Until a few years ago, doctors used to recommend all women to perform a thorough breast self-examination once a month. However, recent studies have shown that such meticulous examination doesn't provide any advantage, and the medical community abandoned the strong recommendation for monthly self-examination.
Nevertheless, it is highly recommended for women to be aware of any changes in their breasts and perform a self-examination occasionally, in addition to regular medical check-ups.
Many women have fibrocystic breast tissue (uneven, lumpy), which often causes varying pains throughout the menstrual cycle and the formation of benign lumps or cysts (a space containing fluid). It is essential to emphasize that there is no connection between fibrocystic breast tissue and the risk of developing cancer. It is advisable to perform a self-examination close to the physician's examination to learn about findings that are not considered significant. In the case of an indistinct lump, you can wait for two to three weeks before revisiting the doctor, as some lumps may disappear, saving unnecessary trips for examination. If the finding remains unchanged or if the waiting period is associated with stress, it is recommended to be examined promptly. In the case of a palpable lump or noticeable changes, it is advisable to seek an examination promptly. It is essential to know that even a palpable and clear lump can be benign.
Routine medical check-up:
It is recommended to be under the care of a specialized breast clinic. These clinics are usually staffed by interested and experienced doctors. An appropriate follow-up in such a framework can decrease the likelihood of missing growths, reduce the number of unnecessary imaging tests, and tailor a more accurate personal follow-up plan based on your data. It is essential to understand that a normal mammogram does not completely rule out growths, and there is importance in combining manual examinations and imaging tests that are tailored to you.
During menstruation, many women experience breast swelling and a feeling of fullness. A manual examination during this period might be more problematic due to breast tissue changes. Therefore, it is recommended to schedule an examination at a more comfortable time, approximately 10 days to two weeks after the end of the menstrual cycle. However, there are women who have no difficulty in performing a manual examination even during their menstrual cycle, and in any case, there is no medical reason to avoid examination during this time. In periods of pregnancy and breastfeeding, manual examination is usually more challenging to perform. Still, some women, who have been following up regularly, refrain from undergoing examinations for an extended period. It is incorrect to act this way. It is possible to perform a breast examination even during pregnancy. In case of doubt, the physician will use additional tests, mainly ultrasound.
Routine manual follow-up in women without known risk factors:
The recommendations regarding the frequency of routine manual examinations by a physician are not uniform. Some experts advise starting regular follow-up at the age of 20. However, since the disease's occurrence is very low in women in their early twenties, and the follow-up might involve many tensions, other experts recommend starting regular follow-up once a year from the age of 30. This is also our recommendation. In rare cases where the manual examination is particularly problematic due to the breast's structure, it is recommended to conduct more frequent manual follow-up, even in the absence of risk factors (usually every six months). In such situations, breast ultrasound can help distinguish between dense breast tissue and a lump that requires further clarification.
Manual follow-up in women with an increased risk of breast cancer:
The recommendation for the frequency of manual examinations in a situation of increased risk should be given according to the level of risk. In principle, in such situations, a manual examination is recommended every six months, combined with imaging tests, usually once a year. For carriers of mutations in the BRCA gene, mammography and MRI are performed once a year. We recommend having the examinations every six months, alternatively, but it is not necessary to act this way.