• Clinical breast exam CBE (breast exam by a doctor or nurse)
• Mammogram (X-ray of the breast)

What you should know about CBE

Women in their 20s and 30s should have a clinical breast examination (CBE) as part of a periodic (regular) health exam by a health professional preferably every 3 years. After age 40, women should have a breast exam by a health professional every year.
 

A clinical breast examination (CBE) is an examination of your breasts by a health care professional, such as a doctor, nurse practitioner, nurse, or doctor's assistant. For this examination, you undress from the waist up. The health care professional will first look at your breasts for changes in size or shape. Then, using the pads of the fingers, the examiner will gently palpate your breasts.

Special attention will be given to the shape and texture of the breasts, location of any lumps, and whether such lumps are attached to the skin or to deeper tissues. The area under both arms will also be examined.

A good time for the health care professional to teach breast self-examination to the patient who does not already know how to examine her breasts is during the CBE. Ask your doctor or nurse to teach you and watch your technique.

CBE is a complement to mammograms and an opportunity 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 with the purpose of getting more familiar with your own breast.

Women should also be given information about the benefits and limitations of CBE and breast self-examination (BSE). Breast cancer risk is very low for women in their 20s and gradually increases with age. Women should be told to promptly report any new breast symptoms to a health professional.

What you should know about Mammography

A mammogram is an x-ray of the breast. A diagnostic mammogram is used to diagnose breast disease in women who have breast symptoms. Screening mammography is used to look for breast disease in women who are asymptomatic; that is, they appear to have no breast problems. Screening mammography usually involves 2 views (x-ray pictures) of each breast. For some patients, such as women with breast implants, additional pictures may be needed to include as much breast tissue as possible. Women who are breast-feeding can still get mammograms, although these are probably not quite as accurate. They can express their breast milk before the mammogram.

American Cancer Society Recommendations

Women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health.

Evidence supporting mammograms is even stronger than in the past. In particular, recent evidence has confirmed that mammograms offer substantial benefit for women in their 40s. Women can feel confident about the benefits associated with regular mammograms for finding cancer early. However, mammograms also have limitations. A mammogram will miss some cancers, and it sometimes leads to follow up of findings that are not cancer, including biopsies.

Women should be told about the benefits, limitations, and potential harms linked with regular screening. Mammograms can miss some cancers. However, mammograms, despite their limitations, remain a very effective and valuable tool for decreasing suffering and death from breast cancer.

Mammograms for older women should be based on the individual, her health, and other serious illnesses, such as congestive heart failure, end-stage renal disease, chronic obstructive pulmonary disease, and moderate-to-severe dementia. Age alone should not be the reason to stop having regular mammograms. As long as a woman is in good health and would be a candidate for treatment, she should continue to be screened with mammography.

The Canadian Cancer Society Recommendations

Women age 70 or older, should talk to their doctor about a screening program for them.
Women age 50 to 69, should have a screening mammogram every 2 years.
Women age 40 to 49, should discuss with their doctor their risk of breast cancer, along with the benefits and risks of mammography.