Clinical breast examinations can detect lumps or other changes in your breasts that might indicate the need for further testing. Breast exams are one of the most important early screenings for breast cancer. These exams improve the chance of finding breast cancer in the early stages when it is easier to treat.
Why are breast exams recommended?
When should I get a breast exam?
For most cisgender women, a breast exam is recommended every 1 to 3 years when you are in your 20s and 30s. Once you turn 40, an annual breast exam is recommended. These exams are usually done as part of an annual check up.
If you have had breast or ovarian cancer or have a family history of breast or ovarian cancer, more frequent breast cancer screenings may be needed.
What happens during a breast exam?
During a breast exam, your provider is checking your breasts for any signs of possible cancer or other breast problems. They may also talk to you about your risks for breast cancer as well as prevention strategies.
To prepare for the exam, you will be asked to take off your shirt and bra. Your provider will do a visual examination of your breasts to note the size, shape and texture of the skin. They will do a manual exam with the tips of their fingers to check for lumps or anything else that doesn't feel normal. They will check one breast at a time, including nipples and armpits.
What are the risk factors for breast cancer?
There are different types of risk factors for breast cancer. Some risk factors are inherent - you can't change them. Other risk factors are related to lifestyle choices and can be changed. Some factors can put you at higher risk than others and risk factors can change over time. Some of the risk factors that cannot be changed include:
Biological sex - being a person assigned female at birth is the main risk factor for developing breast cancer. (Note: people of all genders can develop breast cancer, although the incidence of breast cancer among cisgender men is low. Approximately 1,500 cisgender men will be diagnosed with breast cancer and 400 will die from the disease each year in the U.S.)
Age - your risk of developing breast cancer increases as you get older.
Genetics - 10% of breast cancer cases are hereditary as a result of gene changes (mutations).
Family History - breast cancer risk is higher among people whose close blood relatives have this disease.
Personal History - someone with cancer in one breast has a 3- to 4-fold increased risk of developing a new cancer in the other breast or in another part of the same breast.
Race - White women are slightly more likely to develop breast cancer than are African-American women. Asian, Latino, and Native American women have the lowest risk of developing breast cancer.
Previous Biopsies - people whose earlier breast biopsies detected proliferative breast disease are at higher risk.
Previous Irradiation - people who as children or young adults have had radiation therapy to the chest area as treatment for another cancer (such as Hodgkin's disease or non-Hodgkin's lymphoma) have a significantly increased risk for breast cancer.
Menstrual History - people who started menstruating at an early age (before age 12) or who went through menopause at a late age (after age 50) have a slightly higher risk of breast cancer.
Risk factors that are related to lifestyle choices that can possibly be changed include:
Not having children - people who have not had children or who had their first child after age 30 have a slightly higher breast cancer risk.
Oral contraceptive use - studies have found that oral contraceptive users may have a slightly greater risk of breast cancer than those not using them, although the level of risk is still not clear.
Hormone replacement therapy - most studies suggest that long-term use (5 years or more) of hormone replacement therapy (HRT) after menopause will increase your risk of breast cancer.
Not breast-feeding - many studies have shown that breast feeding lowers breast cancer risk.
Alcohol consumption - if you drink 2 to 5 alcoholic beverages a day it can increase the risk of developing breast cancer to 1.5 times the risk of non-drinkers.
Obesity and high-fat diets - being overweight is associated with an increased risk of developing breast cancer, especially after menopause.
(Adapted from American Cancer Society, "What are the risk factors for breast cancer.")
It is important to remember that just because you have one or more risk factors does not guarantee that you will develop breast cancer. Some people with a number of risk factors never develop breast cancer while the majority of people with breast cancer have no identifiable risk factors.
Should I do breast self-exams?
For many years, monthly breast self-exams were recommended. A self-exam is a specific way of feeling and checking your own breasts for lumps or other changes. However, research has found that breast self-exams may not be helpful and so they are no longer recommended.
Instead, looking at and feeling your breasts from time to time is good to do. The key is knowing what is normal for you so that you are more likely to notice any changes in the appearance or feel of your breasts.
What does it mean if I find a lump?
It is important to remember that breast changes are normal, especially in young people. Just because you find a lump or notice a change in your breasts doesn't mean that you have breast cancer. Some people have lumpy breasts and others experience regular breast changes during their menstrual cycle. If you are concerned about a lump, have your medical provider perform a clinical breast exam to determine whether you need further testing, such as a mammogram, ultrasound or biopsy. These tests will help determine if the lump is cancerous or if the lump is actually a cyst, a symptom of nodular sensitive breasts or another benign (not cancerous) breast condition. Out of the lumps that are biopsied, 80% are found to be benign. However, if you do notice a lump, enlargement, tenderness or other unexplained changes in your breasts, talk to your medical provider right away. The sooner you have the lump diagnosed, the more treatment options you will have and the more successful your treatment will be.
What are mammograms?
A mammogram is a procedure that uses x-ray photographs to look deep into the breast tissue. Mammograms can detect a lump well before it can be felt. The process involves a mildly uncomfortable squeezing of the breast between 2 plastic plates in a x-ray machine. The procedure should not be painful and only lasts a few minutes.
There are two reasons to get mammograms - for screening or for diagnostics. Most people with breasts should begin getting screening mammograms once each year beginning at age 40. You may need to get one before age 40 if you have a family history of breast cancer or if you have cysts in your breasts, which can mask any symptoms of breast cancer. Diagnostic mammograms are recommended when there is a potential problem area in your breasts. A diagnostic mammogram might be recommended if a provider has found a lump during a clinical exam or if a screening mammogram returned abnormal results.
To learn more about BSEs and breast cancer, you can visit:
National Breast Cancer Foundation's Early Detection Plan Tool
Allows you to set up a personalized early detection plan. You can choose to be reminded about BSEs and other detection steps by e-mail or text message.