Breast Cancer Checks: From Self-Exams to Screening Tests

Table of ContentsView AllTable of ContentsDetermining Your RiskBreast Self-ExamsClinical Breast ExamsMammogramsBreast MRIsScreening Recommendations

Table of ContentsView All

View All

Table of Contents

Determining Your Risk

Breast Self-Exams

Clinical Breast Exams

Mammograms

Breast MRIs

Screening Recommendations

There are different screening tools used to check for breast cancer. These include breast self-exams (BSE) and clinical breast exams (CBE) that help detect lumps and other abnormalities that may besigns of breast cancer. From age 30 to 40, routinebreast cancer screening—involving mammograms or breast MRIs—is recommended based on your individual risk.

The benefits of breast cancer screening outweigh the risks. Even so, it is important to understand the risks and limitations of the different screening methods so that cancer can bedetected earlywhen it is most treatable.

Verywell / Julie Bang

Determining Your Risk of Breast Cancer

For screening purposes, a woman is considered to be ataverage riskif they have:

By contrast, a woman is considered to be athigh riskif they have:

The tool commonly used for women ataverage riskis a mammogram. For women athigh risk, a mammogram with a breast MRI is recommended.

The benefits of breast self-exams and clinical breast exams remain under debate.

Breast Self-Examination

Most BSE methods suggest that a woman stand in front of a mirror and look for visual signs of dimpling, swelling, or redness on or near the breasts or nipples. This is usually repeated in several positions (such as placing your hands on your hips or holding each arm over your head).

The woman thenpalpates(presses and touches) her breasts with the pads of her fingers to feel for lumps or signs of tenderness or pain.

BSEs are performed monthly. For premenopausal women, the self-exam would be at the same stage of theirmenstrual cycle(due to the fact that normal hormonal fluctuations can cause changes in breasts). Postmenopausal are advised to perform BSEs on the same calendar date each month.

Current Recommendations

Even so, the ACS accedes that BSEs may be useful in increasing breast awareness (meaning an awareness of changes that warrant medical investigation).

Clinical Breast Examination

As common as the practice is, there is conflicting evidence as to whether CBE aids in the early detection of breast cancer or helps lower the risk of breast cancer-related death. The USPSTF states that there is insufficient evidence to assess the harms and benefits of CBE, while the ACS recommends against the practice in average-risk women.

With that said, both organizations agree that CBE may have a place in ongoing comprehensive evaluations of women at high risk of breast cancer. For these women and women with breast cancer symptoms. the CBE continues to be a recommended part of the evaluation.

2D and 3D Mammograms

Mammogramsare low-dose X-rays of the breast that are highly effective in detecting early breast cancer. It is considered the most important tool in breast cancer screening.

There are today two different methods of mammography used for breast cancer detection:

There is some debate as to whether a 3D mammogram is any better at detecting breast cancer in women at average risk than a 2D mammogram. However, some studies suggest that it may be useful in women withdense breastsin whom 2D mammograms sometimes fall short.

How Accurate Are Mammograms?Mammograms are not perfect. Overall, the sensitivity of mammography is around 87%, meaning that it correctly identifies 87 out of every 100 women with breast cancer, leaving 13 undiagnosed.Moreover, if something is found on a mammogram, other tests (such as abreast ultrasoundorstereotactic breast biopsy) may be needed to find out if it is cancer.

How Accurate Are Mammograms?

Mammograms are not perfect. Overall, the sensitivity of mammography is around 87%, meaning that it correctly identifies 87 out of every 100 women with breast cancer, leaving 13 undiagnosed.Moreover, if something is found on a mammogram, other tests (such as abreast ultrasoundorstereotactic breast biopsy) may be needed to find out if it is cancer.

Mammograms are not perfect. Overall, the sensitivity of mammography is around 87%, meaning that it correctly identifies 87 out of every 100 women with breast cancer, leaving 13 undiagnosed.

Moreover, if something is found on a mammogram, other tests (such as abreast ultrasoundorstereotactic breast biopsy) may be needed to find out if it is cancer.

Breast MRI

Breast magnetic resonance imaging (MRI)is a non-radioactive imaging technique that uses powerful magnetic and radio waves to generate highly detailed images of soft tissues.

Although a breast MRI can provide a very detailed view of the breast, it is not a substitute for a mammogram.

Among other things, breast MRIs can miss certain cancers that mammograms can detect. A breast MRI also cannot differentiate between abenign(non-cancerous) andmalignant(cancerous) tumor but only shows that a tumor exists. A breast MRI is also associated with a threefold increased risk offalse-positiveresults compared to a mammogram.

Outside of screening, a breast MRI is more commonly used for the staging of breast cancer and monitoring women who have undergone a lumpectomy for breast cancer.

Current Breast Cancer Screening Recommendations

Routine mammograms are the best way to detect breast cancer early. BSEs should never be used to determine when screening is necessary.

The ACS currently advises the following for women ataverage riskof breast cancer:

The ACS advises that women athigh riskof breast cancer should undergo an annual mammogram with a breast MRI starting from age 30 and continue for as long as they are in good health.

Summary

Breast cancer screening is used to detect breast cancer as early as possible. Routine mammograms are the standard of care for breast cancer screening, starting as early as age 40. Women at high risk are advised to undergo an annual mammogram with a breast MRI from age 30.

12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.American Cancer Society recommendations for the early detection of breast cancer.U.S. Preventive Services Task Force.Recommendations: breast cancer screening.National Breast Cancer Awareness Foundation.Breast self-exam.Huang N, Chen L, He J, Nguyen QD.The efficacy of clinical breast exams and breast self-exams in detecting malignancy or positive ultrasound finding.Cureus. 2022 Feb;14(2):e22464. doi:10.7759/cureus.22464American College of Obstetricians and Gynecologists.Breast cancer risk assessment and screening in average-risk women.Løberg M, Lousdal ML, Bretthauer M, Kalager M.Benefits and harms of mammography screening.Breast Cancer Res. 2015;17:63. doi:10.1186/s13058-015-0525-zNational Cancer Institute.Breast cancer screening.Duffy SW, Tabar L, Yen AMF, et al.Mammography screening reduces rates of advanced and fatal breast cancers: results in 549,091 women.Cancer.2020 Jul 1;126(13):2971–2979. doi:10.1002/cncr.32859Kleinknecht JH, Ciurea AI, Ciortea CA.Pros and cons for breast cancer screening with tomosynthesis – a review of the literature.Med Pharm Rep.2020 Oct;93(4):335–341. doi:10.15386/mpr-1698Susan G. Komen for the Cure.Accuracy of mammograms.Chhor CM, Mercado CL.Abbreviated MRI protocols: wave of the future for breast cancer screening.AJR Am J Roentgenol.2017;208(2):284-289. doi:10.2214/AJR.16.17205Saadatmand S, Geuzinge HA, Rutgers EJT, et al.MRI versus mammography for breast cancer screening in women with familial risk (FaMRIsc): a multicentre, randomised, controlled trial.Lancet Oncol.2019:20(8):1136-1147. doi:10.1016/S1470-2045(19)30275-X

12 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.American Cancer Society recommendations for the early detection of breast cancer.U.S. Preventive Services Task Force.Recommendations: breast cancer screening.National Breast Cancer Awareness Foundation.Breast self-exam.Huang N, Chen L, He J, Nguyen QD.The efficacy of clinical breast exams and breast self-exams in detecting malignancy or positive ultrasound finding.Cureus. 2022 Feb;14(2):e22464. doi:10.7759/cureus.22464American College of Obstetricians and Gynecologists.Breast cancer risk assessment and screening in average-risk women.Løberg M, Lousdal ML, Bretthauer M, Kalager M.Benefits and harms of mammography screening.Breast Cancer Res. 2015;17:63. doi:10.1186/s13058-015-0525-zNational Cancer Institute.Breast cancer screening.Duffy SW, Tabar L, Yen AMF, et al.Mammography screening reduces rates of advanced and fatal breast cancers: results in 549,091 women.Cancer.2020 Jul 1;126(13):2971–2979. doi:10.1002/cncr.32859Kleinknecht JH, Ciurea AI, Ciortea CA.Pros and cons for breast cancer screening with tomosynthesis – a review of the literature.Med Pharm Rep.2020 Oct;93(4):335–341. doi:10.15386/mpr-1698Susan G. Komen for the Cure.Accuracy of mammograms.Chhor CM, Mercado CL.Abbreviated MRI protocols: wave of the future for breast cancer screening.AJR Am J Roentgenol.2017;208(2):284-289. doi:10.2214/AJR.16.17205Saadatmand S, Geuzinge HA, Rutgers EJT, et al.MRI versus mammography for breast cancer screening in women with familial risk (FaMRIsc): a multicentre, randomised, controlled trial.Lancet Oncol.2019:20(8):1136-1147. doi:10.1016/S1470-2045(19)30275-X

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American Cancer Society.American Cancer Society recommendations for the early detection of breast cancer.U.S. Preventive Services Task Force.Recommendations: breast cancer screening.National Breast Cancer Awareness Foundation.Breast self-exam.Huang N, Chen L, He J, Nguyen QD.The efficacy of clinical breast exams and breast self-exams in detecting malignancy or positive ultrasound finding.Cureus. 2022 Feb;14(2):e22464. doi:10.7759/cureus.22464American College of Obstetricians and Gynecologists.Breast cancer risk assessment and screening in average-risk women.Løberg M, Lousdal ML, Bretthauer M, Kalager M.Benefits and harms of mammography screening.Breast Cancer Res. 2015;17:63. doi:10.1186/s13058-015-0525-zNational Cancer Institute.Breast cancer screening.Duffy SW, Tabar L, Yen AMF, et al.Mammography screening reduces rates of advanced and fatal breast cancers: results in 549,091 women.Cancer.2020 Jul 1;126(13):2971–2979. doi:10.1002/cncr.32859Kleinknecht JH, Ciurea AI, Ciortea CA.Pros and cons for breast cancer screening with tomosynthesis – a review of the literature.Med Pharm Rep.2020 Oct;93(4):335–341. doi:10.15386/mpr-1698Susan G. Komen for the Cure.Accuracy of mammograms.Chhor CM, Mercado CL.Abbreviated MRI protocols: wave of the future for breast cancer screening.AJR Am J Roentgenol.2017;208(2):284-289. doi:10.2214/AJR.16.17205Saadatmand S, Geuzinge HA, Rutgers EJT, et al.MRI versus mammography for breast cancer screening in women with familial risk (FaMRIsc): a multicentre, randomised, controlled trial.Lancet Oncol.2019:20(8):1136-1147. doi:10.1016/S1470-2045(19)30275-X

American Cancer Society.American Cancer Society recommendations for the early detection of breast cancer.

U.S. Preventive Services Task Force.Recommendations: breast cancer screening.

National Breast Cancer Awareness Foundation.Breast self-exam.

Huang N, Chen L, He J, Nguyen QD.The efficacy of clinical breast exams and breast self-exams in detecting malignancy or positive ultrasound finding.Cureus. 2022 Feb;14(2):e22464. doi:10.7759/cureus.22464

American College of Obstetricians and Gynecologists.Breast cancer risk assessment and screening in average-risk women.

Løberg M, Lousdal ML, Bretthauer M, Kalager M.Benefits and harms of mammography screening.Breast Cancer Res. 2015;17:63. doi:10.1186/s13058-015-0525-z

National Cancer Institute.Breast cancer screening.

Duffy SW, Tabar L, Yen AMF, et al.Mammography screening reduces rates of advanced and fatal breast cancers: results in 549,091 women.Cancer.2020 Jul 1;126(13):2971–2979. doi:10.1002/cncr.32859

Kleinknecht JH, Ciurea AI, Ciortea CA.Pros and cons for breast cancer screening with tomosynthesis – a review of the literature.Med Pharm Rep.2020 Oct;93(4):335–341. doi:10.15386/mpr-1698

Susan G. Komen for the Cure.Accuracy of mammograms.

Chhor CM, Mercado CL.Abbreviated MRI protocols: wave of the future for breast cancer screening.AJR Am J Roentgenol.2017;208(2):284-289. doi:10.2214/AJR.16.17205

Saadatmand S, Geuzinge HA, Rutgers EJT, et al.MRI versus mammography for breast cancer screening in women with familial risk (FaMRIsc): a multicentre, randomised, controlled trial.Lancet Oncol.2019:20(8):1136-1147. doi:10.1016/S1470-2045(19)30275-X

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