A breast self examination should include more than the centre of the breast. The outer breast tissue and the underarm area matter too. During breast self-awareness, notice whether there is a new lump, thickening, swelling, skin change, nipple change or a persistent lump in the armpit.
The underarm contains lymph nodes, and breast tissue extends toward this area. A change under the arm does not automatically mean breast cancer. Infections, skin irritation, recent vaccination, benign breast conditions and other causes can also make the area feel different. Still, a new or persistent change deserves a timely clinical review.
Quick answer: Check the entire breast area from the collarbone to the lower breast and from the breastbone to the underarm. Use the finger pads of the opposite hand to gently feel the armpit and the outer breast. If you notice a new, persistent or growing lump, swelling or skin change, arrange an appointment with a breast doctor.
Why Should You Check Your Underarms During Breast Self-Examination?
Breast tissue is not limited to the rounded area visible on the chest. It extends outward toward the armpit. The underarm, also called the axilla, contains lymph nodes that help the immune system filter fluid and respond to infection.
When breast cancer spreads beyond the breast, nearby axillary lymph nodes can be involved. However, underarm swelling has many non-cancer causes. A tender node may occur with a skin infection, a recent illness, shaving irritation or a vaccination. This is why a self-check is useful for noticing a change not for diagnosing its cause.
In Nepal, breast cancer was the most commonly diagnosed cancer among females in GLOBOCAN’s 2022 estimates, with 2,255 new cases. That makes practical breast awareness, timely assessment and appropriate screening important parts of women’s health.
A self-check cannot find every breast cancer. Some changes are too small to feel, and many cancers are first found on imaging. Think of breast self-awareness as a way to know what is normal for you and to speak up promptly about changes between routine appointments or mammograms.
For a broader overview of symptoms, diagnosis and care, read Breast Health and Breast Cancer: When to See a Breast Cancer Surgeon in Nepal.
Is Breast Self-Examination the Same as Breast Cancer Screening?
No. A breast self-examination is a personal check for changes in the breasts and underarms. It is not a replacement for screening mammography, clinical assessment or diagnostic imaging.
Many health organisations now emphasise breast self awareness rather than requiring everyone to perform a strict monthly examination. The goal is to understand your usual breast and underarm appearance and feel, then report a meaningful change without delay.
| Method | Main purpose | What it can and cannot do |
|---|---|---|
| Breast self-awareness | Helps you notice changes in your own body | Can identify a new lump, swelling or skin/nipple change; cannot confirm cancer |
| Clinical breast examination | A trained clinician examines the breast and nodes | May identify abnormalities that need imaging; does not replace appropriate screening |
| Mammography or other screening | Finds possible cancer before symptoms develop in eligible people | Can detect some cancers too small to feel; needs an individual plan based on age and risk |
| Diagnostic imaging and biopsy | Investigates a concerning symptom or screening finding | Helps establish the diagnosis and guide treatment |
Do not wait for a self check to replace scheduled screening. Discuss the right screening schedule with a breast doctor in Nepal, particularly if you have a strong family history, a previous high-risk breast condition, a genetic mutation, prior chest radiation or a personal history of breast cancer.
What Can You Notice During a Breast and Underarm Self-Check?
Breast self-awareness is about noticing a new or different change. It is not about deciding whether something is harmless or cancerous by touch.
| Change to notice | Where it may appear | What to do |
| New lump, thickening or firm area | Breast, outer breast or armpit | Arrange a clinical examination |
| Underarm swelling or a distinct node | One armpit or near the upper outer breast | Get reviewed if new, persistent, growing or unexplained |
| Skin dimpling, puckering, thickening or redness | Breast, nipple or underarm skin | Seek prompt medical advice |
| Change in nipple direction or shape | Nipple/areola | Discuss a new inversion or persistent change |
| Clear or bloody nipple discharge not related to breastfeeding | Nipple | Arrange a medical review |
| Change in breast size, shape or contour | One or both breasts | Get checked when it is new or progressive |
| Persistent localised pain | Breast or underarm | Review if it does not settle or has no clear explanation |
Most lumps are not cancer. Cysts, fibroadenomas, hormonal changes, infection and enlarged lymph nodes are common examples of non-cancerous causes. But a new lump should be assessed rather than watched indefinitely.
For more on painless lumps and other warning signs, see Breast Cancer Lumps: Most Are Painless, So Don’t Ignore Them.
How Can the Underarms Be Checked During a Self-Exam?
The aim is to gently feel for a new, distinct or persistent change. You do not need to press hard, repeatedly squeeze the area or search for a diagnosis.
A Simple Underarm Self-Check
- Look first. Stand in front of a mirror with your arms relaxed, then raised. Notice new swelling, redness, rash, puckering or a visible difference between sides.
- Relax one arm. Keep your right arm relaxed by your side or rest your right hand lightly behind your head. Use the finger pads not the tips of your left hand.
- Feel the full armpit. Gently sweep from the front of the armpit near the chest wall, through the centre, to the back edge near the shoulder blade. Then repeat a little higher and lower in the armpit.
- Include the outer breast. Feel the area from the upper outer breast into the underarm. This is sometimes called the axillary tail of the breast.
- Compare, but do not expect perfect symmetry. Bodies are not identical on both sides. What matters is a new change, a firm fixed area, increasing fullness or a lump that remains.
- Repeat on the other side. Use the same gentle method. A one-time check should take only a few minutes.
If you find a change, make a short note of the date, side, location and whether it is painful. Then arrange an appointment rather than repeatedly checking it every day.
How to Check Breasts and Armpits for Lumps: A Practical Routine
A structured check can help you cover the whole area. It is best done when you are calm and not rushed. People who menstruate may find the breasts less tender after their period; people without regular cycles can choose the same day of the month if they prefer a routine.
Step 1: Look in the Mirror
With your upper body uncovered, look at both breasts with arms relaxed at your sides. Then raise your arms and place your hands on your hips or press your palms together to tighten the chest muscles slightly.
Look for a new change in shape, size, contour, skin texture, redness, dimpling, swelling, nipple position or rash. Include the upper chest and underarms.
Step 2: Feel the Breasts While Standing or in the Shower
Use the flat pads of the three middle fingers of your opposite hand. Keep the fingers together and make small circular movements. A systematic vertical up-and-down pattern is usually easy to follow.
Cover the breast from the collarbone to the bra line and from the breastbone across to the underarm. Use light pressure near the skin, medium pressure for tissue in the middle and firmer pressure for tissue closer to the chest wall.
Step 3: Feel the Breasts While Lying Down
Place a small pillow or folded towel under the shoulder of the side you are checking. Put that arm behind your head. This position spreads breast tissue more evenly over the chest wall.
Repeat the same pattern across the whole breast, including the area beneath the nipple and the upper outer breast leading into the armpit.
Step 4: Check the Nipple Area
Notice a new inward pulling of the nipple, scaling, rash, persistent crusting or spontaneous discharge. Avoid repeatedly squeezing the nipple to see whether fluid appears, because this can irritate the tissue and create discharge.
Step 5: Check the Underarms
Finish by gently checking both armpits and the upper outer breast as described above. This final step is often missed, even though it is part of complete breast awareness.
What Are the 7 P’s of Breast Self-Examination?
The 7 P’s are an educational mnemonic that can help people remember a structured self-check. They are useful as a guide, but they are not a diagnostic test and should not replace screening.
| The 7 P’s | What it means |
| Position | Look and feel while standing and lying down |
| Perimeter | Check the whole area: collarbone to lower breast, breastbone to underarm |
| Palpation | Use the finger pads in small circular movements |
| Pressure | Use light, medium and firm pressure to feel different depths |
| Pattern | Follow one consistent route so that no area is missed |
| Practice | Become familiar with your own normal look and feel |
| Plan | Know what to do if a new or concerning change is found |
The most important part is the final “P”: have a plan. Do not assume a lump is cancer, but do not postpone medical review because it is painless or because you hope it will disappear.
What Is a Normal Armpit Supposed to Look and Feel Like?
There is no single “perfect” normal. Armpits can differ slightly in shape, hair growth, skin tone, sweat-gland activity and fatty tissue. You may also feel soft tissue or a ridge of muscle near the chest wall.
In general, a normal underarm should not have a new, persistent, enlarging or clearly defined lump. The skin should not develop ongoing redness, dimpling, ulceration or unexplained swelling.
A tender or temporarily enlarged lymph node can happen with a cold, skin irritation, a wound on the arm, infection or a recent vaccination. Yet it is sensible to seek advice if the swelling lasts, grows, feels hard or fixed, is present with breast changes or causes concern.
When Should You See a Breast Doctor in Nepal?
Book an appointment with a breast doctor in Nepal if you notice a new breast or underarm lump, even if it does not hurt. Prompt assessment is especially important when the change is firm, enlarging, fixed in place or present with another breast symptom.
Arrange a timely review for:
- A lump or swelling in the breast, upper chest or armpit
- A breast change that remains after your menstrual period
- New nipple inversion, rash, scaling or unexplained discharge
- Skin dimpling, thickening, redness or “orange peel” texture
- A visible change in one breast’s shape or size
- Persistent pain in one spot of the breast or underarm
- A high-risk family history or a known genetic mutation
Seek urgent clinical advice for a rapidly red, swollen or painful breast, especially with fever, because infection may need prompt treatment. Your clinician may use examination, breast ultrasound, mammography and, when necessary, a core biopsy. This is sometimes called a “triple assessment”: clinical examination, imaging and tissue diagnosis when indicated.
A consultation does not mean surgery is inevitable. It helps identify the cause and decide whether reassurance, follow-up, imaging, medicine or surgical care is appropriate.
For patients with a family history, this guide to breast cancer without family history explains why risk assessment and screening still matter. For confirmed disease, breast cancer treatment in Nepal outlines how surgical and multidisciplinary care are planned.
Why Early Assessment Matters
Finding a new change early does not guarantee that it is cancer. It does, however, make it possible to investigate without delay. Some breast cancers are found before a lump can be felt through screening, while others first appear as a change noticed by the person themselves.
Early medical assessment can also prevent unnecessary anxiety. A breast doctor can explain whether the finding fits a hormonal change, a benign lump, an infection, an enlarged lymph node or something needing further tests.
For many people, the hardest part is taking the first step. A clear, respectful clinical assessment replaces uncertainty with a plan.
Frequently Asked Questions
How can the underarms be checked during a self-exam?
Relax one arm and use the finger pads of the opposite hand to gently sweep the entire armpit, including the front, centre and back edges. Also feel the upper outer breast where tissue extends toward the underarm. Report a new, persistent or growing lump or swelling.
What are the 7 P’s of breast self-examination?
The 7 P’s are Position, Perimeter, Palpation, Pressure, Pattern, Practice and Plan. They are a teaching guide for covering the full breast and underarm area and knowing what to do if a new change is found.
What can be detected during a breast self-examination?
You may notice a new lump, thickening, swelling, skin dimpling, nipple change, unusual discharge, breast-shape change or an underarm lump. A self-exam cannot confirm whether a change is cancer and cannot replace mammography or medical evaluation.
How to self examine an armpit?
With the arm relaxed, use the opposite hand’s finger pads to gently check the front, middle and back of the armpit. Compare both sides and include the outer breast area. Avoid repeated pressing; note a new or persistent change and arrange a clinical review.
How to check breasts and armpits for lumps?
Look in the mirror first, then use a consistent finger-pad pattern while standing and lying down. Cover the whole breast from collarbone to bra line and breastbone to underarm. Finish by checking each armpit and upper outer breast.
What is a normal armpit supposed to look like?
Normal varies. It may have hair, sweat glands and soft tissue, and the two sides may not be identical. A new, persistent, hard, growing or clearly defined lump, or skin swelling/redness that does not settle, should be assessed by a clinician.
The Bottom Line
Yes, your underarms should be included in breast self-awareness. They are part of the wider breast and lymph-node area, and a new underarm lump or swelling can be worth checking.
Do not let fear delay care, and do not rely on a self-check alone. Most breast and underarm changes are not cancer, but only proper clinical assessment and appropriate imaging can tell what a change means. For a new or persistent breast or armpit concern, book a consultation with a breast cancer surgeon in Nepal.
About Dr. Kapendra Shekhar Amatya
Dr. Kapendra Shekhar Amatya is a Consultant Surgical Oncologist and Head of the Department of Surgical Oncology at Nepal Cancer Hospital & Research Center. With more than 20 years of experience in surgical oncology, his clinical work includes breast cancer surgery, breast-conserving surgery, sentinel lymph-node procedures, breast reconstruction and multidisciplinary breast cancer care.
Medical disclaimer: This article is for general education and does not replace personalised medical advice. Seek urgent medical care for severe symptoms, rapidly worsening swelling, high fever with a red painful breast, or any condition that feels urgent.
