Checking for breast cancer involves two things: knowing your own body well enough to notice changes, and staying current on mammogram screening. The U.S. Preventive Services Task Force recommends all women get a screening mammogram every two years starting at age 40 and continuing through age 74. Between screenings, a breast self-exam helps you learn what’s normal for you so that anything new stands out quickly.
How to Do a Breast Self-Exam
A self-exam has two parts: a visual check and a physical check. Neither one replaces a mammogram, but together they make you familiar with your own tissue so you’re more likely to catch something early.
Visual Check
Stand in front of a mirror with your shirt and bra off. With your arms resting at your sides, look at both breasts for changes in shape, swelling, dimpling in the skin, or shifts in nipple position. Then raise your arms high above your head and look for the same things. Skin that pulls or puckers when you move your arms can be an early clue that something underneath has changed.
Physical Check
Lie down and place a pillow under your right shoulder. Using the pads of your left hand’s three middle fingers, press across the entire right breast in a circular pattern. Use light pressure for the tissue just under the skin, medium pressure for the middle layers, and firm pressure to feel the tissue closest to your chest wall and ribs. Make sure to cover the area extending into your armpit, since breast tissue reaches further than most people realize.
Check under your areola and gently squeeze each nipple to see if there’s any discharge. Repeat the full process on the other side. Many people find it easiest to also do a quick standing check in the shower, when wet skin lets your fingers glide smoothly over the tissue.
There’s no single “right” schedule for self-exams. The real goal is breast awareness: if you know what your tissue normally feels like, you’ll notice a new lump, thickening, or texture change much sooner than if you never check at all.
Warning Signs to Watch For
Not every lump is cancer, and not every breast cancer starts with a lump. The CDC lists these warning signs to take seriously:
- A new lump or thickening in the breast or underarm area
- Swelling in part of the breast, even without a distinct lump
- Skin irritation or dimpling that gives the breast an orange-peel texture
- Redness or flaky skin on the nipple or breast
- Nipple pulling inward or new nipple pain
- Nipple discharge other than breast milk, especially if it’s bloody
- A change in breast size or shape that wasn’t there before
- Persistent pain in any area of the breast
Any single one of these is worth getting checked out. Most turn out to be benign, but catching the ones that aren’t early makes a significant difference in treatment options and outcomes.
Mammogram Screening by Age and Risk
For women at average risk, the current USPSTF recommendation is straightforward: a mammogram every two years from age 40 through 74. This schedule is designed to balance catching cancers early against the downsides of false positives and unnecessary follow-up procedures.
If you’re at higher risk, screening starts earlier and includes more imaging. The American Cancer Society recommends that high-risk women get both a mammogram and a breast MRI every year, starting as early as age 30. The National Comprehensive Cancer Network pushes that starting age even younger, to 25 in some cases, for women who carry a BRCA1 or BRCA2 gene mutation or have a first-degree relative (parent, sibling, child) with one of those mutations.
You may be considered high risk if you have a known genetic mutation, a strong family history of breast or ovarian cancer, or a history of radiation therapy to the chest before age 30. If you’re unsure where you fall, a risk assessment tool your doctor can walk you through will clarify whether you need earlier or more frequent screening.
Why Breast Density Matters
About half of women who get mammograms have dense breast tissue. This matters because dense tissue and tumors both appear white on a mammogram, making it harder for radiologists to spot abnormalities against the background. Mammograms are genuinely less sensitive in women with dense breasts, meaning they’re more likely to miss a cancer that’s there.
If your mammogram report says you have dense breasts, you may get called back for additional views or follow-up imaging more often than someone with mostly fatty breast tissue. Supplemental tests like ultrasound or MRI can help, though the USPSTF has not yet made a formal recommendation for or against routine supplemental imaging for dense breasts specifically. It’s worth discussing your density category with your provider to decide if extra screening makes sense for your overall risk profile.
What Happens When Something Looks Suspicious
Finding a lump or getting an abnormal mammogram does not mean you have cancer. Most suspicious findings turn out to be cysts, fibroadenomas, or other benign changes. But the workup follows a fairly standard path.
The first step is usually additional imaging. If a mammogram flagged something, you’ll likely get a diagnostic mammogram (more detailed views of the specific area) or an ultrasound to determine whether the mass is solid or fluid-filled. A simple fluid-filled cyst is almost always benign and may not need further testing.
If imaging can’t rule out cancer, the next step is a biopsy, where a small sample of tissue is removed and examined under a microscope. The most common type is a core needle biopsy: a radiologist uses a thin, hollow needle, often guided by ultrasound, to remove several tiny tissue samples about the size of a grain of rice. The procedure is done with local anesthesia, takes roughly 30 to 60 minutes, and you go home the same day. For lumps that can be felt easily, a fine-needle aspiration may be used instead, which involves an even thinner needle that draws out cells or fluid.
For abnormalities that only show up on a mammogram and can’t be felt, a stereotactic biopsy uses mammogram images to pinpoint the exact location. You typically lie face down on a padded table with the breast positioned through an opening while the radiologist takes targeted samples. Results from any biopsy usually come back within a few days to a week.
Breast Cancer in Men
Men have breast tissue too, and while male breast cancer is rare, it does happen. The symptoms overlap heavily with what women experience: a lump or swelling in the breast, redness or flaky skin, dimpling, nipple discharge, or nipple pain and retraction. Because most men aren’t thinking about breast cancer, these signs often get dismissed or caught later than they would in women.
There’s no routine screening recommendation for men at average risk, but men with a family history of breast cancer or a known BRCA2 mutation should talk with their doctor about whether periodic mammograms make sense. Any new, persistent change in the chest area is worth getting evaluated promptly.