BREAST EXAMS What you should know
What you should know
Breast cancer is the most common type of cancer among American
women. Each year in the United States, more than 175,000 women
learn they have breast cancer. Two-thirds of them will be more
than 50 years old, but breast cancer does occur in younger women
(and in about 900 men a year). The average woman has 1 chance in
9 (or about 11 percent) of developing breast cancer during her
Understanding the need for and practicing breast exams will help
you increase your chances of detecting breast cancer in its
earliest stages. Only about 20 percent of biopsied breast lumps
are cancerous. And, if cancer is found early, there are choices
for treatment. With prompt treatment, the outlook is good. In
fact, most women treated for early breast cancer will be free
from breast cancer for the rest of their lives.
The National Cancer Institute (NCI) suggests a three-point breast
cancer detection plan for you to follow. Mammography is the key
to detecting breast cancer at its earliest stage because it can
find a cancer up to two years before it can be felt. Women
should start having this test at age 40. For women of all ages,
other important exams include a breast examination by a doctor or
other health professional and breast self-examination. These
guidelines should be considered along with your background and
Doctors do not yet know how to prevent breast cancer. But you
can increase your chances of detecting breast cancer in its
earliest stages by following the three steps of NCI's early
Beginning at age 40, all women should be encouraged to have
a mammogram every 1 to 2 years until age 50. After 50,
mammography should be done annually.
A mammography is an x-ray of the breast. It can reveal
tumors too small to be felt and can show other changes in
the breast that doctors believe may suggest cancer. In
mammography, the breast is pressed between two plates; some
pressure is applied to get a clear picture. Usually, two
x-rays are taken of each breast, one from the top and one
from the side. Although some women are concerned about
radiation exposure, the risk is very small.
Doctors recommend routine mammography because it is
effective in finding breast cancer early. Long-term studies
have shown that using mammography along with a breast exam
by a health professional can reduce deaths from breast
cancer among women age 40 or older. These guidelines may
change as new scientific information becomes available.
The final decision regarding mammograms, of course, should
be made on an individual basis.
A doctor may also suggest a mammogram if a symptom of breast
cancer is found, whether through BSE (breast self-exam), the
annual exam, or by chance. If you have a symptom of breast
cancer, you should not hesitate to have a mammogram if your
doctor recommends it.
A PHYSICAL BREAST EXAM IS A MUST
Women should have breast examinations during their routine
checkups. Women 40 and older should have them annually.
The next step in early detection is breast examination by a
health professional. You may find it convenient to schedule
this exam during your routine physical checkup. If a breast
exam is not done during that checkup, you should ask for
one. During the exam, the health professional feels the
breast and underarm with the fingers, checking for lumps.
This is called palpation. The breasts also are checked for
other changes such as dimpling, scaling, or puckering of the
skin or a discharge from the nipples.
Women should do breast self-examination monthly.
Breasts come in all sizes and shapes, just as women do. Your
own breasts will even change throughout your life. Your
monthly menstrual cycle and menopause, childbirth,
breastfeeding, age, weight changes, and birth control pills
or other hormones may change the shape, size and feel of
your breasts. It is important to learn what is normal for
you. This can be done by using BSE. It is easy to do, and
as the name implies, you do it yourself. Women taking
charge of their own health are doing BSE regularly. They
are also eating healthy foods, exercising regularly and
avoiding tobacco use.
BSE is done once a month so that you become familiar with
the usual appearance and feel of your own breasts.
Familiarity makes it easier to notice any changes in your
breasts from one month to another. In fact, some health
professionals suggest that, at first, women do BSE every day
for a month so that they really know the "geography" of
their breasts. Early discovery of a change from what is
normal is the whole idea behind BSE.
The best time to do BSE is 2 or 3 days after the end of your
period, when your breasts are least likely to be tender or
swollen. A woman who no longer has periods may find it
helpful to pick a particular day, such as the first day of
the month, to remind herself that it is time to do BSE.
If you discover anything unusual, such as a lump, a
discharge from the nipple, or dimpling or puckering of the
skin, you should see your doctor at once. Remember, 8 out
of 10 biopsied breast lumps are not cancer. Many women have
irregular or "lumpy" breasts. The term "benign breast
condition" refers to those changes in a woman's breasts that
are not cancerous. Many doctors believe that nearly all
women have some benign breast changes after age 30. But any
change is best diagnosed by your doctor. (More information
about benign breast conditions can be found in the National
Cancer Institute booklet Questions and Answers About Breast
Discussing BSE with your doctor will help you understand the
procedure better. Ask your doctor or other health
professional to review with you the steps of BSE, as well as
to explain what you are feeling in your breasts. This will
assure you that you are doing your BSE correctly and
thoroughly, and you will gain more confidence in examining
Remember every part of the breast cancer detection plan:
M-~ Regular mammograms.
M-~ Routine breast examination by a health professional.
M-~ Monthly breast self-examination.
Used together, they offer you the best chance of finding breast
OTHER METHODS USED FOR EARLY DETECTION
Currently, mammography is the most common and useful technique
for finding breast cancer. However, several other methods are
also being used.
Ultrasound detects breast changes by sending high-frequency sound
waves into the breast. The pattern of echoes from these sound
waves is converted into an image of the breast's interior.
Ultrasound may be helpful in distinguishing between solid masses
and cysts (fluid-filled sacs). Unlike mammography, ultrasound
cannot detect small calcium deposits that may be present in the
breast and that sometimes indicate cancer, nor does it identify
Thermography measures heat patterns given off by the skin.
Changes in the image, including "hot spots", may suggest the
presence of a breast problem. There is no known risk of using
thermography, but it is not reliable enough to replace
Diaphanography, or transillumination, shines a bright light
through the breast. Transillumination can show the difference
between a solid tumor and a cyst. Current studies indicate that
this method does not identify the very small cancers that can be
detected by mammography. The technique remains experimental.
CURRENT EARLY DETECTION GUIDELINES
One day there may be a single method for the early detection of
breast cancer. Until then, using a combination of methods will
increase your chances of detecting cancer in an early stage.
Here is your personal checklist for breast cancer detection:
M-~ Mammography for all women who are age 40 or older.
M-~ A regular breast exam by a health professional.
M-~ Monthly breast self-examination.
M-~ Personal alertness for changes in the breast.
M-~ Readiness to discuss quickly any such changes with a
FOR ADDITIONAL INFORMATION
For answers to your questions about breast exams or breast
cancer, write to the Office of Cancer Communications, National
Cancer Institute, Bethesda, Maryland 20892, or call the toll-free
telephone number of the Cancer Information Service at:
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