Following are general guidelines recommended by the Margie Petersen Breast Center associated with screening for breast cancer.
Breast self-examination (BSE) is an option for women starting in their 20s, though research has shown that BSE plays a small role in finding breast cancer compared with finding a breast lump by chance or simply being aware of what is normal for each woman. However, doing a BSE can be one way to know how your breasts normally look and feel and to notice any changes. The goal, with or without BSE, is to report any breast changes to us right away.
If a change occurs, such as development of a lump or swelling, skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk (such as staining of your sheets or bra), you should see your health care professional as soon as possible for evaluation. Remember that most of the time these breast changes are not cancer.
Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a regular health exam by a health professional every three years. Women age 40 and older should have a mammogram every year and should continue to do so for as long as they are in good health.
- A CBE is done along with a mammogram and offers a chance for women and their doctor or nurse to discuss changes in their breasts, early detection testing, and factors in the woman's history that might make her more likely to have breast cancer.
- There may be some benefit in having the CBE shortly before the mammogram. The exam should include instruction for the purpose of getting more familiar with your own breasts. Women should also be given information about the benefits and limitations of CBE and breast self-examination (BSE). The chance of breast cancer occurring is very low for women in their 20s and gradually increases with age. As with a BSE, you should report any new breast symptoms to a health professional.
Women should report any breast changes to their health professional right away.
Women at high risk should get an MRI and a mammogram every year. Women at moderately increased risk should talk with us about the benefits and limitations of adding MRI screening to their yearly mammogram
Who’s at risk?
Breast cancer risk can be divided into those who have a high, moderate (lifetime risk 15-20 percent) or significant (lifetime risk greater than 20 percent). Breast cancer risk can be estimated based on risk assessment tools such as the Gail model or the Tyrer-Cuzick model.
Women at significant increased risk for breast cancer include those who:
- Have a lifetime risk of breast cancer of 20 percent or greater, according to risk assessment tools.
- Have a known BRCA1 or BRCA2 gene mutation.
- Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves.
- Had radiation therapy to the chest when they were between the ages of 10 and 30 years old.
- Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have one of these syndromes in first-degree relatives.
Women at a moderately increased risk for breast cancer include those who:
- Have a personal history of breast cancer, lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH).
- Have extremely dense breasts or unevenly dense breasts when viewed by mammograms.
- Have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH).