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Breast Health: 3-Step Plan for Preventive Care

Picture of a female physician teaching a patient how to perform a self-breast examination

What is the 3-step plan?

Finding breast cancer early is the main goal of routine breast care. That's why it's so important to follow this 3-step plan for preventive care. Finding problems early gives you the best chance of successful treatment. Routine care can also help find other noncancerous or benign conditions, too.

Step 1. Breast self-exam (BSE)

The American Cancer Society (ACS) says all women should get to know how their breasts normally look and feel. This can help you notice any changes more easily. Changes to your breasts may include:

  • A lump

  • A leaky fluid, or discharge, other than breastmilk

  • Swelling

  • Skin irritation or dimpling

  • Nipple problems (for example, pain, redness, flaking, or turning inward)

If you notice any of these changes, see your healthcare provider right away.

The U.S. Preventive Services Task Force (USPSTF) and the ACS do not recommend breast self-exams (BSEs). That is because evidence suggests BSEs do not lower the risk of dying from breast cancer. Talk with your healthcare provider about the benefits and limitations. This can help you decide if you should start doing BSEs.

Step 2. Clinical breast exam (CBE)

Your physical exam should include a clinical breast exam (CBE) by a healthcare provider or nurse trained to check breast problems. The American College of Obstetricians and Gynecologists recommends:

  • Between ages 29 and 39, women should have a CBE  by a health professional every 1 to 3 years.

  • After age 40, women should have a breast exam by a health professional every year.

The USPSTF and the ACS, however, believe there isn't enough evidence to assess the value of CBEs for women ages 40 and older. Talk with your healthcare provider about your personal risk factors. That will help you decide if you should have a CBE.

A CBE by a healthcare provider or nurse is done very much like a breast self-exam. If you do regular BSEs, be sure to ask questions and talk about any concerns with your provider during your CBE.

Step 3. Mammogram

A mammogram is a low-dose X-ray of your breasts. It's the most common imaging test. A mammogram can find cancer or other problems early, before a lump can be felt. It can also help diagnose other breast problems. But a biopsy is needed to know for sure if you have cancer.

Health experts have different recommendations for mammograms:

  • The USPSTF recommends screening every 2 years for women ages 50 to 74.

  • The ACS recommends yearly screening for all women ages 45 to 54. Women ages 55 and older should change to mammograms every 2 years. Or they may choose to still have a yearly screening.

Talk with your healthcare provider about your own personal risk factors. This will help you decide when to start getting mammograms and how often to have them.

A diagnostic mammogram may be needed when an abnormal area is found during a screening mammogram.

Both the National Cancer Institute and the ACS suggest that women who may be at greater risk for breast cancer should talk with their healthcare providers about whether to begin having mammograms at an earlier age. Depending on the level of risk, a breast MRI may also be done along with mammograms.