of the western world, is such that out of every nine or ten women whom you know, possibly one will develop breast cancer. This is quite an alarming statistic. However, it is one which should only encourage us to do monthly breast self-examinations so that, should something develop which seems unusual, then we have the very important advantage of early detection.

Let me assure you that all lumps are not cancerous, not at all, but this is something which can only be determined by your doctor. Every woman over the age of twenty should check her breasts once a month. The reason for starting young is that if you make a habit of examining your breasts then you will become confident and comfortable about doing it before you reach the age at which the risks of developing breast cancer are higher. Moreover, breast cancer is not unknown in girls in their twenties, though it is unlikely. Early detection is the best possible means of ensuring prompt, successful treatment and, in many cases, total cure.

You should, first of all examine your breasts while standing in front of a mirror. With two hands behind your head, note whether the size of shape of your breasts has changed since the last examination, and remember that both breasts are not always the same size and also that one usually is lower than the other. Next raise your arms above your head. Do both breasts move in the same way? Now lean forward from the waist and place your hands on your hips.

Again look for changes in the appearance of your breasts. Does the skin in any one area look unusual? Is there any discolouration, or dimple or a pucker, that is, is it drawn inwards or upwards in any one area? Next, examine your nipples. Are they red or shiny, is there any scab or rash which has been there for a while, or is either nipple retraced or drawn inwards? Is there any discharge from your nipples? You should examine each breast, feeling for lumps with the flat part of your fingers, not poking with your fingertips. This should be done both in the shower, while you are soapy, and while lying on your bed, when you might find that powder or lotion on your hands may make the examination easier. When lying down, put a pillow or folded towel under the shoulder on the same side as the breast which you are going to examine. You then put one hand behind your head, in order to stretch the breast tissue and the underlying muscles.

With your other hand you examine the beast on the opposite side, that is you use your left hand for the right breast and vice versa. Starting just below your collarbone, and with your fingers together, move your hand in a systematic way round your outer breast and gradually work your way in smaller circles until you have covered all your breast tissue, right up to the nipple.

Don't forget the area that extends up into your armpit. Try to imagine that you are searching for a raisin in a bowl of bread dough, or that you are feeling for a small pebble or something like a frozen pea. You need to press your breast tissue fairly hard against your ribs in order to be thorough.

Your breasts are not entirely smooth and can be quite lumpy naturally, but you will soon be able to recognise your own general lumpiness and to distinguish something which doesn't feel like it belongs there, once you have been doing your breast exams regularly. If you find an area which feels suspicious, then just feel in the same place on the opposite breast and if it feels similar then you can be assured that it is normal. When you have thoroughly examined one breast, then put your other hand behind your head and examine your other breast. Don't be afraid to do this just because you think that you don't know what you are looking for. You would soon recognise a lump which does not feel like your normal breast tissue, once you have been doing this for a while.

Remember, also, that pain does not have to be present for there to be a serious problem.

This exam should be done without fail once every month. A doctor examining you once a year is just not enough. The best time is just after your period. If you do not have periods, then try to do it on the first day of each calendar month. Report any changes to your doctor, without delay. Some symptoms and lumps are not serious but only a medical person can determine that. It is far better to see your doctor and set your mind at rest than risk neglecting something serious. Don't hesitate to ask for advice. It is always much better to be safe than sorry. -- MARY BOORMAN MATERNAL HEALTH/FAMILY PLANNING, DEPARTMENT OF HEALTH.