Checking for breast cancer starts with knowing what to look and feel for on your own body, then following through with routine screening mammograms. Most breast cancers are found through one of these two paths: you notice something unusual, or a mammogram catches something you can’t feel yet. Both matter, and understanding each gives you the best chance of catching a problem early.
Signs You Can See and Feel
The most recognized warning sign is a new lump in your breast or underarm area. But breast cancer doesn’t always announce itself as a lump. Other changes to watch for include dimpling or puckering of the skin, redness or flaky patches on the breast or nipple, a nipple that has recently turned inward, or a change in the size or shape of one breast.
Nipple discharge also deserves attention. Discharge that comes from one breast only should be evaluated regardless of its color. While bloody or clear discharge is more commonly linked to a higher risk of cancer, whitish discharge has also been found in early-stage cases. The key detail is whether the discharge is happening on one side or both. Discharge from both breasts is more often hormonal and benign.
Pain alone is rarely the first sign of breast cancer, but it can be part of the picture. Tenderness, a feeling of heaviness, or burning in one breast are all worth mentioning to your doctor, especially if they don’t go away after your menstrual cycle.
Inflammatory Breast Cancer Looks Different
One form of breast cancer skips the lump entirely. Inflammatory breast cancer blocks the tiny lymph vessels in the skin, causing the breast to swell, turn pink or reddish-purple, and feel warm. The skin often develops a texture that looks like an orange peel, with visible ridges or pitting. These symptoms come on fast, sometimes over days or weeks, and can be mistaken for an infection. If your breast changes rapidly in size, color, or texture, that’s a reason to get evaluated promptly rather than wait for antibiotics to work.
How to Do a Self-Exam
A breast self-exam has two parts: looking and feeling. Neither requires special equipment or training beyond knowing the basic steps.
For the visual check, stand in front of a mirror with your shirt and bra off. Look at your breasts in three positions: arms at your sides, arms raised above your head, and hands on your hips with your chest muscles flexed. In each position, look for changes in shape, new swelling, skin dimpling, or a shift in nipple position.
For the physical check, use the pads of your three middle fingers rather than your fingertips. Many people find it easiest to do this in the shower, when wet skin allows your fingers to glide smoothly. Use your right hand to examine your left breast and vice versa. Move in a circular pattern, covering the entire breast from the collarbone down to the bra line, and from the armpit to the center of your chest. Press at three different depths: light pressure for the tissue just under the skin, medium for the middle layer, and firm pressure to feel the tissue near the ribcage. Check under the areola and gently squeeze each nipple to see if there’s any discharge.
Lying down spreads the breast tissue more evenly across your chest, which makes changes easier to detect, especially if you have larger breasts. Place a pillow under the shoulder on the side you’re examining, and follow the same circular pattern.
The goal isn’t to diagnose anything yourself. It’s to learn what your normal feels like so that when something changes, you notice.
Screening Mammograms for Average-Risk Women
The U.S. Preventive Services Task Force recommends mammograms every two years starting at age 40 for people at average risk. This applies to anyone assigned female at birth, regardless of gender identity. Mammograms can catch cancers too small to feel, sometimes years before a lump would develop.
If you have dense breast tissue, screening becomes more complicated. Dense tissue appears white on a mammogram, and so does cancer, which means tumors can hide behind the density. Your mammogram report will tell you if you have dense breasts. A 3D mammogram (tomosynthesis) helps radiologists see past dense areas more effectively than a standard 2D image. In some cases, your doctor may also recommend a supplemental ultrasound or MRI, though these extra tests do carry a higher chance of flagging something that turns out to be benign.
When You’re at Higher Risk
Some people need to start screening earlier or use additional tools beyond standard mammograms. You may be considered higher risk if you have a family member who carried a harmful change in the BRCA1 or BRCA2 genes, a personal or family history of breast cancer diagnosed at age 50 or younger, a family history of ovarian cancer or male breast cancer, or Ashkenazi Jewish heritage.
For people who carry an inherited BRCA gene change, professional guidelines generally recommend starting screening younger than 40 and adding breast MRI to the routine. If any of these risk factors apply to you, a formal risk assessment with your healthcare team can help determine whether your screening schedule should be adjusted.
What Happens After Something Is Found
If you report a symptom or a mammogram picks up something suspicious, the next step is usually a diagnostic mammogram, which takes additional images of the area in question. An ultrasound may be done at the same appointment to get a closer look, particularly to determine whether a mass is solid or fluid-filled (a cyst).
If imaging confirms something that needs further evaluation, a biopsy is the only way to know whether cancer is present. The most common type is a core-needle biopsy, which removes small cylinders of tissue using a hollow needle. This approach gives pathologists enough material to determine not just whether cancer cells are present, but also the type of cancer, how fast it’s growing, and whether it responds to hormones. That information directly shapes treatment decisions. The specific type of biopsy your doctor recommends (ultrasound-guided, mammogram-guided, or MRI-guided) depends on which imaging method shows the area most clearly.
A less common option, fine-needle aspiration, draws out a smaller sample of cells. It’s now mostly reserved for evaluating cysts or checking whether cancer has spread to a lymph node. It can’t distinguish between certain early-stage cancer types, which is why core-needle biopsy has become the standard.
Breast Cancer in Men
Men can develop breast cancer too, though it accounts for less than 1% of all breast cancer diagnoses. The most common first sign is a firm, painless lump behind the nipple. Other symptoms mirror what women experience: skin dimpling on the chest, redness or scaliness near the nipple, nipple discharge (clear or bloody), or a newly inverted nipple. Men with BRCA gene changes are at elevated risk and may benefit from annual mammograms, a recommendation that many people aren’t aware of. Because men have less breast tissue, lumps tend to be easier to feel, but they’re also easier to dismiss or attribute to something else.