Virginia Commonwealth University

VCU Massey Cancer Center

Breast cancer screening guidelines

Physicians recommend that breast self-examination be practiced along with regularly scheduled clinical breast examination and mammography. Scheduling guidelines depend on various factors, including family health history. Consult with your clinician to create a screening plan.

The VCU Breast Imaging Center provides the latest screening recommendations and guidelines.

When should breast self-examination be done?

By doing breast self-examination regularly, you get to know how your breasts normally feel so that you are more apt to detect any change.

Women should begin practicing breast self-examination by age 20 and continue the practice throughout their lives — even during pregnancy and after menopause.

Breast self-examination should be performed every month. Become familiar with how your breasts usually look and feel so that you may notice any change from what is normal for you.

  • If you still menstruate, the best time to do breast self-examination is several days, or about a week, after your period ends. These are the days when your breasts are least likely to be tender or swollen.
  • If you no longer menstruate, pick a certain day — such as the first day of each month — to remind yourself to do breast self-examination.
  • If you are taking hormones, talk with your physician about when to do breast self-examination.

Based on your self-exam, check with your physician if you find any change in your breast(s) that causes you concern. Changes may include:

  • Development of a lump
  • A bloody or clear discharge from nipple
  • Swelling of the breast
  • Skin irritation or dimpling
  • Nipple abnormalities (such as pain, redness, scaliness, turning inward)

When and how often should I have a mammogram?

In the medical community, there is some disagreement on these questions. Studies and an editorial published in the Annals of Internal Medicine suggest that mammograms are not beneficial to women ages 40-49.

In the opinion of experts at VCU and VCU Massey Cancer Center, these reports contradict volumes of science with regards to mammography’s pro ven record of saving and extending lives.

Gilda Cardeñosa, M.D., director of breast imaging at VCU Medical Center, researcher, medical textbook author and a key member of the Breast Health Center at VCU Massey Cancer Center, has thoroughly reviewed the reports and provides important insight on this topic.

Dr. Cardeñosa’s expert opinion: "The current best standard of care for women ages 40-49 who are at average risk for breast cancer is to get annual screening mammograms.

A new report runs counter to the scientific information that the worldwide breast imaging research community has acquired over the last several decades. The report relies on computer models for its data and includes many assumptions.

The gold standard for medical research is through clinical trials on human subjects in which one group of participants are randomly assigned a treatment or procedure, and another group, the control group, is not.

Data from seven randomized clinical trials have demonstrated that screening mammography in women ages 40-74 reduces breast cancer mortality. For the 50 years prior to the introduction of mammography in 1990, breast cancer mortality rates were flat. Since routine screening guidelines were adopted in the United States in 1990, we have seen mortality from breast cancer decrease by 30 percent.

I join many other physicians, researchers and breast cancer awareness advocates in urging women to not be alarmed by this new report, and to continue to get annual mammograms."