Breast cancer
screening
101
Cancer screening is recommended for women without breast symptoms. Screening can often detect tumors before they spread, which increases the probability of successful treatment. The Affordable Care Act mandates mammograms at no cost.
- Have clinical breast exams — exams by a health professional — at least once every three years starting in your 20s and 30s.
- Become familiar with how your breasts normally feel so you can detect changes.
- Initiate yearly mammograms and clinical breast exams at the age of 40.
- Get a yearly MRI as well as mammogram if you are at very high risk for breast cancer.
- Establish a screening schedule with your doctor that accommodates your personal risk. Some people may start screening before the age of 40.
Source: American Cancer Society

Got a pencil? Great! Sharpen it, please, and take this quiz on mammograms.
Quite likely, you’ve heard a lot about these breast X-rays, which may detect cancer long before it can be seen or felt. Just as likely, only part of what you’ve heard is true.
1. If there’s no history of breast cancer in your family, you don’t need to have a mammogram.
❒ True ❒ False
False. Just 5-10 percent of breast cancer cases can be traced to genetic glitches handed down through your family, says the American Cancer Society (ACS). Roughly 20-30 percent of women diagnosed with breast cancer have a family member who has had it, too. That means 70-80 percent of women who develop it have no family history of breast cancer. So mammograms are an important screening tool for all women. Talk to your doctor about when to start having mammograms and how often to have them. The answer varies depending on family history and other risk factors.
BRCA1 and BRCA2 are the most well-known gene mutations affecting breast cancer risk. They raise risks for cancer of the breast, ovaries, prostate and other sites. While these gene changes are most common in people of Ashkenazi Jewish descent, they occur more often than usual in Norwegian, Dutch and Icelandic people also. African Americans are not exempt, however.
2. Having a mammogram is the only way to find breast cancer.
❒ True ❒ False
False. Certain physical signs are warning flags for breast cancer. As a tumor grows, it can change how a breast looks or feels. That’s why it’s important to have regular clinical breast exams performed by your doctor or another clinician trained to check for worrisome changes, such as:
- a lump or thickened area on the breast or underarm
- changes in breast size or shape
- dimpled or puckered skin
- a nipple turning inward into the breast or leaking fluid other than breast milk
- scaly, reddened or swollen skin on breast, nipple or areola (the darker circle of skin around the nipple)
- ridges or pitting that looks much like the skin of an orange
While the American Cancer Society no longer recommends doing monthly breast self-exams, it continues to emphasize breast awareness — that is, knowing how your breasts usually look and feel as you shower or dress so that you’ll notice changes like those described above. If this happens, call your doctor for advice.
3. Mammograms can find every breast cancer.
❒ True ❒ False
False. According to the National Cancer Institute (NCI), screening mammograms may miss up to 20 percent of breast cancers in women who have no signs or symptoms. Called a false negative, this is more likely to occur in younger women, who generally have a higher proportion of dense breast tissue, which can hide tumors. That’s why it is important to have periodic clinical breast exams and to keep your mammogram appointments.
4. Mammograms cause cancer.
❒ True ❒ False
False. Radiation is one cause of cancer. Like any X-ray, mammograms use radiation to form images of breast tissue. The radiation doses are very small and the risk of harm is considered low although it can potentially rise with repeated exposure. The National Cancer Institute (NCI) states that the benefits of mammography nearly always outweigh the risks.
Some people worry that bruising or even touching the breast can cause cancer. While mammograms require compression of the breast to get the clearest images, you cannot get cancer by bumping, bruising or touching the breast, notes the NCI.
5. All mammograms diagnose breast cancer.
❒ True ❒ False
False. There are two kinds of mammograms. Screening mammograms check for breast cancer when a woman has no obvious signs or symptoms. Diagnostic mammograms take a closer look at a suspicious area in the breast. Neither test can actually diagnose cancer. Only a biopsy — a procedure to remove breast cells or tissue via a hollow needle or scalpel — can do that. The cells or tissue must then be checked under a microscope for abnormalities that indicate cancer.



The female breast contains lobes, which are made up of smaller sacs called lobules, in which milk is produced. Thin tubes called ducts carry the milk from the lobules to the nipple when a woman is breastfeeding. The breast also contains vessels that carry clear fluid, or lymph, to small, round organs called lymph nodes. 
