Breast Exams and Mammograms

Detecting breast cancer in the earliest and most curable state could save the lives of many women.

There are three methods of early detection that all women should practice: monthly breast self-exams, annual clinical breast examinations by a health care professional, and regular mammograms.

Women 20 years of age and older should perform a breast self-exam (BSE) each month, 2 to 3 days after their period or on the same date each month if they no longer have periods. Monthly BSE helps you learn the way your breasts typically look and feel and allows you to notice changes. The following changes should be reported to your health care provider:

• new lump in or near the breast or under the arm
• thickening or swelling of part of the breast
• irritation or dimpling of breast skin
• redness or flaky skin in the nipple area or the breast
• pulling in of the nipple or pain in the nipple area
• nipple discharge other than breast milk that occurs without squeezing
• any change in the size or the shape of the breast
• pain in any area of the breast

Remember that some of these warning signs can happen with other conditions that are not cancer.

Hands at side. Compare for symmetry. Look for changes in:

• shape
• color

Check for:

• puckering
• skin changes
• nipple discharge
• dimpling

Hands over head. Check front and side view for:

• symmetry
• puckering
• dimpling

Hands on hips, press down, bend forward. Check for:

• symmetry
• nipple direction
• general appearance

Lie down with a towel under right shoulder; raise right arm above the head.

Examine area from:

• underarm to lower bra line
• across to breast bone
• up to collar bone
• back to armpit

Use the pads of the three middle fingers of the left hand. Hold hand in bowed position. Move fingers in dime-sized circles.

Use three levels of pressure:

• light
• medium
• firm

Examine entire area using vertical strip pattern.

Be sure to examine both breasts in the same way at the same time every month. If there are any lumps, knots or changes, tell your doctor right away.

A CBE should be a part of every yearly health exam for women 20 years of age and older. During the CBE, your doctor or nurse will carefully feel your breasts and under your arms checking for lumps and other changes. During the CBE, your health care provider can show you the correct way to perform a breast self-exam, if you ask for help.

Mammograms are the best available method to detect breast cancer in its earliest,most treatable stage. However, mammograms are not perfect and can miss some cancers. A woman should not ignore something she feels because her mammogram is normal. Changes can be especially difficult to spot in dense, glandular breast of a younger woman. This is why women of all ages should have a clinical breast exam (an exam done by a health care provider) every year.

A screening mammogram is an X-ray examination of the breast in a woman who has no breast complaints (asymptomatic). The goal of screening mammography is to find cancer when it is still too small to be felt by breast self-examination or your doctor. Finding small breast cancers early by a screening mammogram greatly improves your chance for successful treatment. Mammograms produce high quality X-rays, with a low dose of radiation. For a mammogram, the breast is positioned between two smooth plastic plates to flatten your breast tissue and allow a lower dose of X-ray. Although this may be temporarily uncomfortable, it only lasts for a few seconds. The entire procedure for a screening mammogram takes about 20 minutes.

Most women should have their first mammogram at age 40 and then have another mammogram every year. If you have any symptoms or changes in your breast, or if breast cancer runs in your family, talk to your health care professional. He or she may recommend that you have mammograms earlier or more often than other women.

• Make your mammogram appointment for one week after your period. Your breasts hurt less after your period.
• Bring a list of the places, dates of mammograms, biopsies, present symptoms, or other breast treatment you have had before.
• If you have had mammograms at another facility, you should bring them so the doctor can compare the results with previous scans.
• On the day of the examination, do not wear deodorant, perfume or powder; this can interfere with the mammogram by appearing on the X-ray film as calcium spots.
• Wear a shirt with shorts, pants or a skirt. That way you can undress from the waist up and leave your shorts, pants, or skirt on when you get your mammogram.

Be sure to get a mammogram from a facility certified by the Food and Drug Administration (FDA). These places must meet high standards for their X-ray machines and staff. Check out the FDA's website (see Resources) for a list of FDA-certified mammography facilities or call the American Cancer Society at 800-227-2345.

Partial or total costs of mammograms are covered by Medicare, Medicaid and most private health plans. To find out what the law requires insurance carriers to provide, go to the Illinois Department of Insurance’s website (see Resources).

The Illinois Breast and Cervical Cancer Program provides free mammograms and Pap tests for women who qualify - women age 35 to 64 who are uninsured. Younger women may qualify if they have symptoms. To find a site near you that provides this free service, call the Women’s Health-Line at 888-522-1282 (TTY 800-547-0466).

All mammogram facilities are required to send results to you within 30 days. Generally, you will be contacted within five working days if there is a problem with the mammogram. If you do not hear from your doctor, do not assume that your mammogram was normal — call your doctor or the facility that administered the mammogram.

If your health care provider orders additional tests, such as a breast ultrasound or breast biopsy, ask for information about these tests. Remember, if you have a lump in your breast, a normal mammogram is not enough testing to make sure the lump is not cancer.

Only two to four mammograms out of every 1,000 lead to a diagnosis of cancer. About 10 percent of women will require more tests such as a diagnostic mammogram or breast ultrasound. Do not be alarmed if this happens to you. Only 8 percent to 10 percent of those women will need a biopsy, and 80 percent of those biopsies will not be cancer.

More than 2 million women live with breast cancer. If detected early, women diagnosed with breast cancer have a survival rate of 98 percent. Early detection also gives women more treatment options.

You can find out more about breast cancer by reading the Illinois Department of Public Health’s “Your Right to Know” (updated 12/13) (see Publications) or the National Cancer Institute’s “Understanding Breast Cancer: A Women’s Health Guide for Women” (see Resources). 

• Illinois Department of Insurance
• FDA - Mammography Facilities
• Understanding Breast Cancer: A Women’s Health Guide for Women
• Illinois Breast and Cervical Cancer Program
• American Cancer Society
• National Cancer Institute
• U.S. Centers for Disease Control and Prevention

• Breast Density
• Breast Density (Spanish)
• Your Right to Know
• Your Right to Know (Spanish)