Mammograms (screening)

Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant (cancer) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. Breast cancer occurs almost entirely in women, but men can get breast cancer, too.

Who is at risk

• Being female although some men do develop breast cancer
• Increasing age
• A personal history of breast conditions
• A personal history of breast cancer
• A family history of breast cancer
• Inherited genes that increase cancer risk
• Radiation exposure
• Beginning your period before age 12
• Beginning menopause at an older age
• Having your first child after age 30
• Having never been pregnant
• Postmenopausal hormone therapy that combine estrogens and progesterone to treat the signs and symptoms of menopause
• Drinking alcohol

Breast Cancer Risk Assessment Tool

Symptoms

The most common signs include a change in the look or feel of the breast, a change in the look or feel of the nipple and nipple discharge.

• A breast lump or thickening that feels different from the surrounding tissue
• Change in the size, shape or appearance of a breast
• Changes to the skin over the breast, such as dimpling
• A newly inverted nipple
• Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
• Redness or pitting of the skin over your breast, like the skin of an orange

What you can do

• Do breast self-exams.
• Use the lowest dose of hormone therapy possible for the shortest amount of time.
• Talk to your doctor about if you should take preventive medications.

What Can I Do to Reduce My Risk? 

Preventive service at no cost

Why screening is important

Breast cancer is the second-leading cause of cancer death among women in the United States. Early detection and treatment are vital to survival chances. But, many women with breast cancer have no symptoms. A mammogram can find breast changes that could be cancer years before physical symptoms develop.

What the screening is

A mammogram is an x-ray picture of the breast. Mammography may find tumors that are too small to feel. It may also find ductal carcinoma in situ (DCIS).

A 3D mammogram (breast tomosynthesis) is an imaging test that combines multiple breast X-rays to create a three-dimensional picture of the breast.

MRI may be used as a screening test for women who have a high risk of breast cancer. MRI is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). MRI does not use any x-rays and the woman is not exposed to radiation. Factors that put women at high risk include the following:

• Certain gene changes, such as changes in the BRCA1 or BRCA2 genes
• A family history (first degree relative, such as a mother, daughter or sister) with breast cancer
• Certain genetic syndromes, such as Li-Fraumeni or Cowden syndrome

Treatment

If screening finds something abnormal, it’s important to get follow-up without delay. If breast cancer is found, it’s best to be diagnosed and treated at the earliest possible stage.

Follow-up after an abnormal finding on a screening test may include a diagnostic mammogram, a breast MRI and/or a breast ultrasound.

Additional tips

The harms of mammography include the following: 

• False-positive test results can occur.
• False-positive results can lead to extra testing and cause anxiety.
• False-negative test results can delay diagnosis and treatment.
• Finding breast cancer may lead to breast cancer treatment and side effects, but it may not improve a woman's health or help her live longer.
• Mammography exposes the breast to low doses of radiation.
• There may be pain or discomfort during a mammogram.

Additional resources

• Office on Women’s Health