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Women's Healths

Breast Health

Mammography - Preparing for a Mammogram - Clinical Breast Exam - Prevention and Early Detection of Breast Cancer - When to Call a Health Professional

Breast cancer is the leading cause of cancer deaths in women who are 40 to 55 years old. The good news is that breast cancer can often be cured if it is detected early. There are 3 methods of early detection: mammography, clinical breast exam, and breast self-exam.

One of the most important risk factors for breast cancer is age. The risk goes up significantly after age 50. Women younger than 50 are at relatively low risk for breast cancer. However, if your mother or a sister had breast cancer before menopause, talk with your doctor about starting mammography and other screenings before age 40.

Mammography

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A mammogram is a breast X-ray that can reveal breast tumors that are too small to be detected by breast self-exam or a clinical breast exam.

Studies have shown that mammograms save lives. In women over 50, mammograms reduce breast cancer death rates by up to 1/3. The outcomes of studies for women younger than 50 are less clear.

Your doctor may tell you how often he or she would like you to get a mammogram. The following is a schedule that a doctor may recommend for a woman who is not at high risk for breast cancer:

Yearly mammograms are recommended for any woman who has had cancer in one breast. If you have a female relative (mother, sister) who had breast cancer before menopause, talk to your doctor about when to start and how often to have mammograms.

Getting all the facts and thinking about your own needs and values will help you make a wise decision about mammography.

Preparing for a Mammogram

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Clinical Breast Exam

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During a clinical breast exam, a doctor or nurse looks at your breasts and gently feels them for lumps or other unusual changes. During the exam, the doctor or nurse can also teach you how to examine your breasts yourself.

A clinical breast exam is recommended every 1 to 2 years after age 40. Not all health organizations agree that clinical breast exams should begin before age 50. Discuss this with your doctor. A clinical breast exam is also done whenever a woman has symptoms indicating that there may be a problem with her breasts.

Breast Self-Exam

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The breast self-exam is a simple way for you to learn how your breasts usually feel, and it is useful for finding lumps (not all of which are cancerous), cysts, and other noncancerous problems. If you notice any changes, you can get help early instead of waiting until your next checkup.

If you want to do breast self-exams, a good time is a few days after your period ends, when your breasts are less likely to be swollen or sore. You may also want to check how your breasts feel at other times. One of your breasts is likely to be larger than the other. Most women's breasts have some lumpiness or places where the tissue feels thicker. If the lumpiness is the same in both breasts, it is probably normal. If you find a lump that is different or much harder than the rest of your breast tissue, or if you find anything else that worries you, have it checked by your health professional.

The breast self-exam takes place in 2 stages.


Stage 1: In front of the mirror

Stand in front of a well-lighted mirror and examine your breasts carefully: first with your arms at your sides; then with your hands pushing firmly on your hips to tighten your chest muscles; then with your arms raised overhead; and finally while bending forward (arms at sides).

Look for changes in the shape of your breasts (indentations, flattening, or puckering of the skin) as you move your arms. Both breasts should change in the same way. Also check to see if either nipple appears to be turning inward when it never did before, and look for changes in the skin of the nipple. Squeeze each nipple carefully between your thumb and index finger to feel for lumps. A milky discharge that happens only when you squeeze your breast or nipple is usually normal.


Stage 2: Lying down

To examine your right breast, place a pillow or folded towel under your right shoulder. Put your right arm under your head and use your left hand to examine your breast.

Put your fingers flat on your skin (don't use just the fingertips). Move your fingers in dime-sized circles over your skin, and push down gently to feel for lumps, thickening, or changes of any kind. Be sure to feel all of your breast, including the nipple, as well as your breastbone and the armpit on that side.

Move the pillow or towel to the left shoulder. Use your right hand to examine your left breast.

Instead of lying down, some women like to do the second stage of the exam while standing in the shower. If your skin is wet and soapy, it may be easier to feel your breast tissue.

Stand with one arm raised (hand behind your head) and feel the breast with your other hand.

Prevention and Early Detection of Breast Cancer

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When to Call a Health Professional

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