How is screening for breast cancer done?

Screening for breast cancer in women of average risk can include:

• Breast self-awareness. In the past, a breast self-exam (BSE) was recommended. It was a detailed method of examining your breasts once a month. Most experts now advise breast self-awareness instead. This means having a sense of what's normal for your breasts. If you notice even small changes in how they look or feel, contact your healthcare provider right away.

• Clinical breast exam (CBE). The American Congress of Obstetricians and Gynecologists (ACOG) advises CBEs every 1 to 3 years for people ages 25 to 39. ACOG advises CBEs every year for women 40 and older. Other experts don't agree that there's enough evidence to say there's a clear benefit of CBEs. Talk with a healthcare provider about your risk factors and decide whether to have a CBE.

• Mammography. A mammogram is a kind of X-ray used to help find breast tumors before they can be felt or cause other symptoms. During the test, your breast is pressed between two plastic plates that flatten and spread the tissue. Very low levels of radiation are used to take a picture of the inside of your breast. Many facilities have digital mammography. This displays results on a computer instead of on film. The test can be uncomfortable, but it lasts only a few moments. There are more details about mammograms below.

• Breast MRI. An MRI uses magnets, radio waves, and a computer to make detailed pictures of the inside of the breast. Before the MRI, a contrast dye may be put into your blood through a vein. This helps to better outline the breast tissue and possible tumors. MRI is only used to screen people who are at a high risk for breast cancer based on factors such as family history or genes.

These screening methods can improve your chances of finding cancer early. Women at high risk for breast cancer may be advised to start breast cancer screening at a younger age. They may also be advised to have an MRI along with their routine mammograms. For some women with dense breast tissue, ultrasound may be done along with mammograms. Your healthcare provider can tell you more about your risks and what screenings are right for you.

More about mammograms

A mammogram detects tumors and calcium deposits in the breast. Most calcium deposits are not cancer. But a cluster of very tiny specks of calcium (microcalcifications) can be an early sign of breast cancer. If your mammogram shows anything abnormal, you may need more tests.

A mammogram is the best way to find breast cancer early. But it may not always detect cancer. And in some cases, it may find an abnormality that turns out not to be cancer. This is called a false positive.

The benefits and limits of a mammogram vary. They’re based on factors such as age and personal risk. Experts have different advice for who should have mammograms.

• U.S. Preventive Task Force (USPSTF). This group advises screening every 2 years for women ages 40 to 74.

• American Cancer Society (ACS). This group advises yearly screening for all women ages 45 to 54, then a choice of screening every 1 or 2 years for people ages 55 and older. People ages 40 to 44 have the option to start screening yearly. Screening can continue as long as a woman is in good health and is expected to live 10 years or more.

• American Congress of Obstetricians and Gynecologists (ACOG). This group advises that starting at age 40, people should have the option of getting mammograms every 1 or 2 years. All people should start at age 50. Mammograms every 1 or 2 years should be done until age 75. At that time, a woman should talk with their healthcare provider about whether to continue screening.

All people should talk with their healthcare provider about their personal risk factors and the pros and cons of testing before deciding when to start and how often to get a mammogram.