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Quick guide to breast cancer screening

Michele Borboa, MS is a freelance writer and editor specializing in health, fitness, food, lifestyle, and pets. Michele is a health and wellness expert, personal chef, cookbook author, and pet-lover based in Bozeman, Montana. She is also...

Quick guide to breast exams

Early detection is crucial in successfully treating breast cancer. Sure, you probably don't often think about checking your breasts for changes or lumps, and having your breasts smashed in a mammogram isn't the way you want to spend an hour, but ignoring breast cancer doesn't make it go away. Worse, the longer you put off breast cancer screening, the more likely your cancer will progress to the point that even aggressive treatments will prove futile. Here is a quick guide on breast cancer screening methods - print it out and use it as a reminder to check yourself - and to tell other women in your life to check themselves, too.

Breast cancer screening methods

There are four breast cancer screening methods – one you can do yourself and three are performed by your doctor.

Self-Exam

Breast self-exam

The only way you are going to know if your breasts feel different is if you know how they normally feel. A breast self-exam (BSE) is the first line of defense against breast cancer – it improves the chances you will find breast cancer in the early stages.

A BSE involves you looking at and feeling your breasts, and it only takes a few minutes to perform. Every woman, no matter her age, should do a BSE monthly. If you have regular periods, the best time to examine your breasts is a week after your period, to avoid breast tenderness and bloating. If you are on birth control pills, do a BSE when you start a new pack. If your periods are irregular or you no longer have periods, simply do one at the start of each month.

For step by step instructions, visit the Susan G. Komen for the Cure website for:

If you detect any changes in the color, tenderness, firmness or density in your breasts, or if you find a lump, make an appointment with your doctor immediately. Though changes can be due to hormones – and a lump can be benign – the only way you will know is if you have additional screening.

Clinical breast exam

A clinical breast exam is done by your health care provider, who will carefully look at and feel your breasts and underarm area. If it is your first time, you will be asked detailed questions about your health history, including questions regarding your period, pregnancies and family health history. Your answers help your healthcare provider determine your risk factors for breast cancer. If you see your healthcare provider regularly, he or she will have a better chance of knowing if your breasts have changed since your last visit.

During the clinical breast exam, your healthcare provider may ask you, while you are in a standing position, to lift your arms over your head, put your hands on your hips and lean forward. He or she will look at and feel your breasts for skin changes, such as rashes, dimpling or redness.

You will also be asked to lay on your back with your arms at your sides as well as behind your head. Your healthcare provider will use his or her fingers to examine your breasts and under your arms to detect lumps or other changes. In addition, your healthcare provider will gently press around your nipple to check for any discharge. If you have discharge, a sample may be collected for further examination.

How often do you need a clinical breast exam? At least every three years if you are 20 to 39 years old and once a year if you are 40 and older. Make your appointment for a week after your period to avoid menstrual-related tenderness.

If your healthcare provider does find a lump or noticeable changes, he or she will recommend additional screening, such as a mammogram.

Mammogram

Mammograms are highly effective in finding breast cancer before it produces noticeable changes or palpable lumps in your breasts. A mammogram is an x-ray picture of your breast tissues. It can detect cysts, tumors, calcifications and other abnormalities. The results are stored on film or digitally by computer for the radiologist and your healthcare provider to examine.

To prepare for your mammogram, you will have to remove all jewelry and clothing from your upper body. It is also recommended that you don't wear deoderant, antiperspirants or powders because they may interfere with the mammography. Also, schedule your appointment for a week after your period and avoid drinking caffeine for a few days prior to reduce the chance of breast tenderness.

Each of your breasts will be placed on a flat shelf and compressed by a second shelf. Though its slightly and temporarily uncomfortable, compressing your breasts spreads the tissue out so the x-ray can take a clear picture.

If a prior breast exam detected a lump, a small x-ray marker may be placed on the area before the mammogram. Generally, two views of each breast is taken. However, if you have large breasts or breast augmentation, additional views may be necessary.

The American Cancer Society recommends that women get their first baseline mammogram between the ages of 35 and 40. After the age of 40, women should get yearly mammograms. Women who are at high risk of developing breast cancer should consider getting mammograms earlier than age 40 and more frequently.

If your mammogram does detect a tumor, your healthcare provider will recommend additional screening, such as a biopsy.

Breast tissue biopsy

A breast biopsy is a procedure that removes tissue from the breast using a needle or scalpel. The thought of having a biopsy can be frightening, but it is the only way to accurately diagnose if a lump or abnormality in your breast is breast cancer – or benign.

There are different types of biopsies – from minimally invasive procedures to full excision of a tumor – that your healthcare provider may recommend. Before making a decision, discuss the pros and cons of each biopsy and get all of your questions answered. And keep in mind, the majority of breast abnormalities and lumps are not cancerous. But it is crucial that you get an accurate diagnosis - sooner better than later.

Bottom line

Breast exams are essential in catching breast cancer in its early stages – when it can be more successfully treated. The next time you see a product, advertisement or individual sporting a pink ribbon in support of breast cancer research, let it be a reminder to do your own personal breast exam and keep your yearly appointment with your healthcare provider.

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