Four breast cancer screening options

By: Keely Hack, MD .

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From feeling a lump while getting dressed to high-definition images from advanced technology, there are many ways breast cancer can be diagnosed. Here are four screening options and how to determine which one is right for you.

1. Breast self-examination

You may have heard that doing monthly breast self-examinations is recommended to help you find potentially cancerous lumps. But now some organizations recommend not doing self-exams. Why the difference?

Reasons not to do breast self-exams:

  • Large research studies involving hundreds of thousands of women around the world have failed to show an improvement in breast cancer survival among women who did monthly self-exams.
  • Most lumps felt on self-exams are not cancerous, so women may undergo unnecessary testing and suffer anxiety associated with this.
  • Most breast cancers are diagnosed because a women felt a lump during regular daily activities such as bathing or dressing.

Reasons to do breast self-exams:

  • Doing regular self-exams will make you more aware of how your breasts normally feel, so you are more likely to notice when there is a change.
  • About 40 percent of breast cancers are diagnosed because a woman felt a lump in the breast.
  • About 10 percent of breast cancers cannot be seen on a mammogram, even if they are felt.

When to do a breast self-exam:

Talk to your doctor about whether monthly self-exams are right for you—factoring in potential risks, family history and other personal preferences.

If you choose to do self-breast exams, you should do them at the same time of every month.

  • For pre-menopausal women, this should be several days after each period ends.
  • For post-menopausal women, picking a certain day of the month and doing it that same day every month is helpful.

Some great step-by-step instructions for how to do breast self-exams is available at breastcancer.org.

2. Mammogram

A mammogram is a low-dose X-ray of the breast. This is the most widely recommended screening test for women.

Some mammograms include 3D technology, called breast tomosynthesis, where multiple images of the breast can be compiled to pinpoint the size, shape and location of abnormalities.

Who should get a mammogram?

  • Organizations have various recommendations for women to start getting mammogram screenings starting from age 40 to 50.
  • Some organizations recommend getting a mammogram every year, while others recommend getting them every other year.
  • Whatever schedule you and your doctor agree is best for you, regular mammograms should continue for as long as you are in good health.

3. Breast MRI

A breast MRI is generally only recommended for women who have at least a 20 percent risk of developing breast cancer in their lifetime, and for some women with very dense breast tissue.

A breast MRI should not be used in place of an annual mammogram screening but rather in addition to it, if recommended.

4. Whole breast ultrasound

Breast ultrasounds are not routinely done as a breast cancer screening. This option is typically only recommended for people who are unable to complete an MRI or who have certain syndromes, such as Li-Fraumini.

When you should see a doctor for a breast concern

In general, you should contact your doctor or provider anytime you notice something different about your breast, such as:

  • Nipple discharge (especially bloody or clear)
  • Swelling of one breast
  • Change in the shape of the breast
  • Dimpling of the skin
  • New pain in one spot that doesn’t go away

Talk to your doctor about your family history, your concerns and the best screening options for you.

Get more information about breast cancer prevention, screening, diagnostics, treatment, survivorship and research from the Edith Sanford Breast Center.

Posted In Cancer, Health, Women's