Are Breast Self-Exams Necessary? The Answer May Surprise You

October 7, 2021
Cara Murez

A shift in thinking means it's OK to skip your monthly breast self-exam -- but don't miss your regular professional checkup and diagnostic imaging, health experts say.

A periodic visual check in a mirror can be helpful, breast health experts from the Cedars-Sinai health system in California suggest.

"Beginning at age 40, women with an average risk for breast cancer should rely on annual mammograms, plus clinical breast exams by a primary health care provider, gynecologist or breast specialist," said Dr. Mary El-Masry, a breast medical oncologist at Cedars-Sinai Tower Hematology Oncology in Beverly Hills, Calif. "Still, it's good for women, beginning at age 18, to become familiar with how their breasts look and get attuned to any changes."

While breast self-exams have become part of a routine women's health regimen, they're not always necessary, according to Cedars-Sinai experts.

Women who are at higher risk should give their breasts a visual check monthly, and have breast imaging once a year starting at age 30 or sometimes younger, said nurse practitioner Sylvia Estrada at the Brandman Breast Center in West Hollywood, Calif.

Estrada said early detection makes breast cancer easier to treat successfully.

"Look in the mirror periodically and recognize what is normal and what is not," she said. "Promptly report changes to your health care provider."

Changes to look for include one breast appearing larger than the other, nipple discharge, a rash, swelling, dimpling or puckering of the skin, or bulging skin.

Women at higher risk of cancer may choose to have clinical breast exams halfway between their yearly mammogram, ultrasound or MRI screenings, El-Masry said.

Factors that put a woman at higher risk include a family history of breast cancer, a previous biopsy with benign results, or genetic mutations such as BRCA1 and BRCA2.

Other factors that boost breast cancer risk include use of hormone replacement therapy, being overweight or obese, a lack of exercise and having more than one serving of alcohol a day, research shows.

"Be aware of your lifestyle choices, and if they're unhealthy, it's important to be screened for breast cancer at least yearly," Estrada said in a Cedars-Sinai news release.

She suggested that people also could check in with a nutritionist, join exercise classes and consult with a genetic counselor, who can help determine breast cancer risk.

The American Cancer Society (ACS) estimates that 281,500 new cases of invasive breast cancer will be diagnosed this year in the United States. The average woman has a one in eight chance of developing breast cancer during her lifetime.

Traditionally, women have been told to examine their breasts regularly. But in 2009, and again in 2016, the U.S. Preventive Service Task Force said doctors should not be required to teach women how to perform the exams. The ACS reached the same conclusion in 2003 after large studies found no benefits from self-exams as well as the potential for unnecessary biopsies. The ACS also warned that an unremarkable self-exam might lead some women to skip their annual mammogram.

That doesn't mean you can't do a regular self-exam, if it makes you feel more comfortable. Estrada suggests learning the technique from a professional.

"No matter what you choose about self-exams, see your health care provider and get all of your cancer and health screenings around your birthday every year," Estrada said. "It's the best gift you can give yourself."

More information

American Cancer Society has more on breast cancer.

SOURCE: Cedars-Sinai, news release, Oct. 4, 2021

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