Women's Health

Your Best Breast Cancer Screening Today

Mammography: Still the Gold Standard continued...

There is an 85% chance that a mammogram will find breast cancer, says Saslow, noting the percentage is significant, even if it's not 100%. A perfect test, she remarks, is not realistic at this time.

Most medical professionals stand by mammography, even with the hazards that come with using it. The device can wrongly highlight something as malignant when it is not. And it can fail to detect a true cancer. But its success rate outweighs those drawbacks, experts say.

"There are risks to most screening methods," reminds Helen Meissner, PhD, chief of National Cancer Institute's Applied Cancer Screening Research Branch.

New Policy on Breast Self Exams

The risks to inspecting your own breasts are similar to the hazards of the mammogram, in that you can miss a true cancer, or mistakenly pinpoint something as a concern. However, doctors have still advised female patients to perform a breast self exam every month.

Leading health groups used to give a strong recommendation for such monthly tests, but after reviewing the studies on screening, they determined there isn't enough evidence to advocate or reject the method.

"The recommendation (for the breast self exam) was never based on evidence," says Saslow, because there is not enough available data on the value of the technique. "It's enough to show that any effectiveness would be extremely small."

Therefore, the US Preventive Services Task Force recommends neither for nor against teaching or performing routine breast self examination. The National Cancer Institute has adopted the same policy.

The American Cancer Society guidelines on breast self exams only advise women to be aware of their breasts, enough to notice any physical changes. Women can achieve this awareness by occasionally looking at breasts while taking a shower, getting dressed, or looking in the mirror.

Still, a monthly self exam is a great way of becoming familiar with the texture of your own breasts, says Meissner. "There may be insufficient evidence to recommend performing a self breast exam, but it doesn't mean that women shouldn't do it."

Burstein encourages self-examination on a regular basis, preferably after a menstrual cycle, when there are fewer changes in the composition of the breast. Using the flat side of several fingers, he suggests moving your fingers around the breast in a circular motion. It's a good idea, he adds, to examine how the breast feels in a horizontal position (while lying down), and in a vertical one (while standing in the shower).

The National Cancer Institute states that women performing breast self exams should watch out for the following symptoms of breast cancer:

• A lump or thickening in or near the breast or in the underarm area
• A change in the size or shape of the breast
• Nipple discharge or tenderness, or the nipple pulled back (inverted) into the breast
• Ridges or pitting of the breast (the skin looks like the skin of an orange)
• A change in the way the skin of the breast, areola, or nipple looks or feels (for example, warm, swollen, red or scaly)

Women who notice these symptoms are urged to see their doctor for a clinical breast exam.