How Do I Know If I Have Breast Cancer?

Breast cancer responds to treatment best when it is detected early. For this reason, you should be sure to have an annual medical checkup, perform monthly breast self-examinations, and get mammograms as recommended by your doctor.

Breast Self-Exam
Starting around age 20, examine your breasts every month so that you are familiar with their structure and can detect any new masses or lumps. Premenstrual changes can cause temporary thickening that disappears after the period, so it is best to check your breasts three to five days after your period ends. If you are no longer menstruating, examine your breasts on the same day of each month. Pick a date that's easy to remember. If a breast self-exam makes you anxious or you have questions about how to perform it, consult your health care provider.

Look for dimpling or changes in shape or symmetry. This may be best done by looking in a mirror. The rest of the breast self-exam is easiest in the shower, using soap to smooth your skin. Using light pressure, you should check for lumps near the surface. Use firm pressure to explore deeper tissues. Squeeze each nipple gently; if there is any discharge -- especially if it is bloody -- see your doctor.

Any time you find a new or unusual lump in your breast, have your doctor check it to make sure it is not cancerous or precancerous. Most lumps are benign and do not signal cancer. The best test for distinguishing a cyst from a solid tumor is ultrasound; a needle biopsy may also be done. Have your breasts examined by a healthcare provider once every three years starting at age 20, and every year after age 40.

A baseline mammogram -- an X-ray of the breast -- is recommended for women at age 35 by the American Cancer Society. Most women should also get a mammogram every year beginning at age 40. You should consult your doctor for the best schedule. Breast lumps can be identified on a mammogram up to two years before they can be felt.

Several tests that can help distinguish a benign lump from a malignant tumor. Because malignant and benign lumps tend to have different physical features, imaging tests such as mammography and ultrasonography can often rule out cancer. The only way to confirm cancer is to perform a needle aspiration or a biopsy and to test the tissue sample for cancer cells.

In the event of malignancy, you and your doctor need to know how advanced the cancer is. Various tests are used to check for the presence and likely sites of spread, or metastasis. Cancer cells can be analyzed for the presence or absence of hormone receptors, to find out if the cancer is likely to respond well to hormone therapy, such as tamoxifen. Other tests can help predict the likelihood of metastasis and the potential for recurrence after treatment.