Screening and Detection 

Guidelines: Mammography | Clinical Breast ExamsMale Breast Cancer

Screening Guidelines for All Ages of Women: Regular screening for breast and cervical cancer is important for good health. Guidelines for regular screening and early detection of breast and cervical cancer are as follows:

2003 American Cancer Society Guidelines for Good Breast Health
Type of Exam Age Frequency

Mammogram

40 & over Annually
Clinical Breast Exam 40 & over Should be part of a woman's periodic physical examination annually.
20s and 30s Should be part of a woman's periodic physical examination about every three years.
Breast Self-Exam (BSE) 20 & over Women should be told about benefits and limitations of BSE. It is acceptable for women not to do BSE or to do it occasionally. Women should report any breast changes promptly to their healthcare provider.

Women at high risk: Women with a higher risk of breast cancer should talk with their doctors about the best approach for them. This might mean starting mammograms when you are younger, having extra tests or having more frequent exams.

Age-Appropriate Screening Guidelines for Good Cervical Health*

  • Cervical cancer screening should begin at age 21. Women less than age 21 should not be tested.
  • Women between ages 21 and 29 should have a Pap test every 3 years. There is also a test called the HPV test. HPV testing should not be used in this age group unless it is needed after an abnormal Pap test result.
  • Women between the ages of 30 and 65 should have a Pap test and an HPV test (called “co-testing”) every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.
  • Women over age 65 who have had regular cervical cancer testing with normal results should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past age 65.
  • A woman who has had her uterus removed (and also her cervix) for reasons not related to cervical cancer and who has no history of cervical cancer or serious pre-cancer should not be tested.
  •  A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.

*2012 Consensus Guidelines-American Cancer Society (ACS), American Society for Colposcopy and Cervical Pathology (ASCCP), American Society for Clinical Pathology (ASCP)

Mammography

Q: What is a mammogram?

MammogramAnswer: A mammogram is an x-ray picture of your breast. Because a mammogram can find lumps and abnormalities that are too small for you or your doctor to feel, it is the best known method for early breast cancer detection. The purpose of a screening mammogram is to detect any abnormalities in a woman who has no symptoms of breast cancer.

Q: How is a mammogram done?

Answer: When having a mammogram, you will be required to remove your top (including your bra) and the person who takes the x-rays will ask you to stand in front of a large mammography machine. You will be asked to place your breast between two plastic plates. The plates will press and somewhat flatten your breast. This may be uncomfortable but it will last only for a few seconds. In most cases, you will have x-rays taken of both breasts, one breast at time.

Once the x-ray pictures are made, a physician trained in reading x-rays (called a radiologist) will examine them to determine if your breasts have any unusual lumps or abnormalities.
How do I know if I need a mammogram? How often should I get a mammogram?

If you are age 40 or over, it is very important to get a mammogram. Because cancer can show up at any time, one mammogram is not enough. It is important to schedule and return for a mammogram every year.

Q: How can I locate a mammography facility?

Answer: To find out where you can schedule mammography, do one of the following:

  • Ask your doctor or nurse.
  • Ask someone at your local health department.
  • Check the information on this Web site regarding eligibility for free screening and mammography through BreastCare.

Q: How do I know if I need a mammogram?

Answer: If you are age 40 or over, it is very important to get a mammogram. Because cancer can show up at any time, one mammogram is not enough.

Q: How often should I get a mammogram?

Answer: It is important to schedule and return for a mammogram every year.

Q: How can I prepare for a mammogram?

Answer: Preparation involves the following:

  • Don’t wear any deodorant, perfume, powders, or ointments of any sort in the underarm area or on the breasts the day of your mammography exam. These products can cause shadows to appear on the mammogram.
  • Because you will have to undress above the waist for the exam, wear a blouse with a skirt or slacks, rather than a dress.
  • If possible, schedule a mammogram 1 week after your menstrual period. This is the time when your breasts are less tender.

Always follow the instructions of the office where you have scheduled your mammogram.

Clinical Breast Exams

Clinical breast examinations (CBE) should be part of a periodic health exam, about every three years for women in their 20s and 30s and every year for women 40 or older. CBE can find a problem that is missed by mammograms and is an opportunity for women and their health care providers to discuss changes in their breasts, risk factors and early detection testing.

During a CBE, a health professional will carefully feel your breasts and under your arms to check for lumps or other unusual changes. Special attention will be given to the shape and texture of the breasts, location of any lumps, and whether such lumps are attached to the skin or to deeper tissues. The area under both arms will also be examined.

For women over age 40, a clinical breast exam is no substitute for regular mammograms.

Male Breast Cancer

Breast cancer also affects more than 1,000 men in this country each year. Although most information about breast cancer is written mainly for women, much of the information on symptoms, diagnosis, treatment, and living with the disease applies to men as well.

The discussion of breast cancer screening does not apply to men. Experts do not recommend routine screening for men.

Regular Screening for Early Detection of Breast and Cervical Cancer

Screening for breast and cervical cancer is testing women for early signs even though they have no symptoms. Regular screening can lead to early detection of breast and cervical cancer. Accepted screening procedures for breast cancer are mammography and clinical breast exams. Breast cancer found in its earliest stages can be much easier to cure. In fact, if women practiced early screening methods, about one-third of all breast cancer deaths could be prevented.

The accepted screening procedure for cervical cancer is a regular Pap test starting at age 21. When detected early, invasive cervical cancer is one of the most treatable cancers with a five-year survival rate of 92 percent for localized cancers.