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Breast Cancer

Although breast cancer may occur in males and females, most breast cancer screening has been directed toward females. Breast cancer is the second leading cause of cancer-related deaths in women (behind lung cancer), and the most common cancer in women. A number of screening tests have been developed to try to diagnose this disease at an early, and thus more treatable, stage. The 3 main tests are breast self-examination, breast examination by a health care professional, and mammography.

• Breast self-examination: This is a simple, cheap, and easy-to-perform test. The American Cancer Society recommends that women should examine their breasts once a month starting at age 20 years. The breast self-examination should be performed in the week after the menstrual cycle, at which time the breasts are least likely to be sore or swollen. Any new lump, discharge, sore, or other change should be brought to the immediate attention of your doctor.
  
  
• Breast examination by a health care professional: It is widely agreed that all women over age 40 years should have annual breast examinations by a health care professional. For women at increased risk, for example, those with a strong family history, this should probably start earlier, at age 35 years. Between the ages of 20 and 40 years, women should have breast examinations performed at least every 3 years.
  
  
• Mammography: This technique uses x-rays to take highly detailed pictures of the breasts. Very small lesions can be detected using this technique. Most experts recommend that women over 50 years have this procedure at least every year. The screening of younger women is much more controversial. Most experts agree that mammography should be performed every other year for women between the ages of 40 and 50. If there is a family history, then this should start earlier, at age 35 years. Because of the range of opinions among experts, it is probably best for women between 35 and 50 years to discuss their options with their doctors, and then come to a decision together, taking into account factors such as family history and your own medical history.