Early Detection of Breast Cancer

Early detection of breast cancer plays a big role in saving the lives and breasts of women of color. Key procedures for early detection are Breast Self-Examination BSE), Clinical Breast Examination (CBE), and Mammography. A description of each follows, as well as the greater benefit of CBE plus Mammography.

Breast Self-Examination or BSE – Just 10 Minutes a Month

Every woman, from teenagers to older adults, should examine her breasts every month. This simple procedure only takes only 10 minutes and gives important information. The purpose of BSE is for a woman to know how her breasts normally look and fee, and to discover any changes, especially lumps in the breasts, while they are small. By seeing the doctor at once for any changes that are found, she greatly increases the chances that if it’s cancer, it can be cured. Also remember that it doesn’t always turn out to be cancer.

Doing Breast Self-Examination – Women should choose a day each month for BSE that’s easy to remember, like the first day of the month or the third day after their period, when the breasts are no longer full or tender.

  • Visual Examination of the Breast

    1. Sit or stand in front of a mirror with your arms at the sides.
    2. Look for unusual differences in size or shape between the two breasts (usually, no woman has two breasts that are exactly the same).
    3. Look for any changes in the position of the nipples or the size of the two nipples.
    4. Press each nipple gently to see if there’s any fluid or discharge.
    5. Then, raise both arms above the head and repeat the visual inspection.
    6. Finally, spread both arms out at shoulder level and bend your elbows so that your hands meet in front of you. Place the back of one hand in the palm of the other. Push your hands together as hard as you can, and look for slight dimpling of the skin or any other unusual appearance, like areas that stand out or sink in.
  • Manual Examination or Examining the Breasts with the Hands

    The second part of BSE is to carefully examine your breasts with your hands. The only thing you need is your bed and a pillow or towel to raise your shoulder.

    1. Lie down and place the pillow or towel under your left shoulder. Then put your left hand behind your head.
    2. With the three middle fingers of your right hand held together, make small circular motions on your left breast. Start at the chest bone in the middle and press firmly, but gently.
    3. Work around the outside of the breast, forming a complete circle around the breast. Continue making gradually smaller circles on the breast until you get to the nipple and have felt the entire breast.
    4. Now place the pillow or towel under your right shoulder and repeat the same examination on your right breast.

    If you notice anything unusual, find any lump(s) or find any discharge or dimpling, see the doctor right away. It’s also a good idea to check with the doctor or other health provider to be sure you are doing BSE correctly.

Clinical Breast Examination or CBE

Clinical breast examination is a breast examination done by a health care provider (doctor, physician assistant, nurse practitioner or nurse). He or she does both a visual and manual examination of the breasts, and examines the area under both arms. CBE combined with mammography is the most effective way to detect breast cancer early. Therefore, breast self-examination alone should not take the place of Clinical Breast Examination plus mammography. CBE should be done every year beginning at age 40.

Mammography or Breast X-ray

Although breast self-examination is helpful in finding early breast cancer, mammography is an even more effective way. A screening mammogram is an x-ray of the breast used to detect breast changes in women who have no signs or symptoms of breast cancer. Usually, two x-rays are taken of each breast. With the mammogram it’s possible to see tiny deposits of calcium in the breast that may be a clue to the presence of cancer, or a tumor that cannot be felt.

Since many women of color begin having mammograms later, it’s very important that they begin having mammograms every year starting at age 40. In addition, women at high risk (see list below) should talk with the doctor about whether they should start taking mammograms earlier, or have them more often. While mammograms are very effective, some cancers may not be detected by mammography, but can be detected by breast examination (See also our discussion of Clinical Breast Examination below).

According to a recent study report in the September 2004 issue of the American Cancer Society’s journal Cancer, key situations that contributed to women delaying mammography included: women without private health insurance, women without a primary care physician, and non-English speaking women. African-American, Hispanic and obese women began after 40 years of age. Another great concern is that many women above 65 years of age appear to think they have to worry any more about breast cancer, which is not true. They still need to get clinical breast examination and mammography every year. Another problem is that many women may begin their mammography screenings on time, but fail to continue getting them every year.

Mammography usually causes little, if any, discomfort, and is a safe procedure if performed at a certified facility. These facilities have special equipment and staff trained to conduct the test. Ask the doctor to recommend a certified facility for mammography, or check with the local health department, the local chapter of the American Cancer Society, or a widely recognized breast cancer advocacy group such as the Susan G. Komen Breast Foundation.

The cost of screening mammograms is usually $100 to $150. However, most states require health insurance companies to pay all or part of the cost. Medicare pays 80 percent of the cost for Medicare beneficiaries 40 years of age and older, with the individual being responsible for a 20 percent co-payment (Call the Medicare Hotline at 1-800-Medicare for more information about coverage). The U.S. Centers for Disease Control and Prevention (CDC)-Call 1-888-842-6355 for more information) and many state and local health departments provide mammograms, directly or indirectly, at no cost.