For Women Facing a Breast Biopsy

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Appendix B: Guidelines for early detection of breast cancer

Breast cancer is most treatable when it’s found early – when it’s small and has not spread. There’s no way to predict who will develop breast cancer, so routine early detection tests (checking for breast cancer when there are no symptoms) are recommended. The following are the American Cancer Society’s recommendations for the 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 at least 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 very small, but talk with your doctor about your history and whether you should have additional tests or start screening at an earlier age.

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

Breast changes

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

Breast cancer can start 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 nipple 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. But having these changes does not mean you have breast cancer. Always tell a doctor or nurse right away about any changes you find. If you want to examine your own breasts, ask your doctor or nurse to show you how to do breast self-exam (BSE).

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 a doctor or nurse touches and gently presses the breast tissue in a circular or vertical pattern, to find any lumps, thickenings, or other changes. They may also look at the shape of your breasts while you are sitting up. They 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.

Last Medical Review: 07/21/2014
Last Revised: 07/21/2014