Breast cancer screening: When should I start and how?
Palm Desert Council members participate in Friday Cruise Night for breast cancer awareness on El Paseo in Palm Desert, Calif., on October 9, 2020. (REUTERS Photo)

The likelihood of getting breast cancer does increase with age but by catching tumors early you'll not only have more options for treatment but also have a high chance of survival. Here's a guide on where to start



Breast cancer stands as the most prevalent type of cancer in the world. Not only do screenings detect over 2 million new cases each year, but 600,000 women are estimated to die because of breast cancer and its complications.

The point many health care systems across the world miss is that early detection can drastically reduce mortality rates and make possible breast-conserving surgery (BCS) instead of complete mastectomies. Furthermore, if the cancer is diagnosed before it has spread to other parts of the body and remains constrained to the breast only, life expectancy for five years skyrockets to over 90%.

Considering these statistics, starting screening practices at an early age has never been more crucial. All the different guidelines and approaches may feel overwhelming, but experts converge on one point: it's always best to err on the side of early.

Here's what you should be doing each decade and in between, with advice from radiology specialist professor Füsun Taşkın.

In your 20s

Although self-examination is technically not breast cancer screening, most cases are diagnosed thanks to women noticing newly developing masses or visual irregularities while self-examining. Therefore, Taşkın recommends women to check their breasts for anything that looks out of the ordinary once a month, the week after their period ends. These regular self-checks should start in your teens or at the latest at age 20, and continue over a lifetime.

Taşkın warns that, however, self-checks cannot replace mammographies and do not reduce breast cancer-related deaths.

"Even if you do not detect a palpable mass in your monthly breast examination, regular mammographies after the age of 40 should never be neglected," she says as a mass might mean things are already too late in some cases.

HOW TO DO A BREAST SELF-EXAM

1. Start by visually examining your breasts. Sit in front of a mirror, without a bra or shirt, and inspect your breasts with your eyes. Keep your arms relaxed, at your sides.

Facing forward, look for any dimpling, puckering or changes in size, shape or symmetry. Turn your gaze to your nipples and check to see if you can notice anything new or if they are inverted.

Repeat these steps with your hands pressed on your hips, arms at sides but torso slightly tilted forward, and your arms raised overhead and palms pressed together. Lastly, don't forget to check underneath for changes in symmetry.

2. Now, move on to the tactile portion of the examination. Use your hands to examine your breasts.

Lie down on your back on a flat surface to help make your breast tissue spread out in an even layer, making it easier to feel any lumps and bumps. Using the pads of your fingers, not the very tips, start feeling all breast tissue. Most doctors recommend using your three middle fingers to do this.

Exert different levels of pressure to feel different depths of tissue. With your firmest touch, you should be able to feel the tissue closest to your chest wall and ribs. If you are not sure of how hard you should press, consult your nurse or doctor.

Follow a pattern: some recommend going in circles from the outside in; some prefer to follow a sectional approach and divide the breast into sections like a pie chart. Start with a light touch and then press to feel deeper layers.

3. Don't forget to examine your armpits and collarbones. Start from your collarbone and make your way toward your nipple. Don't rush and take your time. Make sure you spend a few minutes examining.

If you find: