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Best Breast Tests

These screenings increase your odds of detecting cancer early.

	Self exam	Clinical exam	Mammogram	Ultrasound	MRI
Who it's for	All women, starting in their 20s, should be doing a self check. It will get you well acquainted with your breasts so you can identify anything out of the ordinary.	All women, starting in their 20s, should have a physician examine their breasts. Trained fingers could locate a lump you might miss.	All women, starting at age 40, should have a mammogram (a breast X-ray). Women with a family history of breast cancer (an immediate relative such as your sister or mom had it) should start 10 years earlier than the relative's age at diagnosis. (If your mom was diagnosed at 42, get one at 32.) If there is anything unusual, your doc will schedule you for a diagnostic mammogram to hone in on the suspicious spot.	Women with a suspicious lump who have had an inconclusive mammogram and/or those with dense breasts	Women at high risk, as well as those with implants, dense breasts, or women who have had an inconclusive mammo or ultrasound
How often you should do it	Once a month. Some experts say self exams aren't strictly necessary, but there is no harm in checking. Not all lumps are palpable, but some are, so we say, feel away!	During your annual checkup. Your gyno should routinely perform it when you see her. Go ahead and remind her if she forgets.	Once a year. Regular screenings will increase your chances of finding a cancerous lump early, when treatment may be most effective.	Only when your doctor tells you you need one	Only when your doctor tells you you need one
How it works	Perform each of these steps with your arms at your sides. Then do them again with each arm raised. You can even feel for irregularities while you're in the shower. FEEL FOR LUMPS Imagine pressing on a bag of grapes: It may seem a bit lumpy in some areas, but a small rock in the bag would stand out. Visit your doctor as soon as possible if you sense something unusual. EXAMINE YOUR NIPPLES Look for an inverted nipple, color changes, a rash or discharge. Cancer rarely causes soreness, so pain in the absence of a lump is probably nothing to worry about. SCAN YOUR SKIN One kind of breast cancer results in dimpled skin that resembles an orange peel, caused by cancer cells that block lymphatic vessels. LIE DOWN SO YOUR BREASTS SPREAD OUT Probe the region next to your armpit, which many women forget to check. If you feel something lumpy in one breast, check the other side. A bulge in the same location is probably nothing, but if it's new, contact your doctor right away.	Just as in your self exam, the doctor checks skin and nipple texture and looks for color changes, discharge, a rash or lumps.	Mammograms are done standing up. A technician places one breast at a time between two plates that compress it for about 30 seconds while X-rays are taken. It's not so bad: Imagine sticking your breast in the middle of a Harry Potter opus and pressing the book closed slowly. Don't wear deodorant on test day; on X-rays, the powder can look like white calcification flecks (calcium deposits in your breast ducts that suggest cancer). Learn about discount exams at 800-IM-AWARE.	Ultrasound uses high-frequency sound waves to show the breast interior, creating an image on a computer screen. The visual helps doctors determine whether a lump is a fluid-filled cyst or a solid mass (possibly cancer). You'll lie down on an exam table and have cold gel applied to your breast; then your M.D. will gently move a probe over your skin.	During an MRI, you lie perfectly still in the tube of a large, noisy machine that uses magnetic fields to create an image of the breast. You'll be in there for about an hour.
Need to know	About 25 percent of breast cancers are first detected by a physical exam (try either of the two methods shown below). But don't skip your mammograms! They may find a smaller lump than a physical check, and the earlier a tumor is detected, the better your chance of survival.	If your doctor says everything seems fine, take a minute to feel your breasts so you know what she considers normal and healthy. Use this opportunity to ask her questions ("Is this bump normal?") and show her how you perform your self exam to make sure you're doing a thorough job. If she spots something suspicious, she'll schedule you for a mammogram or ultrasound.	Although the mammogram is the best general screening test, it's only about 80 percent effective at finding cancers. More hospitals are investing in computer-assisted detection, software that does a second read of the mammogram film. CAD may pick up another 5 to 6 percent of missed breast cancers and is particularly effective at spotting calcifications. Another key issue: The screen doesn't work as well in younger women because their breasts tend to have less fatty tissue, making them denser. Because dense tissue and cancer both show up as white on an X-ray, picking out cancer is that much harder. (They may be asked to have an ultrasound instead.) Women with the breast cancer gene may also opt for an ultrasound or MRI, because their lumps develop at a younger age, when their breasts are denser.	Ultrasound can't pick up calcium deposits in your ducts, which are often the first indicator of breast cancer.	MRIs are 96 percent effective at finding cancer, the highest rate of any method. So why not use them first for detection? Because they pick up many false positives as well, leading to unnecessary biopsies and emotional trauma. Unless you're at high risk, you're better off getting a mammogram.