You have a better chance of surviving breast cancer if your doctor finds and treats it early--while it is small and has not spread. The best way to detect breast cancer early is to be screened regularly. This isn't possible for many cancers, but it is with breast cancer. Screening, however, doesn't guarantee that you won't get cancer that you won't die from it, especially if it's found after symptoms develop.
Screening for breast cancer in women of average risk can include a combination of breast self-exams (BSE), clinical breast exams (CBE), and mammography. These three can complement each other, improving your chances of catching cancer early. Although BSE is helpful, its role in detecting cancer early is limited. Here are descriptions of each:
Breast self-exam (BSE). The American Cancer Society (ACS) says BSEs are an option for women 20 and older as a means of familiarizing themselves with their breasts so they can notice changes more easily. The U.S. Preventive Services Task Force (USPSTF) does not recommend BSEs because evidence suggests that BSEs do not lower the risk for death from breast cancer. Talking with your doctor about the benefits and limitations can help you decide if you should start performing BSEs.
Clinical breast exam (CBE). The ACS recommends CBEs at least every three years for all women in their 20s and 30s and annual CBEs for women 40 and older. The USPSTF, however, believes there is not enough evidence to assess the value of CBEs for women 40 and older. Women should talk with their doctor about their personal risk factors and make a decision about whether they should have a CBE.
Mammography. A mammogram is a special kind of X-ray used to help find breast tumors before symptoms of cancer appear. During the test, your breast is placed between two metal or plastic plates that flatten and spread the tissue. Low levels of radiation are used to take a picture of the inside of your breast. Some facilities have digital mammography, which displays results on a computer, rather than on film. The test can be uncomfortable, but it only lasts a few moments. If you're still getting your period, try to schedule your mammogram for a time after your period. Menstruation can cause breast tenderness, which may make you more uncomfortable during the test.
The benefits and limitations of mammography vary based on factors like age and personal risk. Experts have different recommendations for mammography. Currently, the USPSTF recommends screening every two years for women ages 50 to 74. The ACS recommends yearly screening for all women ages 40 and older. Women should talk with their doctor about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them, as well as what other tests may be warranted.
A mammogram detects tumors and calcium deposits in the breast. Most calcium deposits are benign (not cancer). But a cluster of very tiny specks of calcium, called microcalcifications, can be an early sign of breast cancer. If your mammogram shows anything abnormal, you may need more tests.
Although a mammogram is the best way to find breast cancer early, it may not always detect cancer. And sometimes a mammogram may detect an abnormality that turns out not to be cancer, called a false positive. Some people worry about the radiation. But the radiation levels are about the same as those you'd be exposed to during a flight from New York to California.
For some women with dense breast tissue, ultrasound may be a useful supplement to mammography.