Self Breast Exam
The first line of defense in early detection is you. That’s why it’s important for you to be familiar with your breasts. Regularly examining your breasts can be an important tool in finding breast cancer early – when the potential for successful treatment is much greater.
The Breast Diagnostic Center recommends that all women routinely perform breast self-exams (BSE) – as often as once a month – as part of their overall breast healthcare strategy. BSEs should not however replace diagnostic screening tools like clinical breast exams and mammograms, as recommended by your healthcare provider.
While you may be unfamiliar and uncomfortable with the process at first, the more often you do a BSE, the more familiar and at ease you will be.
Get to know how your breasts look and feel – knowing what looks and feels normal will help you in recognizing changes in your breasts. If you note any of the following in your BSE, contact your doctor:
- Lump, hard knot, or thickening
- Swelling, warmth, redness, or darkening
- Change in the size or shape of the breast
- Dimpling or puckering of the skin
- Itchy, scaly sore or rash on the nipple
- Pulling in of your nipple or other parts of the breast
- Sudden nipple discharge
- New pain in one spot that doesn’t go away
Click here to download a Breast Self-Exam Card. Print this and keep it at home for easy reference.
Clinical Breast Exam
A clinical breast exam (CBE) is a simple test that should be done as part of your regular medical checkup. The exam involves either a physician, nurse, nurse practitioner or other trained medical staff evaluating both breasts and underarms. Your healthcare provider will check your breasts while you are sitting up and while you are lying down, and is looking and feeling for any abnormalities, including changes in size and shape, changes in the skin, and lumps.
Women should start getting CBEs at age 20 as part of their routine breast cancer screening strategy. When women begin having mammograms, it’s important to continue receiving CBEs from your physician – as these complement your overall breast health plan.
In conjunction with the American Cancer Society guidelines, we recommend the following:
- Women age 40 and older should have a mammogram every year and should continue to do so for as long as they are in good health.
- Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a periodic (regular) health exam by a health professional preferably every 3 years. Starting at age 40, women should have a CBE by a health professional every year.
- Breast self-examination (BSE) is an option for women starting in their 20s. Women should be informed about the benefits and limitations of BSE. Women should report any breast changes to their health professional right away.
- Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year.
- Women at moderately increased risk (15% to 20% lifetime risk) should have regular mammograms with additional imaging as recommended by the radiologist.
- Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.
Women at high risk include those who:
- Have a known BRCA1 or BRCA2 gene mutation
- Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
- Have a lifetime risk of breast cancer of 20% to 25% or greater, according to risk assessment tools that are based mainly on family history (see below)
- Had radiation therapy to the chest when they were between the ages of 10 and 30 years
- Have Li-Fraumeni syndrome, Cowden syndrome, or hereditary diffuse gastric cancer syndrome, or have one of these syndromes in first-degree relatives
Women at moderately increased risk include those who:
- Have a lifetime risk of breast cancer of 15% to 20%, according to risk assessment tools that are based mainly on family history (see below)
- Have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)
- Have extremely dense breasts or unevenly dense breasts when viewed by mammograms
The American Cancer Society believes the use of mammograms, MRI (in women at high risk), clinical breast exams, and finding and reporting breast changes early, according to the recommendations outlined above, offers women the best chance to reduce their risk of dying from breast cancer. This approach is clearly better than any one exam or test alone.
Without question, a physical exam of the breast without a mammogram would miss the opportunity to detect many breast cancers that are too small for a woman or her doctor to feel but can be seen on mammograms. Mammograms are a sensitive screening method, but a small percentage of breast cancers do not show up on mammograms but can be felt by a woman or her doctors. For women at high risk of breast cancer, such as those with BRCA gene mutations, both MRI and mammogram exams of the breast are recommended.