A nurse is reinforcing breast self-examination (BSE) teaching with a client who is menopausal. Which of the following statements by the client indicate an understanding of the teaching? (Select all that apply.)

A. "I can stand in the shower to perform the examination.": Performing BSE in the shower is an appropriate method because the fingers can easily glide over wet, soapy skin, making it easier to detect lumps or irregularities. This method is effective for all adults, including menopausal clients. B. "I will make sure to feel for changes in my underarm area.": Breast tissue extends into the axillary region, so it is important to palpate the underarm area during BSE to detect any unusual lumps or swelling, which could indicate malignancy. C. "It is important to press my breasts firmly to detect any lumps.": Using varying degrees of pressure allows the client to palpate all layers of breast tissue, including deeper tissue near the chest wall. This ensures that smaller or deeper lumps are not missed. D. "I will use my fingertips to check my breasts.": The pads of the fingertips are more sensitive than the palms and are best suited for feeling subtle changes or lumps within the breast tissue. This technique improves the accuracy of the examination. E. "Since I no longer have periods, I can do the exam at any time of the month.": Menopausal clients do not have cyclical hormonal changes, so BSE can be performed at any consistent time. Choosing the same day each month helps maintain a routine for regular self-examinations.