Breast Screening – Self-Exam and Mammogram

Breast Screening – Self-Exam and Mammogram - What it is

When breast cancer is found at an early stage, more treatment choices may be available and the chance of a complete recovery is higher. Hence there are benefits to detect breast cancer as early as possible through regular breast screening.

Screening simply means performing a procedure or test to detect an abnormality before symptoms appear. This allows problems to be detected earlier, investigated and treated early.

Am I at risk?

All women are at risk of developing breast cancer, and this risk increases if you:

Are aged 50 years and above
Have a family history of breast cancer

Women with risk factors such as a family history of breast cancer should discuss with their doctors when to go for and the interval of regular screening.

Breast screening methods include:

A. Breast Self-Examination

Breast Self-Examination (BSE) is recommended once a month about 1 week from the first day of menses.

For women who no longer menstruate, choosing a date each month is an easy way to remember. For example, the 1st day of each month.

Report to the doctor any breast changes such as redness, swelling, presence of a lump, skin changes or discharge from the nipple. Self-awareness of breast changes through regular Breast Self-Examination (BSE) and being familiar with what is normal and stable is useful to detect abnormalities.

HOW TO PERFORM BREAST SELF-EXAMINATION (BSE)

1. Look for changes in front of a mirror

First, with arms at your sides
Next, with arms raised above your head
Finally, with hands pressed firmly on hips and chest muscles contracted

In each position, turn slowly from side to side and look for:

Change in size or shape of your breasts
Dimpling of the skin
Change in nipples

2. Feel for the changes lying down

Put a small pillow under your right shoulder
Place your right hand under your head

Breast Self-examination

Use the pulp of your left fingers to feel for any lumps or thickening in your right breast
Feel for the changes lying down
First, feel the armpit
Then start on the outside edge of your breast and feel round the whole breast in smaller and smaller circles
Finally, feel behind the nipples itself

Breast Self-examination

3. Look for bleeding or discharge from the nipple

Squeeze the nipple gently to see if there is bleeding or any discharge

Breast Self-examination

4. Repeat step 2 and step 3 for the left breast.

B. Clinical Breast Examination

Have a doctor or breast specialist nurse examine your breasts once every year if you are 40 years and above. This includes a visual examination and a manual check of the entire breast and underarm area for changes. Changes in the breast may not be due to cancer and diagnostic tests may be performed to assess these changes.

C. Mammogram Screening

Regular mammograms are the most reliable way to detect breast cancer, even before lumps can be felt.

Mammography is a low-powered X-ray technique that gives an image of the internal structure of the breast. Usual screening mammograms involve taking X-ray images with the breast compressed between two plates with two views taken — cranial caudal or horizontal and mediolateral oblique or diagonal.

Mammogram Screening

Additional angles and magnified views may be taken if there are areas of concern. It can detect the presence and position of abnormalities and help in the diagnosis of breast problems, including cancer.

Find out what to expect when you go for a mammogram.

Mammograms for Singapore residents under Screen for Life are subsidised by the Health Promotion Board and are Medisave-claimable if you are aged 50 years and above.

For enquiries on mammogram screenings at SingHealth institutions, call 6536 6000.

There are other tests such as breast ultrasound, tomosynthesis and MRI, available for assessment of the breasts. These are not used for regular screening in well women and are used for further evaluation after initial screening mammogram, but may be considered for women with high risk of breast cancer.