How Should I Check My Breasts? The NHS 5-Point Plan, in Plain English

Short answer: There is no single right way to check your breasts. The NHS advice is simple: get to know what is normal for you, look at and feel your breasts regularly, learn which changes to watch for, report any change to your GP without delay, and attend routine breast screening when invited. Checking takes a few minutes and fits into an ordinary routine, in the shower, while dressing, or before bed.

October is Breast Cancer Awareness Month, which makes this week a good time to learn the routine properly rather than relying on a half remembered technique from years ago. This guide follows the NHS Breast Screening Programme five point plan, in plain English, and explains what each point means in practice.

What does checking your breasts actually mean?

Checking your breasts is not a medical test and it is not a formal examination with a set technique. NHS trusts are consistent on this point: there is no right or wrong way to check. What matters is familiarity. Every woman’s breasts are different in size, shape and consistency, and it is common for one breast to be larger than the other. Breasts also change across the menstrual cycle, for example feeling tender or lumpy near the armpit before a period, and after the menopause they typically feel softer, less firm and less lumpy.

The point of checking is to learn your own normal, so that a new change stands out. That is a different job from screening. Screening looks for cancers too small to see or feel in people without symptoms. Checking is what you do between screenings, and it matters at every age, including before screening starts and after it ends.

The NHS 5-point plan for being breast aware

The NHS Breast Screening Programme sets out five points. They are worth learning as a set, because each one supports the others.

1. Know what is normal for you. Learn how your breasts usually look and feel, including how they change during your cycle. Normal is personal: there is no standard breast to compare yourself with.
2. Know what changes to look and feel for. Learn the change list in the next section, so you know what counts as a change worth reporting.
3. Look and feel. Look at your breasts and feel them regularly, covering all parts of each breast, your armpits and up to your collarbone.
4. Report any changes to your GP without delay. Do not wait for your next screening appointment, and do not wait to see whether a change goes away on its own.
5. Attend routine breast screening when invited. If you are aged 50 to 71 and registered with a GP, you will be invited for screening every three years.

How to check, step by step

Start by looking. Stand in front of a mirror with your shoulders straight and your arms by your sides, then look for changes in size, shape and outline, and for visible changes in the skin or nipples. Raise your arms and look again, since that stretches the skin and can reveal dimpling or puckering that is easy to miss.

Then feel. Use the pads of your fingers, not the fingertips, and work over the whole breast in a pattern that covers every part, from the collarbone down to the bottom of the breast and from the breastbone across to the armpit. Press firmly enough to feel the deeper tissue, but not so hard that it hurts. NHS guidance stresses checking all parts of your breasts, right up to your collarbone, as well as your armpits, because breast tissue extends further than most people realise.

You can do this in the shower, while applying body lotion, when getting dressed, or lying down. Lying down spreads the breast tissue more evenly and can make deeper lumps easier to feel. There is no need to change your everyday routine or to set aside a special session: the trusts that publish this guidance suggest fitting it into something you already do, so it actually happens.

How often should I check?

Regularly, but not rigidly. The Department of Health position, repeated by Newcastle Hospitals NHS Foundation Trust, is that there is no scientific evidence that self examination performed at the same time every month works better than a more relaxed approach to breast awareness. In other words, a fixed monthly date is fine if it helps you remember, but it is not a rule, and missing the date does not make the check useless.

A practical rhythm is to check often enough that you stay familiar with your normal, for example every few weeks, and to check promptly if anything feels different. If your breasts change during your cycle, checking a few days after your period, when tenderness settles, can make comparison easier. After the menopause, when cycle timing no longer applies, any regular rhythm works.

The changes to look for

Most breast changes are not cancer, but every change on this list deserves a prompt GP appointment. NHS trusts list the same core changes:

• A change in the size, outline or shape of one breast
• A lump, swelling, thickening or bumpy area in one breast or armpit that is new for you
• Puckering or dimpling of the skin, sometimes described as looking like orange peel
• A change in nipple position, such as a nipple being pulled in or pointing differently
• Discharge or bleeding from a nipple
• A rash, redness, crusting, scaly or itchy skin on or around the nipple
• Swelling under the armpit or around the collarbone
• Constant pain or discomfort in one part of a breast or armpit that is different from your normal pattern

Two points in that list surprise people. First, pain on its own is usually not a sign of cancer, but constant pain in one spot that differs from your usual pattern is still worth reporting. Second, changes do not usually come with other symptoms such as tiredness or loss of energy, so feeling otherwise well is not a reason to wait.

What happens if I find a change?

Book a GP appointment without delay, even if you feel fine and have no other symptoms, and even if you had a clear screening result recently. Screening is for people without symptoms; a new symptom takes a different route, and waiting for the next screening round would waste time.

At the appointment, your GP will ask about the change and examine your breasts, and will refer you to a breast clinic if further checks are needed. Most changes turn out not to be cancer: they may be cysts, harmless lumps, hormonal changes or skin conditions. NHS trusts put it plainly: you are not wasting anyone’s time. Reassurance and advice help, and when a change does turn out to be cancer, earlier detection gives a better chance of successful treatment.

If you are worried about being examined, you can ask for a chaperone, and you can say so when booking. You can also write down what you noticed and when, so you describe it clearly at the appointment.

Breast screening: what it adds

Routine NHS breast screening uses mammograms, which are X-rays of the breast, to look for cancers too small to see or feel. Women registered with a GP as female are invited every three years from age 50 until their 71st birthday, with the first invitation arriving at some point between the ages of 50 and 53. If you are over 71, you no longer receive automatic invitations, but you can still request screening by contacting your local service.

Screening does not replace checking. A mammogram is a snapshot on one day, and a change can appear between screenings. That is why the five point plan pairs the two: screening catches what you cannot feel, and checking catches what appears between appointments. If you notice a change at any age, contact your GP straight away rather than waiting for a screening invitation.

One correction to an older version of this advice is worth noting. Some older leaflets describe screening simply as starting at 50, while current NHS programme guidance states invitations run from age 50 to the 71st birthday, every three years. This guide uses the current programme wording.

Men and breast awareness

Although this guide is written mainly for women, men can get breast cancer too, and Public Health Wales notes that men should be breast aware as well. A new lump, nipple change or discharge in a man deserves the same prompt GP appointment.

Building the habit

The hardest part of breast awareness is not the technique, it is remembering to do it. Three small choices help. First, attach checking to something you already do, such as showering. Second, learn your normal across a full cycle before worrying about technique: familiarity is the whole method. Third, treat any change as a reason to book, not a reason to watch and wait. That last point is the one the NHS repeats most firmly, because delay is the avoidable risk.

Checking your breasts is a small routine with a clear purpose: knowing your normal so that a real change gets seen quickly. Learn the five points, learn the change list, and use both.

Frequently asked questions

How often should I check my breasts?

Regularly, but there is no rule that it must be on the same day each month. NHS guidance says there is no evidence a rigid monthly schedule works better than a relaxed, regular approach. Checking every few weeks, fitted into an existing routine such as showering, is a practical rhythm.

Is there a right way to check my breasts?

No. NHS trusts state there is no right or wrong way to check. Look at your breasts and feel them, covering all parts of each breast, your armpits and up to your collarbone. What matters is learning what is normal for you, so a new change stands out.

Does a lump always mean cancer?

No. Most breast changes are not cancer, and many lumps turn out to be cysts or other harmless conditions. Any new lump still deserves a prompt GP appointment, because only examination and, where needed, further tests can tell what it is.

Why do my breasts feel different before my period?

Hormonal changes during the menstrual cycle commonly make breasts tender or lumpy, especially near the armpit, before a period. After the menopause, breasts typically feel softer and less lumpy. Learning how your breasts change across your cycle is part of knowing your normal.

Should I wait for my next screening appointment if I find a change?

No. Screening is for people without symptoms. If you notice a change, book a GP appointment without delay, whatever your age and whenever you were last screened. Waiting for a screening round wastes time.

At what age does NHS breast screening start and stop?

Women registered with a GP as female are invited for NHS breast screening every three years from age 50 until their 71st birthday, with the first invitation arriving between the ages of 50 and 53. After 71, you can still request screening by contacting your local service.

Sources

• Hull University Teaching Hospitals NHS Trust, Breast Awareness: the Department of Health five point checklist, how to check, and the changes to look for. https://www.hey.nhs.uk/hbss/breast-awareness/
• East Lancashire Hospitals NHS Trust, Be Breast Aware: the five point code and the changes to look for. https://elht.nhs.uk/services/breast-imaging-screening-service/be-breast-aware
• Public Health Wales, Be Breast Aware leaflet: the five point code, how to check, and what to look for, including breast awareness in men. https://publichealthwales.nhs.wales/services-and-teams/screening/breast-screening/information-resources/leaflets/be-breast-aware/
• Newcastle Hospitals NHS Foundation Trust, Breast Awareness: no evidence for a rigid monthly schedule, and the five point code. https://www.newcastle-hospitals.nhs.uk/services/breast-screening/breast-awareness/
• Leeds Teaching Hospitals NHS Trust, Your Screening Appointment: invitations for women aged 50 to 71, every three years, first invitation before the 53rd birthday. https://www.leedsth.nhs.uk/services/breast-screening-service/your-screening-appointment/
• House of Commons Library, NHS breast screening briefing: national programmes invite women from age 50, every three years, until age 71. https://commonslibrary.parliament.uk/research-briefings/cbp-10922/

Related reading

• The Menopause Symptoms Women Miss Most: A Plain-English Checklist for World Menopause Day
• Paracetamol or Ibuprofen for a Child with a Fever: Which Comes First?
• Half-Term Starts Monday: The Medicine Cabinet Checklist Worth Doing Today

Medical disclaimer: This article is general information only and is not medical advice. If you notice a change in your breasts, contact your GP promptly. If you are worried about a symptom, NHS 111 can advise on what to do next.