How to Prevent Breast Cancer

Screening for Breast Cancer

There is no doubt that the best chance for curing breast cancer is through early detection. Early detection relies on a program of screening, which involves breast self-examination (BSE), clinical breast examination and mammography.

Women who have not had any breast problems should probably have their first baseline mammography examination at age 50. Screening intervals should be individualized and at least every other year between ages 50-79.

Mammograms are the standard of care to detect breast cancer before it can be felt during a breast examination. Research has shown that mammograms can increase breast cancer survival. However, not all breast cancers can be detected on mammography. This is especially true for younger women who have denser breast tissue. Thus, it is important to include a breast examination (by BSE and an examination by a doctor or nurse) as part of the screening process.

Recognizing Normal, Hormonal Changes

Breast physical examinations can be very challenging. Breast tissue changes during a woman's entire life. It is particularly sensitive to estrogen and progesterone hormone influences.

In some women, changes in hormone balances during normal, monthly cycling can create symptomatic breast changes that are referred to as "fibrocystic change." This is a general term that consists of a number of different findings, including:

• breast swelling
• tenderness
• pain
• nodularity (tissue resembling or containing small nodes)
• thickening
• lumps
• masses

Fibrocystic changes can occur in one or both breasts. The changes are often prominent during a woman's 40s. It is relatively uncommon for postmenopausal women to have symptomatic breast changes due to a lack of hormone stimulation of the breast tissue.

Detecting Breast Changes Through Breast Self-Examination

Many women are anxious about practicing breast self-examination. They wonder what is normal and what is not normal. The best way for a woman to become familiar with her breast tissue is to practice BSE regularly.

Breast self-examination should be performed at the same time each month. For premenopausal women, the best time is usually 3-5 days after the end of a menstrual period. Over time, women who practice BSE become familiar with how their breast tissue changes from month to month. This can help them to be more alert to any changes that are not normal.

Conditions that should be checked by a physician include:

• An area that is distinctly different from any other area on either breast.
• A new fullness or thickening that persists through one's menstrual cycle.
• A mass or a lump, which may feel as small as a pea.
• A marble-like area under the skin.
• Any changes in the skin, nipple or contour of the breast.
• Bloody or clear discharge (fluid) from the nipple.

Fortunately, the majority of breast lumps are non-cancerous.