TYPES OF SCREENING TESTS  ♦  SCREENING TESTS FOR WOMEN  ♦  BREAST SELF-EXAMINATION  ♦  MAMMOGRAPHY

[ TYPES OF SCREENING TESTS ]

A woman should talk with her health care provider about her personal risk of getting breast cancer. She should ask questions about when to start and how often to be checked for the disease. These decisions, like many other medical decisions, should fit each woman's needs.

Screening for cancer before there are symptoms can be important. It can help doctors find and treat cancer early. Treatment is more likely to be effective when cancer is found early. The health care provider may suggest screening tests to check for breast cancer before any symptoms develop:

	Screening mammogram
	Clinical breast exam
	Breast self-exam

Screening Mammogram

To find breast cancer early, it is recommends that:

	Women in their 40s and older should have mammograms (pictures of the breast made with x-rays) every one to two years.
	Women who are at higher than average risk of breast cancer should talk with their health care providers about whether to have mammograms before age 40 and how often to have them.

Screening mammograms can often show a breast lump before it can be felt. They also can show a cluster of very tiny specks of calcium. These specks are called microcalcifications. Lumps or specks can be signs of cancer.

If the doctor sees an abnormal area on the mammogram, the woman may need more pictures taken. Also, the woman may need to have a biopsy. A biopsy is the only way to tell for sure if cancer is present.

Mammograms are the best tool doctors have to find breast cancer early. However, it is good for a woman to keep in mind that:

	A mammogram may miss some cancers that are present. (This is called a "false negative.")
	A mammogram may show things that turn out not to be cancer. (This is called a "false positive.")
	Some fast-growing tumors may already have spread to other parts of the body before a mammogram detects them.

Mammograms (as well as dental x-rays, and other routine x-rays) use very small doses of radiation. Although the benefits nearly always outweigh the risks, repeated exposure to x-rays could be harmful. It is a good idea for a woman to talk with her health care providers about the need for each x-ray and to ask about the use of shields during the x-ray to protect other parts of the body.
 

Clinical Breast Exam

During a clinical breast exam, the health care provider feels the breasts while the woman is standing or sitting up and lying down. The woman may be asked to raise her arms over her head, let them hang by her sides, or press her hands against her hips.

The health care provider looks for differences between the breasts, including unusual differences in size or shape. The skin of each breast is checked for a rash, dimpling, or other abnormal signs. The nipples may be squeezed to see if fluid is present.

Using the pads of the fingers to feel for lumps, the health care provider checks the entire breast, the underarm, and the collarbone area, first on one side, then on the other. A lump is generally the size of a pea before anyone can feel it. The lymph nodes near the breast may be checked to see if they are swollen.

A thorough clinical breast exam may take 10 minutes.
 

Breast Self-Exam

Some women perform monthly breast self-exams to check for any changes in their breasts. When a woman does this exam, it is important for her to remember that each woman's breasts are different, and that changes can occur because of aging, the menstrual cycle, pregnancy, menopause, or taking birth control pills or other hormones. It is normal for the breasts to feel a little lumpy and uneven. Also, it is common for a woman's breasts to be swollen and tender right before or during her menstrual period.

Women who notice anything unusual during a breast self-exam or at any other time should contact their health care provider.

Also, it is important to remember that breast self-exams cannot replace regular screening mammograms and clinical breast exams. Although breast self-exams lead to more breast biopsies, studies so far have not shown that breast self-exams reduce the number of deaths from breast cancer.