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Pregnancy & birth

Breast Self-Examination—Even During Pregnancy and While Breastfeeding

Here's how to perform a breast self-exam in 5 steps, even during pregnancy and while breastfeeding. What's normal, which lumps you should have checked, and what preventive care covers.

By the LIINI editorial teamUpdated 9 min read21 sources

Brust abtasten Schwangerschaft Stillzeit Krebsprävention
Contents

In short

Examine your breasts about once a month. If you’re having your period, a good time is about a week after it starts, because the tissue is softer then. If you’re pregnant, choose a set day each month; if you’re breastfeeding, it’s best to examine your breasts right after breastfeeding or pumping. Look at your breasts in the mirror, examine them thoroughly while standing and lying down—leaving no area unchecked—and don’t forget your armpits. Most lumps that appear while breastfeeding are harmless, but have a lump checked out if it doesn’t go away after about a week of treating a milk duct blockage, doesn’t change while breastfeeding, or appears for the first time during pregnancy.

October is Breast Cancer Awareness Month—a great opportunity to get to know your breasts better. If you check your breasts regularly, you’re more likely to notice any changes, even during pregnancy and while breastfeeding. Here you’ll find simple instructions and learn what’s normal during this time and what you should have checked out. First off: Many changes in the breasts are harmless, according to the Swiss Cancer League.

Why should you check your breasts regularly?

Self-examination helps you get to know your breasts and what’s “normal” for them. That way, you’re more likely to notice if something changes, according to the Swiss Cancer League and the German Cancer Information Service. According to the U.S. National Cancer Institute (NCI), most women diagnosed with breast cancer around the time of pregnancy discover the lump themselves.

According to the Cancer Information Service, there is no evidence that self-examination alone reduces breast cancer mortality. It is not a substitute for a medical examination or a mammogram (Cancer League). The German Professional Association of Gynecologists advises women to continue performing regular self-exams of their breasts even during pregnancy and while breastfeeding, and to continue with their regular preventive screenings.

Good to Know

Good news for breastfeeding mothers: According to the Cancer League, women who have breastfed for an extended period of time have a lower risk of breast cancer.

When to Check: Menstrual Cycle, Pregnancy, Breastfeeding

How well you can feel something depends on how firm the tissue is at the moment:

Life StageWhen to screenWhy
During your periodabout one week after the start of bleeding; while on the pill, at the start of a new packThe tissue is softer at that time (Cancer Information Service, Cancer League).
PregnancyOnce a month on a fixed day, for example, always on the 1st.If you don’t have a regular cycle, setting a fixed time helps you stay on track.
BreastfeedingImmediately after breastfeeding or pumping, once a monthThe breast is softest and emptiest at that time (Hoag Clinic, USA).
After menopauseon a set day each monthThis helps maintain a regular cycle (Cancer Information Service).

Choose a quiet place with good lighting. You can also do a breast self-exam while standing in the shower.

Breast Self-Exam: A 5-Step Guide

Breast check in 5 steps, once a month: 1. Look in the mirror: shape, skin, nipples. 2. Move your arms: hands on hips, then arms up. 3. Feel while standing, with flat fingers in small circles, leaving no gaps. 4. Don't forget the armpit, up to the collarbone. 5. Repeat lying down. To check systematically, go in lines, in quarters or in a spiral.Breast check in 5 stepsonce a month, take your time1Lookin the mirror: shape, skin, nipples2Move your armshands on hips, then arms up3Feel while standingflat fingers, small circles, no gaps4Don't forget the armpitand up to the collarbone5Repeat lying downcheck both sides againHow to check without gapsLinesQuartersSpiral

Here’s how to do it, following the guidelines from the Cancer Information Service and the German Professional Association of Gynecologists:

  1. Look: Stand in front of the mirror with your arms hanging loosely at your sides. Pay attention to the size, shape, and skin of your breasts, as well as your nipples.
  2. Move your arms: Place your hands on your hips and look again. Then raise your arms above your head and examine your breasts from the front and from the side. Is the skin pulling in anywhere?
  3. Palpation while standing: Use the flat pads of your index, middle, and ring fingers to feel your breasts in small circles—first gently, then moderately, then more firmly. Proceed systematically, in rows, quarters, or in a spiral from the outside toward the nipple, so you don’t miss any spots.
  4. Armpit and Collarbone: Also check the armpit and the area above the breast up to the collarbone. According to the Cancer Information Service, breast cancer most commonly develops in the upper outer part of the breast, toward the armpit.
  5. Repeat while lying down. Lie on your back and examine both breasts again in the same way.

Also take a look at your nipples: Is one retracting, is it weeping or flaking, or is fluid leaking from it? During breastfeeding, milk is normal. If there is a bloody discharge, have it checked out.

Tip

Not sure how hard to press? Ask your gynecologist to show you how to do the exam during your next checkup. Some clinics even demonstrate the circular motion using a ball of dough, so you can practice without feeling self-conscious.

What to Watch For: Changes in the Breast

According to the Cancer League and the Cancer Information Service, you should have a doctor examine you for the following changes:

  • a new lump or thickening in the breast or underarm
  • a breast changes size or shape, or suddenly becomes noticeably larger than the other
  • dimples, indentations, or skin that looks like an orange peel
  • Redness, swelling, or a rash that does not go away
  • A nipple that has recently become inverted, is oozing, itchy, or flaky
  • clear or bloody discharge from the nipple (milk during breastfeeding is normal)
  • Swollen lymph nodes in the armpit or near the collarbone

If you notice any of these, make an appointment with your gynecologist or primary care physician. Don’t panic: According to the Cancer League, breast pain is usually not a sign of cancer, and many lumps are benign. However, a new lump should be checked out even if it doesn’t hurt.

Lumps in the Breast While Breastfeeding: What’s Normal

During pregnancy, the breasts undergo significant changes. They become larger and more sensitive, the veins become more prominent, and the areola may darken, according to the British organization CoppaFeel!. Starting around the 16th week, the breasts may already begin producing colostrum. The “Calculate Your Due Date” guide will tell you which week you’re currently in. According to the NCI, breasts also feel lumpier during pregnancy, which makes it harder to check them by touch.

During breastfeeding, the breasts feel different depending on how full they are. Typical, usually harmless lumps:

  • Full Milk Glands: Before breastfeeding, the breast often feels lumpy and firm; afterward, it feels softer. According to La Leche League International, most lumps during breastfeeding are milk-filled glands or inflammation.
  • Milk engorgement: a hard, painful, often reddened area. You can read about what helps in the guide “Recognizing and Relieving Milk Engorgement, Milk Blisters, and Mastitis.”
  • Milk cyst (galactocele): A lump filled with milk that is usually painless. According to ABM, the international professional association for lactation medicine, it is the most common benign lump during breastfeeding.
  • Lactating adenoma: a benign lump that, according to Breastcancer.org, often resolves on its own once hormone levels drop again.
Lumps while breastfeeding: what is usually harmless and what to get checked. Usually harmless: the breast feels lumpy before a feed and softer afterwards, changes with breastfeeding, and lumps get smaller within days. Treat a blocked duct and watch it: hard, painful, reddened area; cool, keep breastfeeding, rest; see a doctor if it is no better after 24 hours. Get it checked by a doctor: lump still there after a week of treatment, lump doesn't change with breastfeeding, dimples or an inverted nipple, blood from the nipple, redness persists despite antibiotics, new lump in the armpit.Lumps while breastfeedingWhat's usually harmless, what to checkUsually harmlesslumpy before a feed, softer afterchanges with breastfeedinggets smaller within daysBlocked duct: treat ithard, painful, reddened areacool, keep feeding, restno better in 24 hours: see a doctorGet it checked by a doctorlump still there after 1 week's treatmentlump doesn't change with feedingdimples or inverted nippleblood from the nippleredness stays despite antibioticsnew lump in the armpit

When to Have a Lump Checked Out

  • A lump does not go away after about a week of treating a milk engorgement or mastitis (La Leche League International).
  • It does not change during breastfeeding or remains in the same spot for several days (Hoag Clinic).
  • Redness does not improve after 7 to 10 days despite antibiotics (La Leche League International).
  • A milk engorgement keeps recurring in the same spot (ABM).
  • You notice any of the changes listed in the checklist above.

Important

Don’t put off getting screened just because you’re pregnant or breastfeeding. According to the NCI and the German Society for Gynecology and Obstetrics, breast cancer is often detected late during this time because changes are mistaken for normal conditions or milk engorgement.

Medical Examinations During Pregnancy and Breastfeeding

You do not need to stop breastfeeding or wait until the end of your pregnancy to undergo an examination.

  • Ultrasound: According to the ABM, it is the preferred diagnostic method during breastfeeding. It is also usually the first step during pregnancy because it does not involve radiation (NCI, Cancer Research UK).
  • Mammography: It is possible to have a mammogram while breastfeeding (ABM). If you breastfeed or pump shortly before the exam, there will be less milk in your breasts. The X-rays do not affect your milk, and you can breastfeed again right after the exam (La Leche League International). During pregnancy, your baby is shielded from the radiation (Cancer Research UK).
  • Tissue sample (biopsy): This is also possible while breastfeeding. The ABM expressly advises against weaning beforehand.

Breast cancer during pregnancy and breastfeeding is rare. According to the NCI, it occurs in about 1 in 3,000 pregnancies, most commonly in women between the ages of 32 and 38. Because the breasts change naturally during this time, it can easily be overlooked. That’s why it’s better to get checked one too many times.

Early Detection in Switzerland and Family History

Starting at age 50, mammography is the most important screening test for early detection. Many cantons invite women aged 50 and older to undergo mammography every two years as part of a screening program (Cancer League, Swiss Cancer Screening). You can check the Swiss Cancer Screening website to see if your canton has such a program.

Family History: In 5 to 10 percent of women with breast cancer, the disease is due to a genetic predisposition (Swiss Cancer League). If close relatives have had breast cancer, talk to your gynecologist. If you have a hereditary increased risk, early screening may be advisable even before age 50 (Swiss Cancer Screening).

Questions? The Cancer League can also answer them over the phone at KrebsInfo, 0800 11 88 11. After giving birth, your midwife is also a good person to contact if you notice anything unusual about your breasts. You can read about what she does during the postpartum period in the guide “Postpartum Care: What to Expect and What Your Midwife and Health Insurance Provider Cover.”

In Germany, the mammography screening program invites women aged 50 to 75 every two years (Cancer Information Service); in Austria, it invites women aged 45 to 74 (gesundheit.gv.at).

Frequently Asked Questions

How often and when should I check my breasts?

About once a month, according to the Cancer Information Service. If you have a period, a good time is about a week after your period starts; if you’re pregnant, choose a fixed day each month. Self-examination is not a substitute for a medical exam or a mammogram.

Can I check my breasts while breastfeeding?

Yes, and it’s a good idea. Check your breasts right after breastfeeding or pumping—that’s when they’re softer, and any changes are easier to notice. Lumpy, full areas that get smaller after breastfeeding are usually milk glands.

Is a lump in the breast dangerous while breastfeeding?

Usually not. According to La Leche League International, most lumps that occur while breastfeeding are milk-filled glands or an inflammation, such as a milk duct blockage. If a lump does not go away after about a week of treatment or does not change while breastfeeding, have it checked by a doctor.

Can I have a mammogram while breastfeeding?

Yes. According to the ABM, breast examinations are possible while breastfeeding; they usually start with an ultrasound. If you breastfeed or pump shortly before the mammogram, there will be less milk in your breasts. You don’t have to stop breastfeeding for this.

How common is breast cancer during pregnancy?

Rare. According to the U.S. National Cancer Institute (NCI), it occurs in about 1 in 3,000 pregnancies. Because the breast undergoes significant changes during this time, it is often not detected until late in the pregnancy. A new lump should therefore be evaluated even during pregnancy.

At what age do women in Switzerland begin receiving mammograms for early detection?

Many cantons invite women age 50 and older to undergo a mammogram every two years (Cancer League, Swiss Cancer Screening). You can check whether your canton has a program at Swiss Cancer Screening. If you have an increased family risk, discuss with your gynecologist whether early screening makes sense sooner.

Does breastfeeding increase the risk of breast cancer?

No, on the contrary. According to the Cancer League, the risk of breast cancer decreases in women who have breastfed for an extended period of time.

Sources

  1. Breast Cancer Prevention and Early Detection, Swiss Cancer League
  2. Breast Cancer Early Detection: What You Should Know About Your Breasts (Breast Awareness), Swiss Cancer League
  3. Risk Factors and Early Detection of Breast Cancer (PDF), Swiss Cancer League
  4. Breast Cancer Awareness Month in October, Cancer League Zurich
  5. Early Detection of Breast Cancer, Swiss Cancer Screening
  6. Breast Cancer: Early Detection Through Self-Examination and Mammography, Cancer Information Service, German Cancer Research Center
  7. Breast Cancer: What Are the Benefits of Self-Examination?, Cancer Information Service, German Cancer Research Center
  8. Symptoms of Breast Cancer, Cancer Information Service, German Cancer Research Center
  9. Instructions for Breast Self-Examination (PDF), frauenaerzte-im-netz.de, Professional Association of Gynecologists
  10. Early Cancer Detection Also Recommended During Pregnancy and Breastfeeding, Professional Association of Gynecologists and DGGG
  11. Breast Cancer During Pregnancy and Breastfeeding, German Society for Gynecology and Obstetrics
  12. Clinical Protocol No. 30: Breast Lumps and Imaging in Breastfeeding Women (PDF), Academy of Breastfeeding Medicine
  13. Clinical Protocol #36: The Mastitis Spectrum, Revised 2022 (PDF), Academy of Breastfeeding Medicine
  14. Lumps and Breast Imaging, La Leche League International
  15. Breast Cancer During Pregnancy, National Cancer Institute (NCI)
  16. Breast Cancer During Pregnancy, Cancer Research UK
  17. Breast Changes During Pregnancy and Breastfeeding, CoppaFeel!
  18. Self-exams While Breastfeeding? Yes, They’re Important, Hoag
  19. Breast Changes During Pregnancy and Breastfeeding, Breastcancer.org
  20. Breast Cancer: Early Detection, gesundheit.gv.at, Austria’s Public Health Portal
  21. Detecting Breast Cancer: The Dough Trick for Self-Examination, Blick Brand Studio (Paid Content, Hirslanden)
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