Breast cancer is most treatable when it is found early – when it is small and has not spread. There is no way to predict who will develop breast cancer and who will not. For these reasons, routine early detection tests (checking for breast cancer when there are no symptoms present) are recommended. The following are the guidelines published by the American Cancer Society to ensure early detection of breast cancer:

• All women age 40 and older should have a mammogram every year for as long as they are in good health.
• Women age 40 and older should have a clinical breast exam (breast exam by a health professional) every year. This exam should be done close to or preferably before the mammogram.
• Women ages 20 to 39 should have a clinical breast exam about every 3 years.
• Women should know how their breasts normally look and feel and report any changes to a health professional right away.
• Breast self-exam (BSE) is an option for women starting in their 20s. Women should be told about the benefits and limits of BSE.
• Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRI in addition to mammograms. (The number of women who fall into this category is small: less than 2% of all the women in the US.) Talk with your doctor about your history and whether you should have additional tests at an earlier age.

For more information on screening, please see our document called Breast Cancer: Early Detection.

Breast changes

Early breast cancer is most often – but not always – painless. In its very early stages, it is too small to find by palpating (touching) the breast. This means that there may not be any symptoms present. At this stage of breast cancer growth, a screening mammogram can show the changes before symptoms appear. As the tumor grows larger, it can feel like a lump or thickness.

Breast cancer can develop anywhere in the breast. Some signs to watch for are:

• A lump or thickening of tissue anywhere in the breast
• Skin dimpling or puckering of the breast
• A nipple that is pushed in (inverted) and hasn't always been that way
• Discharge from the nipples that comes out by itself and is not clear in color, staining your clothing or sheets
• Any change in the shape, texture (raised, thickened skin, for example), or color of the skin

These are all changes that you may be able to see or feel yourself. Having these changes, though, does not mean you have breast cancer. They can appear for other reasons. Always tell a doctor or nurse right away about any changes you find. If you are interested in examining your own breasts, ask your doctor or nurse to show you how to do breast self-exam (BSE).

Any suspicious changes in the breast tissue may also be seen or felt by a health professional during a clinical breast exam (CBE). A CBE is a check-up in which the doctor or nurse touches and gently presses the breast tissue in a circular or vertical pattern, to find any lumps, thickenings, or other changes. The examiner may also look at the shape of your breasts while you are sitting up. He or she might ask you to move your arms into positions that make the breast easier to examine. Some may squeeze the nipples gently to check for discharge.

While breast exams are very important, breast cancers often develop without any signs or symptoms. That's why mammograms are important, too.