A thorough breast examination should be part of every routine physical and be included with a yearly gynecologic checkup. There are three well-proven methods for detecting early breast cancer.
Mammography for Apparently Healthy Women There is now widespread agreement that mammography (low-dose x-ray imaging of the breasts) can discover cancers at least a year before—and sometimes as much as four years before—they can be felt. The scientific evidence is most convincing for screening women over age 50, but there is evidence that it may be beneficial for younger women.
• The American Cancer Society recommends that women have mammography every year or two between age 40
and 49 and yearly thereafter. Yearly mammograms are recommended beginning at age 30 when the risk of
breast cancer is very high (because of prior breast cancer, history of premenopausal breast cancer in a mother
or sister or a breast biopsy showing atypical hyperplasia).
• The smallest lump usually felt is about 1/3 in. (1 cm) and contains 1 billion cancer cells . Routine
mammography can detect smaller cancers, some even less than 1/5 in. (0.5 cm). It is estimated that five-year
survival is 20 to 25 percent better for cancers detected by mammography than for those diagnosed after a lump
has appeared. Women screened regularly with modern mammography (after 1985) have only a 10 to 30
percent rate of axillary node metastasis , compared to 50 percent for women who do not undergo screening.
• Some concern has been expressed about the risk of frequent x-ray imaging, but the potential benefits far
outweigh the risks. The x-ray dose of a mammogram today is about one-tenth that of 25 years ago and is about
