast and surrounding tissue so that breast abnormalities can be detected, which is carried out by health workers. Reporting consists of relevant conclusions drawn from the clinical history and description of the CBE, normal or abnormal. Mammography screening is aimed at looking for changes in the breasts of women who do not show signs of cancer on physical examination.

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