Experts say monthly breast self-exams are no longer necessary—doing this less frequently is okay, as long as you know your breasts well.
Research has shown that recommending monthly self-exams hasn’t actually saved lives. A number of organizations, such as the American Cancer Society, have stopped recommending monthly breast self-exams, while others say doing a self-exam periodically can help women notice changes they may want to discuss with their doctor.
Experts agree the most important steps are getting an annual clinical breast exam and a mammogram every year after age 40.
In this Q&A, breast surgical oncologist Tara Balija, MD, FACS, explains some of the steps women should take to monitor their breast health.
“It’s important to know your breasts, because the earlier we find cancer, the easier it is to treat,” she says. “You can do a breast self-exam every so often to be aware of changes, but you don’t need to do it every month.”
Keeping track of your breast health is becoming even more important, she adds, as doctors are seeing more young women develop breast cancer, as young as age 20.
Should I do a breast self-exam every month?
You can, but you don’t have to, says Dr. Balija. Research shows that a monthly breast self-exam doesn’t make much of a difference in terms of mortality. If anything, the studies found that women who regularly do self-exams end up having more biopsies that came back healthy. Biopsies are tests that analyze a small piece of breast tissue.
In response, many organizations stopped recommending that women examine their breasts every month. Instead, we recommend you check your breasts occasionally, to stay aware of any changes.
If I want to do a self-exam, what’s the best way, and when should I do it?
I tell patients the best time of the month to examine themselves is the first day after their period ends, when their breasts are the “quietest” and less enlarged from menstrual cycle hormonal fluctuations. The National Breast Cancer Foundation provides a step-by-step guide.
Tara Balija, MD, FACS
What should a woman do to maintain her breast health?
Once you reach age 40, you should get a mammogram every year and have a clinical exam by a doctor. This means your primary care doctor, gynecologist, or breast specialist if you have one. (Most women will have a breast specialist only if they’ve had cancer or are at high risk.) Having a child before age 30 offers some protection for developing breast cancer.
How do you know if you’re at high risk of breast cancer?
The best way to find out your risk is to get a lifetime breast cancer risk assessment between ages 25 and 30, according to Dr. Balija. There are several of these tools that you can find online. The Tyrer-Cuzick Model is the most up-to-date approach. This model looks at your personal and family medical history. Sometimes a woman is at high risk because of her family history or a genetic mutation. For others, it can be a combination of risk factors. Some doctors go through the assessment with each of their patients.
If the model shows you are at high risk, we can start screening early. We can, for instance, recommend an annual MRI in addition to a mammogram. This allows us to detect breast cancer at an earlier stage, when treatment is often more effective, says Dr. Balija.
When should women begin watching out for breast cancer?
I recommend women begin thinking about breast cancer well before they turn 40 and discuss this with their doctor. I definitely have more young patients with breast cancer than in the past. In our office, we see a few patients in their early 20s each year, Dr. Balija says.
Why are more young people being diagnosed with breast cancer?
The rates of breast cancer in young people have been increasing every decade. And these are women who didn’t have any family history or genetic mutation. That suggests that maybe we are all just more exposed to things that cause cancer, like processed foods and microplastics, according to Dr. Balija. But we don’t really know what is causing this increase.