A nurse is providing breast self-examination teaching to a client who is menopausal. Which of the following statements should the nurse identify as an indication that the teaching was effective? (Select all that apply.)

A. "It is important to press firmly when feeling my breasts to detect changes.": Using firm pressure is part of the technique (use light, medium, then firm pressure) so that both superficial and deep lumps can be detected. B. "Since I no longer have periods, I can perform an examination at any time of the month.": Menopausal clients do not need to coordinate BSE with menses; they should perform it monthly on a consistent day. C. "I will make sure to feel for changes in my underarm area.": Lymph nodes and tissue in the axilla can show changes associated with breast pathology, so checking the underarm area is important. D. "I don't have to lie down to check my breasts. I can stand in the shower.": A shower exam using soapy hands is an acceptable method for palpation; lying down is another option but not the only one. E. "If I feel a firm ridge in the lower curve of my breasts I should report this immediately.": A firm inframammary ridge along the lower breast curve is often a normal anatomic finding, so this by itself does not always indicate pathology and usually does not require urgent reporting.