Standard Guidelines

Early Detection of Breast Cancer


'Screening' is a systematic evaluation of a 'normal' individual to see if there is any underlying cancer. A 'normal' individual implies one who does not have any symptoms or signs of cancer. By now, if you have read the earlier two sections on early detection of breast cancer, you very well know how important it is to detect it early. There are various Screening Guidelines, for early detection of breast cancer. One of the most commonly accepted and followed, are the NCCN Guidelines . The following discussion elaborates on the NCCN Guidelines.


Before we list the guidelines, it is essential to understand a few terms used in the guidelines. They are as follows:

'Breast Awareness'

Breast Awareness implies familiarity with one's own breast. A self examination can be done monthly during bath, best time being just after the end of menses. This helps to keep in notice any irregularity, any lumps, the skin, the nipple etc. Also, breast awareness also includes a knowledge of breast cancer. A woman should be aware of what possible changes could occur in a breast when a cancers develops in the breast. If you haven't read it, please do read the 'Early Detection of Breast Cancer' section.

'Clinical Breast Examination' (CBE)

Clinical Breast Examination (CBE) implies a visit to a doctor, where the doctor makes a detailed evaluation of the patient's history and performs a body checkup including breast examination with an aim to detect any suspicious abnormality. A doctor, who is in touch with the subject and who has an experience in breast disorders may be able to pick up an early cancer even before it may manifest, as also may be able to appropriately rule out any cancer in a woman who may be having some breast symptom.


Mammography is a special x ray of the breast performed in two directions, to show up any abnormal lumps located in the breast. Mammography can detect very small lumps which may not be felt by hand. However, mammography has a sensitivity of at most 60 to 70% and we strongly urge readers preferably not to undergo mammography on their own will; but only after consulting a doctor. Consulting a doctor is of utmost importance, since mammography may show a lot of nonspecific findings which can generate a lot of anxiety for no reason; and on the other hand, if something is diagnosed, then a doctor's guidance for further management will be of prime importance.


Woman in 25 to 40 years of age, Normal risk

For a lady who is between 25 to 40 years of age and does not have any hereditary (familial) or other increased risk factors (see below) for breast cancer, the screening (early detection) guidelines are as follows:

Woman more than 40 years of age, Normal risk

For a lady who is more than 40 years of age and does not have any hereditary (familial) or other increased risk factors (see below) for breast cancer, the screening (early detection) guidelines are as follows:

Woman, any age, Increased risk

For a woman who has an increased risk for breast cancer, the screening (early detection) guidelines are as follows:

Which women have an increased risk?

To explain in simple terms, following women have a higher than average risk of developing breast cancer:


The above discussion was to guide on how to feel for a lump and how to lookout for a lump, so that, on regular breast examinations, one can lookout for such lumps, and if felt, consult a doctor. Following points must be kept in mind:

Who decides my risk (i.e. What risk do I stand, to develop breast cancer)
A doctor, of course; preferably someone who is trained in breast conditions, like a Surgical Oncologist, hwo handles breast cancers. Just because there maybe one family member having a history of breast or ovarian cancer, would not make one as a high risk candidate, a few other factors have to be considered. So it's best, you leave to a doctor, as to what your risk for developing a cancer is.

I am above 40. Should I just go and do mammography?
No, please don't do that directly. Mammography has its own pitfalls and it is very essential to read the report correctly, especially, since it is common to find small non cancerous conditions on mammography. If you do on your own and do not know how to read the report, it will be a source of immense anxiety. So it is best to consult your doc first, and let him or her prescribe the mammography for you. Doing a Mammography under medical guidance will make a lot of difference.

Which doctor should I go to, then?
If you can access a Surgical Oncologist, nothing like it. If not, you can always see a General Surgeon, should not be a problem, as most surgeons dela with breast lumps. If even a Surgeon is not available, you can go to your Family Doctor (Family Physician); most of them can very well guide you to a good Mammography centre and if need be, they will guide you to a Specialist (Surgical Oncologist) accordingly.