• Cancer

    Mayo Clinic Q and A: The changing recommendation on breast self-exams

a close-up of a smiling middle-aged woman looking over the back of a couchDEAR MAYO CLINIC: I’m confused about breast self-exams. I’m 45 years old, and I remember being told to do self-exams monthly. At one point, my health care provider even gave me a laminated card to put in the shower that showed the correct technique. Now it seems self-exams aren’t talked about much anymore. Are we still supposed to do them?

ANSWER: You are correct that the role of breast self-exams have changed. While detailed breast self-exams no longer are recommended as part of formal screening for breast cancer, it is still important for you to know how your breasts usually look and feel. That way, if anything changes, you will be more likely to notice the difference. Breast self-awareness can help you become more familiar with your own breasts, so you understand what’s normal for you.

In the past, health care providers often recommended that women do breast self-exams regularly using a step-by-step approach to detect signs of breast cancer. Although breast self-exams seemed like a good way for women to find breast cancer in its early stages, research showed that those self-exams triggered more breast tests and biopsies being done that came back with normal findings (sometimes called false positives) in women who did breast self-exams, compared to women who did not do the exams.

Now, instead of using detailed self-exams as part of a formal breast cancer screening process, health care providers recommend breast self-awareness, so that women become familiar with the normal look and feel of their breasts. That way, if you notice a change in your breast, such as a lump or bump that seems out of the ordinary to you, you can tell your health care provider about it. From there, the two of you can decide if any further investigation is needed.

Although it is a good idea for you to be aware of the typical look and feel of your breasts, keep in mind that breast self-awareness can’t replace a clinical breast exam conducted by your health care provider. And breast self-awareness should not replace screening mammograms or other breast cancer screening tests that your health care provider recommends.

Screening mammograms often can detect breast changes in women who have no new noticeable breast abnormalities or any other signs or symptoms of cancer. The goal of these screening mammograms is to detect cancer in its earliest stage, before you’d be able to notice any changes. Mammograms continue to play a key role in early breast cancer detection and have been shown to help decrease breast cancer deaths.

Take time to talk to your health care provider about the approach to breast cancer screening that’s right for you. Factors that can make a difference in that approach include your age, medical background and family history. Discuss the benefits, risks and limitations of screening tools, such as mammograms, and decide together what's best for your situation. — Dr. Karthik Ghosh, Breast Diagnostic Clinic, Mayo Clinic, Rochester, Minnesota

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