Monitoring breast health is a proactive part of overall wellness. The practice of self-monitoring has evolved from a rigid routine to a more flexible approach focused on personal awareness. Understanding what is considered normal for your body and knowing the current medical recommendations ensures prompt action if a concern arises. This article provides an overview of current guidelines for personal breast monitoring and professional screening.
Current Guidelines on Breast Self-Examination Frequency
The approach to self-monitoring has shifted away from the formal, mandatory “Breast Self-Examination” (BSE) previously promoted. Major organizations like the American Cancer Society (ACS) no longer recommend a routine, monthly self-exam for women at average risk. This is because large-scale studies have not shown that this practice reduces breast cancer mortality rates.
Current medical consensus emphasizes “Breast Self-Awareness,” which is the practice of knowing how your breasts normally look and feel. This awareness allows a person to quickly notice and report any persistent changes to a healthcare provider. While formal monthly self-exams are not universally mandated, many individuals still choose to perform them.
For those who choose to perform a structured check, doing it monthly helps establish a baseline of what is typical for their breast tissue. The purpose of this consistency is to track subtle differences over time, not to replace professional screening methods. The goal is to detect a change that warrants medical investigation.
What to Look and Feel For During a Check
Visual Inspection
A comprehensive check involves both visual inspection and tactile examination. Visually, look for any changes in breast size or shape, paying attention to sudden or asymmetric swelling. Inspect the skin for signs like dimpling, puckering, or a texture resembling an orange peel. Also check for any persistent redness, scaling, or rash on the breast or nipple.
Tactile Examination
During the tactile part of the check, use the pads of your three middle fingers to feel the entire breast area, including the armpit and up to the collarbone. Apply varying levels of pressure: light for tissue near the surface, medium for the middle layer, and firm for tissue close to the chest wall and ribs. Feel for any new, distinct lumps or an area of noticeable thickening that differs from the surrounding tissue.
Also, look for changes in the nipple, such as sudden inversion or any unusual discharge that is clear or bloody. While most changes are benign, any newly discovered change that persists beyond a menstrual cycle should be reported to a doctor immediately.
Professional Screening: Clinical Exams and Mammography
Self-checks must be complemented by professional screening. A Clinical Breast Exam (CBE) is a physical examination performed by a healthcare provider to check the breasts and underarm area for abnormalities. For women in their 20s and 30s, some practitioners recommend a CBE every one to three years, though the ACS no longer includes it in routine guidelines for average-risk women.
Mammography remains the most effective tool for early detection, often finding cancers years before they are large enough to be felt. The age to begin screening varies slightly between major medical groups, necessitating a discussion with a physician.
Standard Screening Guidelines
- The American Cancer Society (ACS) recommends women at average risk begin annual mammograms at age 45, with the option to start earlier at age 40.
- The ACS recommends annual screening for women aged 45 to 54.
- Women aged 55 and older can transition to screening every two years or continue annually.
- The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening for women aged 40 to 74.
Women with a higher-than-average risk, such as those with a strong family history or a known genetic mutation like BRCA, often require an earlier start to screening and may need additional imaging like a breast MRI.
Practical Timing: When to Perform a Self-Check
For individuals who still experience a menstrual cycle, the optimal timing for a monthly self-check is typically a few days after the period has ended. This timing is preferred because fluctuating hormone levels cause breast tissue to be less swollen, tender, and lumpy. Performing the check then reduces the likelihood of mistaking normal hormonal changes for a new lump.
Consistency is more important than the exact date chosen, as it helps establish a reliable pattern. If a person is post-menopausal, pregnant, or has irregular periods, they should choose a fixed, easy-to-remember day of the month. Adopting a consistent monthly habit ensures that any persistent change can be noticed and addressed promptly.