In terms of breast cancer diagnosis (or any cancer, really), there is a common refrain: The earlier, the better. In the context of cancer, this trite saying can be applied to when the cancer is diagnosed, or “caught.” If you catch a tumor at an earlier stage, your chances of recovery and a return to a high quality of life are far greater.
Because early diagnosis is so important, it’s vital to understand all available diagnostic options. Today we’re discussing two types of breast exam: self and clinical.
Here’s another refrain you’ve likely heard before: “Ignorance is bliss.” But in terms of cancer detection, Ignorance is NOT bliss. In fact, it’s downright dangerous. That’s why breast self-exam is the way to go.
Adult women of all ages — even those in their late teens and early 20s — are encouraged to perform breast self-exams at least once a month.
“Forty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.”
~ Johns Hopkins
Breast self-exams help you to identify your personal “normal”: Many cancers present in early stages as simple, subtle changes to your breast tissue or appearance. So if you’re familiar with how your breasts typically look and feel, you can alert your healthcare professional if there are any changes.
For tips on how to perform a breast self-exam, review this advice from breastcancer.org or this process from the National Breast Cancer Foundation.
There are also apps like B4BC, which can help guide you through the self-exam process.
If, during a breast self-exam, you notice changes, alert your healthcare professional right away. The next step in your care will be a clinical breast exam.
Why Clinical Exams?
Clinical breast exams are needed when you notice a change in the appearance or feel of your breast, as well as during regular health check-ups. The timing recommendations fluctuate from organization to organization, so you are advised to talk with your OB-GYN or primary care provider during your annual visit about the best time frame for you, given your personal history.
According to the Susan G. Komen Foundation, this is what to expect during a clinical breast exam, also called a CBE:
A clinical breast exam is a physical exam done by a health care provider. It's often done during your regular medical check-up.
A CBE should be performed by a health care provider well trained in the technique (this may be a physician, nurse practitioner or other medical staff). Not all providers have this training.
The National Comprehensive Cancer Network (NCCN) recommends a trained provider carefully feel your breasts, underarm and the area just below your clavicle (breast bone) for any changes or abnormalities (such as a lump).
The provider will visually check your breasts while you are sitting up and physically examine your breasts while you are lying down.
If a CBE is not offered at your check-up and you would like one, ask your provider if he or she can perform one (or refer you to someone who can).
In most cases, your CBE will be normal, and you’ll leave with the good news of a clean exam. However, if your CBE finds something abnormal, the exact follow-up tests that will be done depend on the type of finding and your age.
But don’t stress: These exams are designed to give you peace of mind — whether that’s a clean bill of health or speedy detection of something needing treatment.
Follow-up most often begins with the least invasive tests, such as a mammogram (may be called a diagnostic mammogram) or a breast ultrasound.
If needed, your doctor may order more invasive tests, such as a biopsy.
When Should I Get a Mammogram?
You’ll likely have a mammogram if a clinical breast exam reveals anything suspicious. But all women should have mammograms at regular intervals, depending on their age and family history.
The following chart from the Susan G. Komen Foundation shows the breast cancer screening recommendations for women at average risk from three major health organizations. Talk with your OB-GYN or general practitioner (family doctor) about your family history of breast cancer and which recommendations they follow.
The bottom line for all of the above can best be reflected in yet another common expression: Knowledge is power. So do your due diligence, research your specific situation and proactively take control of your breast health.
For more information about breast cancer, visit Sierra Nevada Cancer Center’s breast health page.