Breast self-exams are a screening tool women can use to check their breasts for lumps, changes in size or shape, or other changes that could be signs of breast cancer. While breast self-exams were once touted as an essential part of preventive health care for women, recommendations have changed over the past few decades.
Many major health organizations have moved away from routinely recommending breast self-exams. However, some experts still advise women to do breast self-exams on a monthly basis. So how often should women really examine their own breasts? Here is a detailed look at the current recommendations on breast self-exam frequency.
Current Medical Recommendations on Breast Self-Exam Frequency
Most major medical groups, including the American Cancer Society and the U.S. Preventive Services Task Force, have moved away from routinely recommending monthly breast self-exams for all women. Here are the current recommendations from several leading health authorities:
American Cancer Society (ACS)
The ACS states that breast self-exams are an option for women starting in their 20s. However, the organization no longer recommends that all women do monthly breast self-exams.
U.S. Preventive Services Task Force (USPSTF)
The USPSTF recommends against teaching breast self-exam (BSE). According to the Task Force, teaching women how to perform regular extensive breast self-exams does not lower breast cancer death rates.
American College of Obstetricians and Gynecologists (ACOG)
ACOG recommends that women in their 20s and 30s be told about the benefits and limitations of breast self-exams. Women should report any breast changes to their doctors right away. But ACOG states there is insufficient evidence for or against recommending regular BSE.
National Comprehensive Cancer Network (NCCN)
The NCCN recommends breast awareness instead of routine BSE. Women should know how their breasts normally look and feel and report any changes to their doctors promptly.
Why Recommendations Changed
There are a few reasons why most major health organizations moved away from blanket recommendations for monthly breast self-exams:
– Several large studies found no difference in breast cancer death rates between women who did regular BSE and those who did not.
– Extensive monthly breast self-exams can lead to false positives and unnecessary biopsies and other testing.
– There is concern that recommending routine exams may give women a false sense of security if exams are done improperly or replace getting screened by mammograms.
Simply put, extensive monthly self-exams have not been shown to save lives. That’s why the recommendations shifted towards breast awareness and prompt reporting of changes instead of regimented self-exams.
Pros and Cons of Monthly Self-Exams
Despite the change in official recommendations, there are some potential benefits and downsides to doing monthly breast self-exams:
Potential Benefits
– May find breast cancer early when it is easier to treat
– Creates awareness of how your breasts normally look and feel
– Free and easy screening option for women between mammograms
– Empowering for women to take breast health into their own hands
Potential Cons
– False positives leading to extra testing and anxiety
– False sense of security if exams are done incorrectly
– Time consuming monthly ritual
– May not impact breast cancer mortality rates
Who Should Do Self-Exams and How Often
Most women can be breast aware without formally doing self-exams. But some women may still choose to do self-exams, especially if they have risk factors. Here are some general recommendations on who may want to do self-exams and how often:
Women at high risk
Women at higher risk for breast cancer due to family history, genetic mutations, or other factors should familiarize themselves with their breasts and report any changes promptly. Some doctors recommend monthly self-exams for these higher risk women.
Women getting mammograms
Women who get regular screening mammograms may do occasional self-exams in between mammograms. Mammograms are the best way to detect breast cancer early for most women over 40.
Women in 20s/30s
Younger women in their 20s and 30s may benefit most from self-exams since they are too young for routine mammograms. Monthly or occasional exams can help them learn their breast tissue at a low risk time.
During menstrual cycles
Breasts change throughout the menstrual cycle, so women who choose to do self-exams may find it easiest to examine their breasts 1 week after their period starts when breasts are least likely to be tender or lumpy.
Proper Technique for Self-Exams
If you do choose to perform periodic breast self-exams, be sure to use proper technique:
1. Exams are best done in the shower when wet skin and soapy hands can glide over breasts.
2. Move around the entire breast and up into the armpit area feeling for lumps.
3. Use a variety of pressures, from light to deep, and different motions like circles.
4. Pay attention to changes in skin texture, appearance, or sensations.
5. Feel for discharge from nipples which could indicate a problem.
6. Examine both breasts in the same patterns so you compare any differences.
7. Stand in front of a mirror and inspect breasts for visual changes like swelling, skin dimpling, or nipple inversion.
8. Repeat exam lying down to feel effects of gravity on breast tissue.
Don’t panic if you feel a lump at first. Many lumps turn out to be harmless cysts. But do contact your doctor promptly to examine any abnormalities. Catching cancer early greatly improves treatment options.
Signs to Watch for During Self-Exams
When examining your breasts, keep an eye out for any of these changes and report them to your doctor right away:
– A new lump that feels distinctly different than surrounding tissue
– Thickening or hardening of the breast
– Changes in breast size or shape
– Dimpling, puckering, or indention of breast skin
– Redness, scaliness, or swelling of breast skin
– Nipple discharge or sudden nipple inversion
– Pain, tenderness, or soreness in one breast
– A change in the feel or appearance of breast skin texture
While most breast lumps are non-cancerous, only a doctor can tell for sure. Promptly report any abnormalities for proper evaluation.
The Takeaway on Self-Exam Frequency
While extensive monthly breast self-exams are no longer routinely recommended, many women still choose to do periodic self-exams. The key is staying attuned to how your breasts look and feel normally. If you notice any changes, discuss them with your doctor right away. Self-exams can help raise awareness, but they do not replace mammograms and clinical exams for breast cancer detection. Work with your doctor on the best breast cancer screening plan for your individual risk factors and needs.