Are Monthly Breast Self-Exams Necessary or Optional?

For years, women have been told they must perform monthly breast self-exams for cancer detection. But evidence is growing that there are much more effective ways to detect breast cancer early – and potentially save your life.

What changed? According to breast imaging diagnostic radiologist Donna Plecha, MD, better technologies are now available that detect cancer earlier. This has led to organizations such as the American Cancer Society calling breast self-exams an “optional” screening tool for early detection of breast cancer.

“Women should be aware that breast self-exams and a clinical breast exam performed by a health care provider are simply two tools in a woman’s tool belt to identify breast cancer,” Dr. Plecha says. “Breast mammography, including tomosynthesis (3-D mammography), is a better tool at picking up cancer early, before it is discovered by a health care provider or patient.”

To clear up the confusion about performing breast self-exams, Dr. Plecha answers these six commonly asked questions:

What is a breast self-exam?

This is a procedure where a woman, usually beginning at age 20, physically and visually examines her breasts and her underarm areas for any of these changes:

  • A new lump or bump in her breasts
  • A rash, swelling or redness in her breast
  • Discharge from the nipples

Dr. Plecha says if any of these changes occur, a woman should immediately contact her doctor for further evaluation.

How often should women perform breast self-exams?

“Every month or every other month usually works best, and should be done when a woman’s breasts are the least swollen and tender,” she says. “If you do these exams too often you won’t be aware of any new lumps or bumps or if there is something unusual about your breasts.”

What role does a breast self-exam play?

“Self-exams help women become familiar with how their breasts feel,” Dr. Plecha says. “However, in some cases, by the time a woman notices a lump in her breast, it might be larger than if that lump had been picked up earlier in a routine mammogram.”

At what age should a woman start having a mammogram?

“I recommend mammograms for breast cancer screening at the age of 40 for patients with no increased risk factors,” Dr. Plecha says. "I recommend 3-D mammography – which can pick up 40 percent more invasive cancers than regular mammography and decrease false positives by 15 percent in patients with dense and non-dense breasts.”

Additional screening with ultrasound in dense-breasted women helps find cancers that may hide on a mammogram. If in doubt, ask your doctor what your options are, Dr. Plecha says.

“If you have a family history or other factors increasing your risk, you may benefit from additional screening and surveillance with breast MRI.

How common is breast cancer?

One-eighth of all women in the U.S. will be diagnosed with this disease Dr. Plecha says.

“Breast cancer is the most common cancer in women, and is the second deadliest cancer for women, surpassed only by lung cancer,” she says.

Why is early detection of breast cancer so important?

“If caught early, the five-year survival rate of breast cancer is 98 to 100 percent,” Dr. Plecha says. “Also, early detection means the cancer is less likely to have spread into surrounding lymph nodes and is easier to treat, allowing patients to avoid aggressive forms of chemotherapy and its toxic side effects.”

To schedule your mammography or for other women's health questions, contact University Hospital Women’s Health Institute or call 440-720-3262.

Donna Plecha, MD is a breast imaging diagnostic radiologist, and director, Breast Imaging, Mammography at University Hospitals Cleveland Medical Center, as well as director, Breast Cancer Imaging at University Hospitals Seidman Cancer Center. You can request an appointment with Dr. Plecha or any other doctor online.

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