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Breast Cancer Screening Guidelines

Find out when and how often women should be checking for signs of breast cancer.

Recommendations for Breast Cancer Screenings and Self Breast Exams

  • Monthly self breast exam starting at age 20.
  • Annual breast exam by a health care provider starting at age 40.
  • Annual screening mammography starting at age 40.
  • Women in high-risk categories (first-degree relative with breast cancer; personal history of breast cancer; prior biopsy with atypical ductal hyperplasia or lobular carcinoma in situ) may want to consider starting breast screenings and breast exams at age 30.

Breast surgeon, Dr. Michael Cowher, is a featured expert blogger on Cleveland Clinic's Health Hub. Dr. Cowher's blog post breaks down How to Do a Great Self Breast Exam in a few easy steps.

A monthly self breast exam should be performed by all women starting at about the age of 20. A breast exam increases the chances of early detection and survival of breast cancer.

image showing steps of performing a self breast examination

1. The first part of the breast exam is inspection, or looking at your breasts. Stand undressed from the waist up in front of a large mirror in a well lighted room. Look at your breasts. Don’t be alarmed if they do not look equal. Most women's breasts are not. With your arms relaxed by your sides, look for any changes in your breasts’ size, shape, texture or skin. Look for skin puckering, dimpling, sores or discoloration. Inspect your nipples and look for any sores, peeling or change in the direction of the nipples.

image showing steps of performing a self breast examination

2. Continuing the breast exam, place your hands on your hips and press down firmly to tighten the chest muscles beneath your breasts. During the breast exam, turn from side to side so you can inspect the outer part of the breasts.

image showing steps of performing a self breast examination

3. Then bend forward toward the mirror. Roll your shoulders and elbows forward to tighten your chest muscles. Your breasts will fall forward. Look for any changes in the shape of your breasts.

image showing steps of performing a self breast examination

4. Now, clasp your hands behind your head and press your hands forward. Again, turn from side to side to inspect your breasts’ outer portion. Remember to inspect the border underneath your breasts. You may need to lift your breast with your hand during the breast exam in order to see this area.

image showing steps of performing a self breast examination

5. Check your nipples for discharge. Place your thumb and forefinger on the tissue surrounding the nipple and pull outward toward the end of the nipple. Look for any discharge. Repeat on your other breast.

6. The second part of the breast exam is palpation, or feeling for any changes. It is helpful to have your hands slippery with soap and water during this part of the breast exam. Check for any lumps or thickenings in your underarm area. Place your left hand on your hip and reach with your right hand to feel in the left armpit. Repeat with your right arm.

7. Check for lumps or thickenings above and below your collar bone.

8. Continuing the breast exam, with hands soapy, support the breast with one hand while using the other hand to feel the tissue. Cover the breast in a straight grid pattern with a series of strips from collar bone to bra line.

image demonstrating self breast-examination methods

9. Continuing the breast exam, lie down and place a small pillow or folded towel under your left shoulder. Put your left hand behind your head. Place your right hand on the upper portion of your left breast with fingers together and flat. Body lotion may help to make palpation easier during the breast exam.

image demonstrating slef breast-examination methods

10. Think of your breast as a face of a clock. Start the breast exam at 12 o’clock and move toward 1 o’clock in small circular motions. Continue around the entire circle back to 12. Keep your fingers flat and in constant contact with your breast. When the circle is completed, move in one inch toward the nipple and continue in another circle. Continue the breast exam in this pattern until your entire breast has been palpated. Make sure to palpate the upper outer areas which extend into your armpit.

image demonstrating self breast examination methods

11. Continuing the breast exam, place your fingers flat and directly on top of your nipple. Feel beneath the nipple for any changes. Gently press your nipple inward. It should move easily.

Now place a pillow or folded towel underneath your right shoulder and place your right hand behind your head. Repeat steps 9, 10 and 11 of the breast exam on your right breast.

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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