Recommended Screening
Warning Signs & Symptoms
By regularly examining her own breasts, a woman is likely to notice any changes that occur. The best time for breast self-examination (BSE) is about a week after your period ends, when your breasts are not tender or swollen. If you are not having regular periods, do BSE on the same day every month.
A clinical breast examination (CBE) is an examination of your breast by a health professional, such as a physician, nurse practitioner, nurse, or physician assistant. During the CBE is a good time for the health professional to teach breast self-examination to the woman who does not already know how to examine her breasts.
A mammogram is an x-ray of the breast. Diagnostic mammography is used to diagnose breast disease in women who already have symptoms. Screening mammography is used to look for breast disease in women who are asymptomatic, that is, they appear to have of breast problems.
A note to men: Although it is much less common, it is possible for men to have breast cancer. If you notice any changes in your breast area, discuss them with your physician as soon as possible.
Screening Tests
| Test or Procedure |
Age |
Frequency |
Breast Self-Exam (BSE)
By regularly examining her own breasts, a woman is likely to notice any changes that occur. The best time for breast self-examination (BSE) is about a week after your period ends, when your breasts are not tender or swollen. If you are not having regular periods, do BSE on the same day every month.
How to conduct a breast self exam
|
20+ |
Monthly |
Clinical Breast Exam (CBE)
A clinical breast examination (CBE) is an exam of your breasts by a health professional, such as a physician, nurse practitioner, nurse, or physician assistant. For this examination, you undress from the waist up. The health professional with first inspect (look at) your breast for changes in size or shape. Then, using the pads of the fingers, the examiner will gently palpate (feel) your breast. Special attention will be given to the shape and texture of the breast, location of any lumps, and whether such lumps are attached to the skin or to deeper tissues. The area under both arms will also be examined. During the CBE is a good time for the health professional to teach self-examination to the woman who does not already know ho to examine her breasts. Ask your doctor or nurse to teach you and watch your technique.
|
20-39 |
Every 3 years |
| 40+ |
Annually |
Mammogram
A mammogram is an x-ray of the breast. Diagnostic mammography is used to diagnose breast disease in women who have symptoms of breast cancer. Screening mammography is used to look for breast disease in women who appear to have no symptoms or breast problems.
When performing a mammogram, the breast is compressed to flatten and spread the tissue. Although this may be temporarily uncomfortable, it is necessary in order to produce a good mammogram. The compression only last a few seconds, and the entire procedure for screening mammography takes about 20 minutes. This procedure produces a black and white image of the breast tissue on a large sheet of film that is "read," or interpreted, by a radiologist. The physician reading the films will look for several types of changes:
Calcifications, or microcalcifications, are tiny mineral deposits within the breast tissue which appear as small white spots on the film. They may occur singly or in clusters. They are a sign of changes within the breast that can either be monitored by additional, periodic mammograms, or can be examined by biopsy (removal of a small amount of breast tissue). They may be caused by benign breast conditions, or, less often, by breast cancer. Another important change that can be seen on a mammogram is a mass, which may occur with or without calcifications. Masses can be due to many things, including cysts and fibroadenomas, but may be cancer and usually should be biopsied if they are not fluid-filled cysts.
A cyst, which is a benign collection of fluid in the breast, cannot be diagnosed by physical exam alone, nor can it be diagnosed by mammography alone. Either breast ultrasound, or removal of the fluid with a needle (aspiration), is used to confirm that a mass is a cyst. If a mass is not a cyst, then further imaging may be obtained. As with calcifications, a mass can be caused by benign breast conditions, or by breast cancer. Some masses can be monitored with periodic mammograms, while others may require immediate or delayed biopsy.
A mammogram, while suggestive, cannot prove that an abnormal area is cancer. To confirm whether cancer is present, a small amount of tissue must be removed and examined under a microscope. This procedure is called a biopsy.
Although breast x-rays have been performed for more than 70 years, modern mammography has only existed since 1969. With modern mammography equipment used specifically for breast x-rays, very low levels of radiation are used, usually about 0.1 to 0.2 rad dose per x-ray. Strict guidelines are in place to assure that mammography equipment is safe and uses the lowest dose of radiation possible. Many people are concerned about the exposure to x-rays, and rightly so, but the level of radiation in up-to-date mammograms does not significantly increase the risk for breast cancer. To put dose into perspective, a woman who receives radiation as a treatment for breast cancer will receive several thousands rads. If a woman had yearly mammograms beginning at age 40 years and continuing until 90, she will have received 10 rads.
|
40 |
Baseline |
| 40-49 |
Every 1 to 2 years |
| 50+ |
Annually |
Warning Signs and Symptoms
Although widespread use of screening mammography has increased the number of breast cancers found before they cause any symptoms, some breast cancers are not found by mammography either because the test was not done or because even the ideal conditions mammography cannot find every breast cancer.
The most common sign of breast cancer is a new lump or mass. A mass that is painless, hard, and has irregular edges is more likely to be cancerous, but some rare cancers are tender, soft, and rounded. For this reason, it is important that any new breast mass or lump be checked by a health care provider with experience in diagnosis of breast diseases.
Other signs of breast cancer include a generalized swelling of part of part of a breast (even if no distinct lump is felt), skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk.
Sometimes a breast cancer can spread of underarm lymph nodes that are obviously enlarged, even before the original tumor in the breast tissue is large enough to be felt.
See your provider as soon as possible if you find any of these symptoms. |
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