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Early-Onset Breast Cancer

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Early-Onset Breast Cancer

People, Three, Portrait, Black

Image by trevoykellyphotography/Pixabay

Breast Cancer

Breast Cancer Prevention Exercise

Image by TheVisualMD

Breast Cancer In Young Women

Breast cancer is the most common cancer in women in the United States. About 1 in 8 women will get breast cancer during her life.

Although breast cancer mostly occurs among older women, in rare cases breast cancer does affect women under the age of 45. About 9% of all new cases of breast cancer in the United States are found in women younger than 45 years of age.

Breast cancer in young women is—

More likely to be hereditary than breast cancer in older women.
More likely to be found at a later stage, and is often more aggressive and difficult to treat.
Often coupled with unique issues, including concerns about body image, fertility, finances, and feelings of isolation.

All women are at risk for getting breast cancer, but some things can raise a woman’s risk for getting breast cancer before age 45. Learning what factors increase your chance of getting breast cancer is an important first step in assessing your risk. Learning the symptoms of breast cancer also may also help you know when to talk to your doctor.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (6)

Chromosomes, Genes and Breast Cancer

Image by TheVisualMD

Breast Anatomy With Cancer (Nipple)

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Breast Anatomy with Cancer

Structures of the breast with cancer are visible in a Breast MRI: Nipple, Breast tissue, Fat, Suspensory ligaments, Ducts, Chest wall muscle, Ribs, Tumor

Interactive by TheVisualMD

Introduction to Early Onset Breast Cancer and Risk Factors

Video by Centers for Disease Control and Prevention (CDC)/YouTube

Early Onset Breast Cancer: Risk Reduction and Warning Signs

Video by Centers for Disease Control and Prevention (CDC)/YouTube

Early Onset Breast Cancer: Talking to Your Doctor and Genetic Counseling

Video by Centers for Disease Control and Prevention (CDC)/YouTube

Stage 1 - the cancer is small and only in the breast tissue or it might be found in lymph nodes close to the breast.

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Number Staging System for Breast Cancer

The number staging system for breast cancer divides breast cancers into 4 stages, from 1 to 4. Stage 1 is the earliest stage and stage 4 means the cancer has spread to another part of the body.

Interactive by Cancer Research UK

Chromosomes, Genes and Breast Cancer

TheVisualMD

Breast Anatomy with Cancer

TheVisualMD

4:10

Introduction to Early Onset Breast Cancer and Risk Factors

Centers for Disease Control and Prevention (CDC)/YouTube

3:02

Early Onset Breast Cancer: Risk Reduction and Warning Signs

Centers for Disease Control and Prevention (CDC)/YouTube

4:29

Early Onset Breast Cancer: Talking to Your Doctor and Genetic Counseling

Centers for Disease Control and Prevention (CDC)/YouTube

Number Staging System for Breast Cancer

Cancer Research UK

What Is Breast Cancer?

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Woman with Breast Cancer, Stage 1

Image by TheVisualMD

What Is Breast Cancer?

Breast cancer is a disease in which certain cells in the breast become abnormal and multiply uncontrollably to form a tumor. Although breast cancer is much more common in women, this form of cancer can also develop in men. In both women and men, the most common form of breast cancer begins in cells lining the milk ducts (ductal cancer). In women, cancer can also develop in the glands that produce milk (lobular cancer). Most men have little or no lobular tissue, so lobular cancer in men is very rare.

In its early stages, breast cancer usually does not cause pain and may exhibit no noticeable symptoms. As the cancer progresses, signs and symptoms can include a lump or thickening in or near the breast; a change in the size or shape of the breast; nipple discharge, tenderness, or retraction (turning inward); and skin irritation, dimpling, redness, or scaliness. However, these changes can occur as part of many different conditions. Having one or more of these symptoms does not mean that a person definitely has breast cancer.

In some cases, cancerous cells can invade surrounding breast tissue. In these cases, the condition is known as invasive breast cancer. Sometimes, tumors spread to other parts of the body. If breast cancer spreads, cancerous cells most often appear in the bones, liver, lungs, or brain. Tumors that begin at one site and then spread to other areas of the body are called metastatic cancers.

A small percentage of all breast cancers cluster in families. These cancers are described as hereditary and are associated with inherited gene mutations. Hereditary breast cancers tend to develop earlier in life than noninherited (sporadic) cases, and new (primary) tumors are more likely to develop in both breasts.

Source: MedlinePlus Genetics

Additional Materials (5)

3:36

Why Am I at Risk of Developing Breast Cancer? | Being Jewish and Breast Cancer Risk

Johns Hopkins Medicine/YouTube

3:14

Male breast cancer and other breast issues - Mayo Clinic

Mayo Clinic/YouTube

16:02

Breast Cancer in Women of Color: Controversies in Breast Cancer Screening

NYU Langone Health/YouTube

8:24

Understanding Breast Cancer

You and Breast Cancer/YouTube

3:44

Understand.com | Breast Cancer Animation Library Demo

Understand/YouTube

Key Facts

Screening for Cancer

Image by TheVisualMD

Breast Cancer

Cancer is a disease in which cells in the body grow out of control. When cancer starts in the breast, it is called breast cancer. As it grows, breast cancer can cause changes in how the breast looks or feels. Different women have different warning signs for breast cancer. Some women do not have any signs or symptoms at all. A woman may find out she has breast cancer after a routine mammogram.

Key Facts

Mammograms can find breast cancer early, when it’s easier to treat.
Most breast lumps are not caused by cancer; many conditions can cause them.
Breast cancer symptoms vary, and some women don’t have symptoms.
Men can get breast cancer, but it is not very common. For every 100 cases of breast cancer, less than 1 is in men.

Breast Cancer Awareness

Breast cancer claims the lives of thousands of women in the United States each year. Learn basic information about breast cancer and how to prevent and recognize it.

Breast Cancer in Men

Although it is rare, men can get breast cancer. Learn about symptoms of breast cancer in men and things that may increase your risk.

Breast Cancer in Young Women

Understanding your cancer risk and being proactive about your health may help you lower your risk for getting breast cancer at a young age.

Mammograms Save Lives

Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.

Prevention Tips

Keep a healthy weight and exercise regularly.
Limit the amount of alcohol you drink.
If you are taking hormone replacement therapy or birth control pills, ask your doctor about the risks and find out if it is right for you.
Know your family history of breast cancer. If you have a close relative with breast cancer, ask your doctor how you can manage your risk.
A mammogram can’t prevent breast cancer, but it can help find it early. Talk to your health care provider about whether screening is right for you.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (1)

Lower Your Breast Cancer Risk

Matthew Henry / CDC

Risk Factors

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Breast Cancer

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Risk Factors for Breast Cancer at a Young Age

In addition to the risk factors all women face, some risk factors put young women at a higher risk for getting breast cancer at a young age.

If you are under the age of 45, you may have a higher risk for breast cancer if—

You have close relatives who were diagnosed with breast cancer before the age of 45 or ovarian cancer at any age, especially if more than one relative was diagnosed or if a male relative had breast cancer.
You have changes in certain breast cancer genes (BRCA1 and BRCA2), or have close relatives with these changes, but have not been tested yourself.
You have Ashkenazi Jewish heritage.
You received radiation therapy to the breast or chest during childhood or early adulthood.
You have had breast cancer or certain other breast health problems, such as lobular carcinoma in situ (LCIS), ductal carcinoma in situ (DCIS), atypical ductal hyperplasia, or atypical lobular hyperplasia.
You have been told that you have dense breasts on a mammogram.

Do any of these characteristics describe you? If so, talk to your doctor about your family history and other risk factors you might have.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (2)

4:10

Introduction to Early Onset Breast Cancer and Risk Factors

Centers for Disease Control and Prevention (CDC)/YouTube

3:02

Early Onset Breast Cancer: Risk Reduction and Warning Signs

Centers for Disease Control and Prevention (CDC)/YouTube

Ashkenazi Jewish Heritage

Ashkenazi Synagogue

Image by George Mel/Wikimedia

Jewish Women and BRCA Gene Mutations

Everyone has BRCA1 and BRCA 2 genes. Some people have changes, called mutations, in these genes. One in 40 Ashkenazi Jewish women has a BRCA gene mutation.

Mutations in BRCA genes raise a person’s risk for getting breast cancer at a young age, and also for getting ovarian and other cancers. That is why Ashkenazi Jewish women are at higher risk for breast cancer at a young age. If your mother or father has a BRCA gene mutation, you have a 50% chance of having the same gene mutation.

If you are of Ashkenazi Jewish descent, you have a higher risk for a BRCA gene mutation. If either of the following are true, you should consider genetic counseling—

Any first-degree relative (mother, daughter, or sister) has been diagnosed with breast or ovarian cancer.
Two second-degree relatives (grandmother, aunt, or niece) on the same side of the family have been diagnosed with breast or ovarian cancer. These can be relatives on your mother’s or father’s side of the family.

Not every woman who has a BRCA gene mutation will get breast or ovarian cancer, but having a gene mutation puts you at an increased risk for these cancers.

About 50 out of 100 women with a BRCA gene mutation will get breast cancer by the time they turn 70 years old, compared to only 7 out of 100 women in the general U.S. population.
About 30 out of 100 women with a BRCA gene mutation will get ovarian cancer by the time they turn 70 years old, compared to fewer than 1 out of 100 women in the general U.S. population.

Understanding your cancer risk and being proactive about your health may help you lower your risk for getting breast or ovarian cancer at a young age, or find it at an early stage when treatment works best.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (2)

3:37

Genetic Testing for the BRCA Gene | Being Jewish and Breast Cancer Risk

Johns Hopkins Medicine/YouTube

3:36

Why Am I at Risk of Developing Breast Cancer? | Being Jewish and Breast Cancer Risk

Johns Hopkins Medicine/YouTube

BRCA Gene Mutations

BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA.

Image by TheVisualMD

The BRCA1 and BRCA2 Genes and Hereditary Breast and Ovarian Cancer

The genes most commonly affected in hereditary breast and ovarian cancer are the breast cancer 1(BRCA1) and breast cancer 2(BRCA2) genes. About 3% of breast cancers (about 7,500 women per year) and 10% of ovarian cancers (about 2,000 women per year) result from inherited mutations in the BRCA1 and BRCA2 genes.

Normally, the BRCA1 and BRCA2 genes protect you from getting certain cancers. But some mutations in the BRCA1 and BRCA2 genes prevent them from working properly, so that if you inherit one of these mutations, you are more likely to get breast, ovarian, and other cancers. However, not everyone who inherits a BRCA1 or BRCA2 mutation will get breast or ovarian cancer.

Everyone has two copies of the BRCA1 and BRCA2 genes, one copy inherited from their mother and one from their father. Even if a person inherits a BRCA1 or BRCA2 mutation from one parent, they still have the normal copy of the BRCA1 or BRCA2 gene from the other parent. Cancer occurs when a second mutation happens that affects the normal copy of the gene, so that the person no longer has a BRCA1 or BRCA2 gene that works properly. Unlike the inherited BRCA1 or BRCA2 mutation, the second mutation would not be present throughout the person’s body, but would only be present in the cancer tissue.

Breast and ovarian cancer can also be caused by inherited mutations in genes other than BRCA1 and BRCA2. This means that in some families with a history of breast and ovarian cancer, family members will not have mutations in BRCA1 or BRCA2, but can have mutations in one of these other genes. These mutations might be identified through genetic testing using multigene panels, which look for mutations in several different genes at the same time.

You and your family members are more likely to have a BRCA1 or BRCA2 mutation if your family has a strong history of breast or ovarian cancer. Family members who inherit BRCA1 and BRCA2 mutations usually share the same mutation. If one of your family members has a known BRCA1 or BRCA2 mutation, other family members who get genetic testing should be checked for that mutation.

If you are concerned that you could have a BRCA1, BRCA2, or other mutation related to breast and ovarian cancer, the first step is to collect your family health history of breast and ovarian cancer and share this information with your doctor.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (7)

1:28

What is a BRCA Gene Mutation?

Centers for Disease Control and Prevention (CDC)/YouTube

1:00

Can you explain BRCA 1 and BRCA 2 genes?

Premier Health/YouTube

3:12

BRCA Genes and Breast Cancer

Centers for Disease Control and Prevention (CDC)/YouTube

14:51

BRCA Genetic Testing: What to Know & Why Its Important

Breast Cancer School for Patients/YouTube

52:51

Considering BRCA Genes in Breast Cancer

University of California Television (UCTV)/YouTube

Chances of Developing Breast Cancer by Age 70

National Cancer Institute (NCI)

BRCA1 and BRCA2 gene mutations: autosomal dominant (AD) inheritance pattern

YassineMrabet / NIH

Breast Density

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Breast Density

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Dense Breasts: Answers to Commonly Asked Questions

What are dense breasts?

Breasts contain glandular tissue, fibrous connective tissue, and fatty breast tissue. Breast density is a term that describes the relative amount of these different types of breast tissue as seen on a mammogram. Dense breasts have relatively high amounts of glandular tissue and fibrous connective tissue and relatively low amounts of fatty breast tissue.

Are dense breasts common?

Yes, dense breasts are common. Nearly half of all women who are 40 and older who get mammograms are found to have dense breasts.

What factors influence breast density

Breast density is often inherited, but other factors can influence it.

Factors associated with higher breast density include using menopausal hormone therapy and having a low body mass index.
Factors associated with lower breast density include increasing age and having children.

How do I know if I have dense breasts?

Dense breast tissue cannot be felt by a woman, such as during a breast self-exam, or by her doctor during a clinical breast exam. Only a radiologist looking at a mammogram can tell if a woman has dense breasts. Dense breasts are sometimes called mammographically dense breasts.

How is breast density categorized in a mammogram report?

Doctors use the Breast Imaging Reporting and Data System (BI-RADS) to classify breast density. This system, developed by the American College of Radiology, helps doctors interpret and report back mammogram findings. Doctors who review mammograms are called radiologists. BI-RADS classifies breast density into four categories:

Entirely fatty breast tissue: There is almost all fatty breast tissue. It is found in about 10% of women.
Scattered fibroglandular breast tissue: There is mostly fatty tissue with some areas of dense glandular and fibrous connective tissue. It is found in about 40% of women.
Heterogeneously dense breast tissue: There are many areas of dense glandular and fibrous connective tissue, with some areas of fatty tissue. It is found in about 40% of women
Extremely dense breast tissue: There is almost all dense glandular and fibrous connective tissue. It is found in about 10% of women.

If your mammogram report letter says you have dense breasts, it means that you have either heterogeneously dense breast tissue or extremely dense breast tissue.

The four breast density categories are shown in this image. Breasts can be almost entirely fatty (A), have scattered areas of dense fibroglandular breast tissue (B), have many areas of glandular and connective tissue (C), or be extremely dense (D). Breasts are classified as “dense” if they fall in the heterogeneously dense (C) or extremely dense (D) categories.

Does having dense breast tissue affect a mammogram?

Dense breasts can make a mammogram more difficult to interpret. That's because dense breast tissue and some abnormal breast changes, such as calcifications and tumors, both appear as white areas in the mammogram, whereas fatty tissue appears as dark areas.

As a result, mammography is less sensitive in women with dense breasts—that is, it is more likely to miss cancer. Women with dense breasts may be called back for follow-up testing more often than women with fatty breasts.

Are dense breasts a risk factor for breast cancer?

Dense breasts are not considered an abnormal breast condition or a disease. However, dense breasts are a risk factor for breast cancer. That is, women with dense breasts have a higher risk of breast cancer than women with fatty breasts. This risk is separate from the effect of dense breasts on the ability to read a mammogram.

In most states, mammography providers are required to inform women if they have dense breasts.

Should women with dense breasts have additional screening for breast cancer?

The value of additional, or supplemental, imaging tests such as ultrasound or MRI to screen for breast cancer in women with dense breasts is not yet clear, according to the Recommendation Statement on Breast Cancer Screening by the United States Preventive Services Task Force (USPSTF). Talk with your doctor or nurse to learn what is recommended for you, based on your personal medical history and family medical history.

Are breast cancer patients with dense breasts more likely to die from breast cancer?

No. Research has found that breast cancer patients who have dense breasts are no more likely to die from breast cancer than breast cancer patients who have fatty breasts, after accounting for other health factors and tumor characteristics.

Questions to consider asking your doctor or nurse

Ask these questions to get information that’s specific to you, based on your personal medical history:

What are the dense breast-related findings in my recent mammogram?
Do you recommend additional screening or diagnostic tests for me?
What is my overall personal risk of breast cancer, given my risk and protective factors?

Are there clinical trials for women with dense breasts?

Yes, there are ongoing and completed clinical trials related to dense breasts that are studying better ways to detect breast cancer in women with dense breasts.

What are researchers studying about the relationship between breast density and breast cancer?

Here are some questions that researchers are working to answer:

Can imaging tests such as 3-D mammography, MRI, ultrasound, or other imaging procedures help provide a clearer picture of breast density?
Are there certain patterns or areas of dense breast tissue that are particularly “risky”?
Why do some women with dense breasts develop breast cancer, whereas others do not?
What biologic mechanisms explain the association between high breast density and increased breast cancer risk?
Can biomarkers be identified that may help predict whether breast cancer will develop in a woman with dense breasts?
Are changes in breast density over time associated with changes in breast cancer risk?
Can women reduce their breast density, and potentially their risk of developing or dying from breast cancer, by taking medicines or by applying topical agents on their breasts?

Source: National Cancer Institute (NCI)

Additional Materials (2)

3:36

What Are Dense Breasts? | FAQ with Dr. Kelly Myers

Johns Hopkins Medicine/YouTube

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Dense Breasts and Cancer

National Cancer Institute (NCI)

Symptoms

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Left Breast with Cancer

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Symptoms of Breast Cancer

Different people have different symptoms of breast cancer. Some people do not have any signs or symptoms at all. A person may find out they have breast cancer after a routine mammogram.

Some warning signs of breast cancer are—

New lump in the breast or underarm (armpit).
Thickening or swelling of part of the breast.
Irritation or dimpling of breast skin.
Redness or flaky skin in the nipple area or the breast.
Pulling in of the nipple or pain in the nipple area.
Nipple discharge other than breast milk, including blood.
Any change in the size or the shape of the breast.
Pain in any area of the breast.

Keep in mind that these symptoms can happen with other conditions that are not cancer.

If you have any signs or symptoms that worry you, be sure to see your doctor right away.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (6)

3:02

Early Onset Breast Cancer: Risk Reduction and Warning Signs

Centers for Disease Control and Prevention (CDC)/YouTube

3:01

How to Recognize Breast Cancer Symptoms

Howcast/YouTube

4:15

How to Check Your Breasts for Lumps - Signs Of Breast Cancer Symptoms

WaysAndHow/YouTube

0:50

What Are the Symptoms of Breast Cancer? | UPMC

UPMC/YouTube

Breast cancer - Early Signs - Overview

Raphseck

Breast cancer incidence by anatomical site (females)

Cancer Research UK uploader/Wikimedia

Screening

Breast Self-Exam (3 Methods)

Image by Blausen Medical Communications, Inc.

What Is Breast Cancer Screening?

Breast cancer screening means checking a woman’s breasts for cancer before there are signs or symptoms of the disease. All women need to be informed by their health care provider about the best screening options for them. When you are told about the benefits and risks of screening and decide with your health care provider whether screening is right for you—and if so, when to have it—this is called informed and shared decision-making.

Although breast cancer screening cannot prevent breast cancer, it can help find breast cancer early, when it is easier to treat. Talk to your doctor about which breast cancer screening tests are right for you, and when you should have them.

Breast Cancer Screening Recommendations

The United States Preventive Services Task Force (USPSTF) is an organization made up of doctors and disease experts who look at research on the best way to prevent diseases and make recommendations on how doctors can help patients avoid diseases or find them early.

The USPSTF recommends that women who are 50 to 74 years old and are at average risk for breast cancer get a mammogram every two years. Women who are 40 to 49 years old should talk to their doctor or other health care professional about when to start and how often to get a mammogram. Women should weigh the benefits and risks of screening tests when deciding whether to begin getting mammograms before age 50.

Breast Cancer Screening Tests

Mammogram

A mammogram is an X-ray of the breast. Mammograms are the best way to find breast cancer early, when it is easier to treat and before it is big enough to feel or cause symptoms. Having regular mammograms can lower the risk of dying from breast cancer. At this time, a mammogram is the best way to find breast cancer for most women.

Breast Magnetic Resonance Imaging (MRI)

A breast MRI uses magnets and radio waves to take pictures of the breast. MRI is used along with mammograms to screen women who are at high risk for getting breast cancer. Because breast MRIs may appear abnormal even when there is no cancer, they are not used for women at average risk.

Other Exams

Clinical Breast Exam

A clinical breast exam is an examination by a doctor or nurse, who uses his or her hands to feel for lumps or other changes.

Breast Self-Awareness

Being familiar with how your breasts look and feel can help you notice symptoms such as lumps, pain, or changes in size that may be of concern. These could include changes found during a breast self-exam. You should report any changes that you notice to your doctor or health care provider.

Having a clinical breast exam or doing a breast self-exam has not been found to lower the risk of dying from breast cancer.

Benefits and Risks of Screening

Every screening test has benefits and risks, which is why it’s important to talk to your doctor before getting any screening test, like a mammogram.

Benefit of Screening

The benefit of screening is finding cancer early, when it’s easier to treat.

Risks of Screening

Harms can include false positive test results, when a doctor sees something that looks like cancer but is not. This can lead to more tests, which can be expensive, invasive, time-consuming, and may cause anxiety.

Tests also can lead to overdiagnosis, when doctors find a cancer that would not have gone on to cause symptoms or problems, or even may go away on its own. Treatment of these cancers is called overtreatment. Overtreatment can include treatments recommended for breast cancer, such as surgery or radiation therapy. These can cause unnecessary and unwanted side effects. Other potential harms from breast cancer screening include pain during the procedure and radiation exposure from the mammogram test itself. While the amount of radiation in a mammogram is small, there may be risks with having repeated X-rays.

Mammograms may also miss some cancers, called false negative test results, which may delay finding a cancer and getting treatment.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (6)

1:06

Mayo Clinic Minute: Why breast cancer screening is important

Mayo Clinic/YouTube

1:01

Breast Cancer Screening Guidelines

uvahealth/YouTube

1:00

Breast Cancer Screening and Symptoms

Cancer Treatment Centers of America - CTCA/YouTube

3:47

Breast cancer screening | NHS

NHS/YouTube

28:19

Mammography and Breast Cancer Screening Guidelines

HenryFordTV/YouTube

6:28

CreationVideo.com | NHS Breast Screening: It's Your Choice - 1

CreationVideo | Video Production + Live Streaming/YouTube

Breast Exam

Breast Exam

Also called: Clinical Breast Exam, CBE

A clinical breast exam (CBE) is a physical exam of the breast performed by a health care provider to check for lumps or other changes. It’s often done during your regular medical check-up. If a CBE is not offered at your check-up and you would like one, ask your health care provider to perform one (or refer you to someone who can).

Breast Exam

Also called: Clinical Breast Exam, CBE

A clinical breast exam (CBE) is a physical exam of the breast performed by a health care provider to check for lumps or other changes. It’s often done during your regular medical check-up. If a CBE is not offered at your check-up and you would like one, ask your health care provider to perform one (or refer you to someone who can).

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Use the slider below to see how your results affect your health.
Your result is Normal.
A normal result means that the nipples, breast tissue, and areas around the breast look normal and are normal in size and shape. A normal result does not mean that breast cancer is not present. Depending on your age and your personal and family history of breast cancer, your health care provider may do other tests, such as a mammogram.
Related conditions
1. PDQ® Screening and Prevention Editorial Board. PDQ Breast Cancer Screening. Bethesda, MD: National Cancer Institute. [accessed on Jan 15, 2022]
2. Breast Exam | Michigan Medicine [accessed on Jan 15, 2022]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (8)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining her. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining her. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hand examining. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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This media may include sensitive content

Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

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Breast Exam (Series of 16)

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Breast Exam (Series of 16)

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Mammogram

Mammogram

Also called: Breast Cancer Screening - Mammography, Screening Mammography, Diagnostic Mammography

A mammogram is a low-dose x-ray picture of the breast. A mammogram is used to look for early signs of breast cancer. Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.

Mammogram

Also called: Breast Cancer Screening - Mammography, Screening Mammography, Diagnostic Mammography

A mammogram is a low-dose x-ray picture of the breast. A mammogram is used to look for early signs of breast cancer. Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.

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Use the slider below to see how your results affect your health.
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Your result is Negative.
This score confirms that your mammogram results are negative, indicating that the breast tissue shows no signs of a mass or calcifications. However, it’s important to continue regular screening mammograms.
Related conditions
- Screening mammograms are done for women who have no symptoms of breast cancer. It usually involves two x-rays of each breast. Screening mammograms can detect lumps or tumors that cannot be felt. They can also find microcalcifications or tiny deposits of calcium in the breast, which sometimes mean that breast cancer is present.
- Diagnostic mammograms are used to check for breast cancer after a lump or other symptom or sign of breast cancer has been found. Signs of breast cancer may include pain, thickened skin on the breast, nipple discharge, or a change in breast size or shape. This type of mammogram also can be used to find out more about breast changes found on a screening mammogram, or to view breast tissue that is hard to see on a screening mammogram. A diagnostic mammogram takes longer than a screening mammogram because it involves more x-rays in order to obtain views of the breast from several angles. The technician can magnify a problem area to make a more detailed picture, which helps the doctor make a correct diagnosis.
A digital mammogram also uses x-rays to produce an image of the breast, but instead of storing the image directly on film, the image is stored directly on a computer. This allows the recorded image to be magnified for the doctor to take a closer look. Current research has not shown that digital images are better at showing cancer than x-ray film images in general. But, women with dense breasts who are pre- or perimenopausal, or who are younger than age 50, may benefit from having a digital rather than a film mammogram. Digital mammography may offer these benefits:
- Long-distance consultations with other doctors may be easier because the images can be shared by computer.
- Slight differences between normal and abnormal tissues may be more easily noted.
- The number of follow-up tests needed may be fewer.
- Fewer repeat images may be needed, reducing exposure to radiation.
A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. A mammogram allows the doctor to have a closer look for changes in breast tissue that cannot be felt during a breast exam. Women ages 50 to 74 years should get a mammogram every 2 years. Women younger than age 50 should talk to a doctor about when to start and how often to have a mammogram.
Mammograms can not find all problems. So, every woman should work with her doctor to check her breasts. Call your doctor or clinic if you notice any change in your breasts like:
- a lump
- thickening
- liquid leaking from the nipple or changes in how the nipple looks
First, check with the place you are having the mammogram for any special instructions you may need to follow before you go. Here are some general guidelines to follow:
- If you are still having menstrual periods, try to avoid making your mammogram appointment during the week before your period. Your breasts will be less tender and swollen. The mammogram will hurt less and the picture will be better.
- If you have breast implants, be sure to tell your mammography facility that you have them when you make your appointment.
- Wear a shirt with shorts, pants, or a skirt. This way, you can undress from the waist up and leave your shorts, pants, or skirt on when you get your mammogram.
- Don't wear any deodorant, perfume, lotion, or powder under your arms or on your breasts on the day of your mammogram appointment. These things can make shadows show up on your mammogram.
- If you have had mammograms at another facility, have those x-ray films sent to the new facility so that they can be compared to the new films.
- Tell the clinic if you have physical disabilities that may make it hard for you to sit up, lift your arms, or hold your breath.
- Talk with the staff about how they will handle issues of modesty that you may have due to your religion.

Breast tissue that shows no signs of a mass or calcifications is considered normal. Most abnormal findings on a screening mammogram turn out to be benign (not cancer) or nothing to worry about. New findings or changes must be further evaluated.

What can mammograms show?

The radiologist will look at your x-rays for breast changes that do not look normal and for differences in each breast. He or she will compare your past mammograms with your most recent one to check for changes. The doctor will also look for lumps and calcifications.

Possible mammogram findings include:

Lumps (mass or tumor). Lumps come in different sizes and shapes. Fluid-filled cysts are usually smooth and rounded, with clear, defined edges and are not cancer. Lumps that have a jagged outline and an irregular shape are of more concern.
Calcifications. There are two types of breast calcifications, or calcium deposits:
- Macrocalcifications, which look like small white dots on a mammogram. They are often caused by aging, an old injury, or inflammation and are usually benign.
- Microcalcifications, which look like white specks on a mammogram. If found in an area of rapidly dividing cells or grouped together in a certain way, they may be a sign of DCIS or breast cancer.
Dense breast tissue: A dense breast has relatively less fat and more glandular and connective tissue. This mammogram finding is both common and normal, especially among younger women and women who use menopausal hormone therapy. Dense breast tissue can make a mammogram more difficult to interpret because both dense breast tissue and breast tumors appear as solid white areas in the image.

What happens if my mammogram is normal?

Continue to get mammograms according to recommended time intervals. Mammograms work best when they can be compared with previous ones. This allows the radiologist to compare them to look for changes in your breasts.

What happens if my mammogram is abnormal?

An abnormal mammogram does not always mean that there is cancer. But you will need to have additional mammograms, tests, or exams before the doctor can tell for sure. You may also be referred to a breast specialist or a surgeon. It does not necessarily mean you have cancer or need surgery. These doctors are experts in diagnosing breast problems. Doctors may order some of these tests:

Diagnostic mammogram, to focus on a specific area of the breast
Ultrasound, an imaging test that uses sound waves to create a picture of your breast. The pictures may show whether a lump is solid or filled with fluid. A cyst is a fluid-filled sac. Cysts are not cancer. But a solid mass may be cancer. After the test, your doctor can store the pictures on video or print them out. This exam may be used along with a mammogram.
Magnetic resonance imaging (MRI), which uses a powerful magnet linked to a computer. MRI makes detailed pictures of breast tissue. Your doctor can view these pictures on a monitor or print them on film. MRI may be used along with a mammogram.
Biopsy, a test in which fluid or tissue is removed from your breast to help find out if there is cancer. Your doctor may refer you to a surgeon or to a doctor who is an expert in breast disease for a biopsy.

What is the Breast Imaging Reporting and Database System (BI-RADS®)?

The American College of Radiology (ACR) has established a uniform way for radiologists to describe mammogram findings. The system, called BI-RADS, includes seven standardized categories, or levels. Each BI-RADS category has a follow-up plan associated with it to help radiologists and other physicians appropriately manage a patient’s care.

Breast Imaging Reporting and Database System (BI-RADS)

Category	Assessment	Follow-up
0	Need additional imaging evaluation	Additional imaging needed before a category can be assigned
1	Negative	Continue regular screening mammograms
2	Benign (noncancerous) finding	Continue regular screening mammograms
3	Probably benign	Receive a 6-month follow-up mammogram
4	Suspicious abnormality	May require biopsy
5	Highly suggestive of malignancy (cancer)	Requires biopsy
6	Known biopsy-proven malignancy (cancer)	Biopsy confirms presence of cancer before treatment begins

BI-RADS also includes four categories of breast density that may be reported. The radiologist who reads the mammogram chooses the category that best describes the level of breast density seen on the mammogram film. The categories, from the least amount of breast density to the highest, are as follows:

The breasts are almost entirely fatty
There are scattered areas of dense glandular tissue and fibrous connective tissue (together known as fibroglandular density)
The breasts are heterogeneously dense, which means they have more of these areas of fibroglandular density. This may make it hard to see small masses in the breast tissue on a mammogram.
The breasts are extremely dense, which makes it hard to see tumors in the breast tissue on a mammogram.

Many states in the U.S. have enacted laws requiring mammography providers to tell women if they have dense breasts (i.e., breasts that are heterogeneously or extremely dense on a mammogram) and to inform them of risks associated with having dense breasts. In addition to making mammograms harder to read, dense breasts are a risk factor for breast cancer.

Although they are not perfect, mammograms are the best method to find breast changes that cannot be felt. If your mammogram shows a breast change, sometimes other tests are needed to better understand it. Even if the doctor sees something on the mammogram, it does not mean it is cancer.
As with any medical test, mammograms have limits. These limits include:
- They are only part of a complete breast exam. Your doctor also should do a clinical breast exam. If your mammogram finds something abnormal, your doctor will order other tests.
- Finding cancer does not always mean saving lives. Even though mammography can detect tumors that cannot be felt, finding a small tumor does not always mean that a woman's life will be saved. Mammography may not help a woman with a fast growing cancer that has already spread to other parts of her body before being found.
- False negatives can happen. This means everything may look normal, but cancer is actually present. False negatives don't happen often. Younger women are more likely to have a false negative mammogram than are older women. The dense breasts of younger women make breast cancers harder to find in mammograms.
- False positives can happen. This is when the mammogram results look like cancer is present, even though it is not. False positives are more common in younger women, women who have had breast biopsies, women with a family history of breast cancer, and women who are taking estrogen, such as menopausal hormone therapy.
- Mammograms (as well as dental x-rays and other routine x-rays) use very small doses of radiation. The risk of any harm is very slight, but repeated x-rays could cause cancer. The benefits nearly always outweigh the risk. Talk to your doctor about the need for each x-ray. Ask about shielding to protect parts of the body that are not in the picture. You should always let your doctor and the technician know if there is any chance that you are pregnant.
1. https://www.womenshealth.gov/a-z-topics/mammograms [accessed on Feb 16, 2019]
2. https://www.nibib.nih.gov/science-education/science-topics/mammography [accessed on Feb 16, 2019]
3. https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm [accessed on Feb 16, 2019]
4. https://www.cancer.gov/types/breast/mammograms-fact-sheet [accessed on Feb 16, 2019]
5. https://www.cancer.gov/types/breast/breast-changes#ui-id-4 [accessed on Feb 16, 2019]
6. https://www.fda.gov/ForConsumers/ByAudience/ForWomen/WomensHealthTopics/ucm117967.htm [accessed on Feb 16, 2019]
7. https://medlineplus.gov/ency/article/003380.htm [accessed on Feb 16, 2019]
8. https://www.healthline.com/health/birads-score [accessed on Feb 16, 2019]
9. https://www.acr.org/-/media/ACR/Files/RADS/BI-RADS/Mammography-Reporting.pdf [accessed on Feb 16, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (48)

Mammography Fact Sheet

Mammography is an x-ray imaging method used to examine the breast for the early detection of cancer and other breast diseases. It is used as both a diagnostic and screening tool.

Document by www.nibib.nih.gov

Mammograms

Document by Office on Women's Health, U.S. Department of Health and Human Services

Top Four Mammogram Myths

Knowing the truth about mammograms could help save your life, or the life of someone you love. Over 60% of breast cancer cases are diagnosed before they spread. Nearly 90% of women who find and treat their breast cancer are cancer-free at five years. Mammograms can help reduce the number of deaths from breast cancer among women ages 40 to 70.

Image by The U.S. Food and Drug Administration

Screening for Cancer

Common Screening Tests and American Cancer Society Recommendations

Image by TheVisualMD

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Mammography

A woman getting a mammogram, showing a cone in position on her right breast.

Image by National Cancer Institute / Unknown Illustrator

Mammography

Image by BruceBlaus

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Mammogram

An adult female is assisted in a mammogram machine by an African-American technician.

Image by National Cancer Institute / Alan Hoofring (Illustrator)

Woman Having Mammogram

Photograph of woman having mammogram. Mammograms are considered the gold standard for breast cancer screening. Mammography requires the breasts to be compressed between plates while the image is captured. Typically, two views are taken of the breast: cranial-caudal (top to bottom) and mediolateral oblique (angled side view).

Image by TheVisualMD

Mammography

Mammogram being conducted

Image by CDC

Woman Receives Mammogram

An African-American female technician positions a Caucasian woman at an imaging machine to receive a mammogram.

Image by National Cancer Institute / Rhoda Baer (Photographer)

Woman Receives Mammogram

A Caucasian female technician positions an Asian woman at an imaging machine to receive a mammogram.

Image by National Cancer Institute / Rhoda Baer (Photographer)

Woman Receives Mammogram

A Caucasian female technician positions a Hispanic woman at an imaging machine to receive a mammogram.

Image by National Cancer Institute / Rhoda Baer (Photographer)

Woman Receives Mammogram

An Asian female technician positions an African-American woman at an imaging machine to receive a mammogram.

Image by National Cancer Institute / Rhoda Baer (Photographer)

Mammography Patient

A female technician prepares to give an older Caucasian female patient a mammogram. the patient is preparing for the exam next to machine with technician in background adjusting controls.

Image by National Cancer Institute / Bill Branson (Photographer)

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Mammography

A woman's breast being compressed to get the optimum mammographic image.

Image by National Cancer Institute / Bill Branson (Photographer)

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Mammography

A Caucasian female patient, while sitting, is receiving a mammogram with a technician is standing in the background. The conical tip is compressing the right breast and the left breast is visible. Note the older machine.

Image by National Cancer Institute / Unknown Photographer

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Mammography

A Caucasian female patient receives a lateral mammogram treatment. She is lying on her left side with the left breast compressed and she is holding her right breast out of the way so as to not block the x-ray. Note the older methods of the diagnostic procedure.

Image by National Cancer Institute / Unknown Photographer

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Mammography

A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle that compresses the breast. The patient's face is turned towards the technician, away from the camera, and her right shoulder and breast are exposed.

Image by National Cancer Institute / Bill Branson (Photographer)

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Mammography

A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle used to compress the breast. The patient's face is turned towards the technician, away from the camera, with her right shoulder and breast are exposed.

Image by National Cancer Institute / Bill Branson (Photographer)

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Mammography Patient

A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle used to compress the breast. The patient's face is turned towards the technician, away from the camera. Her right shoulder is raised obscuring the breast.

Image by National Cancer Institute / Bill Branson (Photographer)

Male Breast Cancer

Senior Airman Elisabeth Stone compresses a male patient's breast tissue during a baseline screening of mammogram at Joint Base Elmendorf-Richardson, Alaska

Image by Staff Sgt. Sheila deVera

Doctor Viewing Mammogram

A doctor examines mammograms on a view box.

Image by National Cancer Institute / Bill Branson (photographer)

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Mammogram Showing Dense And Fatty Breasts

Title Mammogram Showing Dense And Fatty Breasts Description A side-by-side of two normal mammograms showing the difference between a dense breast (left) and a fatty breast (right). The dense breast is that of a woman aged 39, the fatty breast is that of a 59-year old woman. Abnormal lesions are easier to detect and diagnose in a fatty breast making mammography more accurate.

Image by Dr. Kathy Cho. NIH Radiology / National Cancer Institute

Abnormal Mammogram

This abnormal mammogram is not necessarily cancerous. Also seen are calcifications through ductal patterns. Patient would be avised to have follow-up at 3-month intervals.

Image by National Cancer Institute / Unknown Photographer

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Mammogram vs. MRI

A mammography on left and a Magnetic resonance image (MRI) on right. Breast imaging technology has changed over the years. Note MRI's enhancement ability to confirm diagnosis.

Image by Mitchell D. Schnall, M.D., Ph.D. University Of Pennsylvania / Unknown Photographer

Bilateral digital mammography images of the breasts

Bilateral digital mammography images of the breasts; mediolateral oblique view.

Image by © Nevit Dilmen

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Normal (left) versus cancerous (right) mammography image.

Normal (left) versus cancerous (right) mammography image.

Image by National Cancer Institute

Duct ectasia of breast

Detail of a mammography showing liponecrosis (round/oval calcifications) and plasma cell mastitis with typical rod-like calcifications

Image by Hellerhoff

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Mammogram - Normal

Breast tomosynthesis (3D Mammography) of the left craniocaudal.

Image by National Cancer Institute (NCI)

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Mammogram - Normal

Breast tomosynthesis (3D Mammography) of the left craniocaudal projection.

Image by National Cancer Institute (NCI)

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Mammogram - Normal

Breast tomosynthesis (3D Mammography) of the left craniocaudal reconstruction.

Image by National Cancer Institute (NCI)

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Mammogram - Normal

Breast tomosynthesis (3D Mammography) of the left mediolateral oblique projection.

Image by National Cancer Institute (NCI)

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Mammogram Showing Dense And Fatty Breasts

A side-by-side of two normal mammograms showing the difference between a dense breast (left) and a fatty breast (right). The dense breast is that of a woman aged 39, the fatty breast is that of a 59-year old woman. Abnormal lesions are easier to detect and diagnose in a fatty breast making mammography more accurate.

Image by Dr. Kathy Cho. NIH Radiology / Unknown Photographer

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Thermography of breast

Image by FDA

Mammograms vs Breast Ultrasounds

Video by Lee Health/Vimeo

Breast Density: Higher Risk & New Screening Options

Video by Breast Cancer School for Patients/YouTube

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Mammography: NCI B-roll [video]

NCI B-roll of female patient (simulated) receiving a digital mammogram. This video is intentionally silent. This footage, which was filmed at Sibley Memorial Hospital (a Johns Hopkins affiliate institution), includes images of a technician setting up the equipment, a Caucasian female being positioned to receive a mammogram, and mammography images of of dense breasts and fatty breasts. Downloadable video files are 960x540 at 30 fps. This image is part of the NCI B-Roll Videos collection. View video using embedded player on this page or at youtube.com.

Video by National Cancer Institute (NCI)

What to Expect -- Digital Mammography

Video by Hologic, Inc./YouTube

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Mammography

Breast radiologist Dr.Gillian Newstead of the University of Chicago Medical Center explains the process of a typical mammogram screening.

Video by TheVisualMD

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Breast Density

Women with dense breast tissue often require a further look with ultrasound for screening. University of Chicago Medical Center breast radiologist Dr. Gillian Newstead and a breast cancer survivor with dense breast tissue explain.

Video by TheVisualMD

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Breast Cancer Screening & Diagnosis

Breast cancer is one of the most common cancers among women in the U.S., with about 1 in 8 women developing the disease within her lifetime. Breast cancer is an uncontrolled growth of breast cells that has the potential to spread into the breast and possibly to other parts of the body. Early detection through screening saves the lives of thousands of women every year. If there is a history of breast cancer in the family, women should consider the BReast CAncer susceptibility test (or BRCA) to identify a gene that may indicate an increased risk of developing the disease. Women forty and over should be screened for abnormalities yearly to detect and evaluate changes in breast tissue. If an abnormality is found, a biopsy and pathological exam are necessary for a definitive diagnosis and prognosis. After diagnosis, your doctor may want to learn more about your specific cancer through immunohistochemistry (IHC) and HER2 protein tests. IHC testing can help determine if a specific abnormality is present in the cancer cells. HER2 tests can tell your physician if the breast cancer is turned on by the HER2 gene, and can help determine the best course of treatment. Knowing what type of breast cancer is involved, what stage the cancer is, and the characteristics of that specific cancer, allows a woman's physician to determine best possible therapy for her individual case.

Video by TheVisualMD

A closer look at modern mammography

Video by Siemens Healthineers/YouTube

Mammogram

A mammographic image is displayed on state of the art mammography monitors at the David Grant USAF Medical Center. (U.S. Air Force photo/Staff Sgt. Liliana Moreno)

Image by U.S. Air Force photo/Staff Sgt. Liliana Moreno

Nipple Aspirate Test No Substitute for Mammogram

Some companies are marketing a new test—the nipple aspirate test—as the latest and greatest tool in early breast cancer screening. But FDA warns that the nipple aspirate test is no substitute for a mammogram.

Image by The U.S. Food and Drug Administration

Do More Screening Tests Lead to Better Health? Choosing Wisely

Video by DocMikeEvans/YouTube

New Guidelines for Mammograms

Video by Lee Health/Vimeo

Mammogram questions | Mercy Health

Video by Bon Secours Mercy Health/Vimeo

Getting Screened for Breast Cancer

Video by Lee Health/Vimeo

Mammography Fact Sheet

www.nibib.nih.gov

Mammograms

Office on Women's Health, U.S. Department of Health and Human Services

Top Four Mammogram Myths

The U.S. Food and Drug Administration

Screening for Cancer

TheVisualMD

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Mammography

National Cancer Institute / Unknown Illustrator

Mammography

BruceBlaus

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Mammogram

National Cancer Institute / Alan Hoofring (Illustrator)

Woman Having Mammogram

TheVisualMD

Mammography

CDC

Woman Receives Mammogram

National Cancer Institute / Rhoda Baer (Photographer)

Woman Receives Mammogram

National Cancer Institute / Rhoda Baer (Photographer)

Woman Receives Mammogram

National Cancer Institute / Rhoda Baer (Photographer)

Woman Receives Mammogram

National Cancer Institute / Rhoda Baer (Photographer)

Mammography Patient

National Cancer Institute / Bill Branson (Photographer)

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Mammography

National Cancer Institute / Bill Branson (Photographer)

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Mammography

National Cancer Institute / Unknown Photographer

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Mammography

National Cancer Institute / Unknown Photographer

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Mammography

National Cancer Institute / Bill Branson (Photographer)

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Mammography

National Cancer Institute / Bill Branson (Photographer)

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Mammography Patient

National Cancer Institute / Bill Branson (Photographer)

Male Breast Cancer

Staff Sgt. Sheila deVera

Doctor Viewing Mammogram

National Cancer Institute / Bill Branson (photographer)

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Mammogram Showing Dense And Fatty Breasts

Dr. Kathy Cho. NIH Radiology / National Cancer Institute

Abnormal Mammogram

National Cancer Institute / Unknown Photographer

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Mammogram vs. MRI

Mitchell D. Schnall, M.D., Ph.D. University Of Pennsylvania / Unknown Photographer

Bilateral digital mammography images of the breasts

© Nevit Dilmen

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Normal (left) versus cancerous (right) mammography image.

National Cancer Institute

Duct ectasia of breast

Hellerhoff

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Mammogram - Normal

National Cancer Institute (NCI)

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Mammogram - Normal

National Cancer Institute (NCI)

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Mammogram - Normal

National Cancer Institute (NCI)

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Mammogram - Normal

National Cancer Institute (NCI)

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Mammogram Showing Dense And Fatty Breasts

Dr. Kathy Cho. NIH Radiology / Unknown Photographer

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Thermography of breast

FDA

1:51

Mammograms vs Breast Ultrasounds

Lee Health/Vimeo

8:30

Breast Density: Higher Risk & New Screening Options

Breast Cancer School for Patients/YouTube

2:39

Mammography: NCI B-roll [video]

National Cancer Institute (NCI)

4:07

What to Expect -- Digital Mammography

Hologic, Inc./YouTube

0:37

Mammography

TheVisualMD

0:43

Breast Density

TheVisualMD

4:57

Breast Cancer Screening & Diagnosis

TheVisualMD

3:37

A closer look at modern mammography

Siemens Healthineers/YouTube

Mammogram

U.S. Air Force photo/Staff Sgt. Liliana Moreno

Nipple Aspirate Test No Substitute for Mammogram

The U.S. Food and Drug Administration

10:18

Do More Screening Tests Lead to Better Health? Choosing Wisely

DocMikeEvans/YouTube

1:41

New Guidelines for Mammograms

Lee Health/Vimeo

1:08

Mammogram questions | Mercy Health

Bon Secours Mercy Health/Vimeo

1:45

Getting Screened for Breast Cancer

Lee Health/Vimeo

Breast MRI Test

Breast MRI Test

Also called: Magnetic Resonance Imaging of the Breast, MRI - Breast, Breast MRI Scan, MRI Screening for Breast Cancer

Breast MRI (magnetic resonance imaging) is a kind of body scan that uses magnets and radio waves to take detailed pictures of areas inside the breast. A breast MRI may be used to look for breast cancer in women at high risk or to detect other abnormalities in the breast.

Breast MRI Test

Also called: Magnetic Resonance Imaging of the Breast, MRI - Breast, Breast MRI Scan, MRI Screening for Breast Cancer

Breast MRI (magnetic resonance imaging) is a kind of body scan that uses magnets and radio waves to take detailed pictures of areas inside the breast. A breast MRI may be used to look for breast cancer in women at high risk or to detect other abnormalities in the breast.

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Use the slider below to see how your results affect your health.
Your result is Normal.
MRI provides detailed pictures of the breast. It also provides clear pictures of parts of the breast that are hard to see clearly on an ultrasound or mammogram.
Related conditions
MRI may be used as a screening test for women who have a high risk of breast cancer. Factors that put women at high risk include the following:
- Certain gene changes, such as changes in the BRCA1 or BRCA2 genes.
- A family history (first degree relative, such as a mother, daughter or sister) with breast cancer.
- Certain genetic syndromes, such as Li-Fraumeni or Cowden syndrome.
Before your MRI exam, you will likely be asked to fill out a screening questionnaire. For your safety, answering the questionnaire accurately is extremely important. In particular, make sure you notify the MRI technologist or radiologist if you:
- Are pregnant
- Have metal or electronic devices in your body, such as a cardiac pacemaker or a metal artificial joint
- Have tattoos or drug patches as these can cause skin irritation or burns during the exam
1. https://www.cancer.gov/types/breast/patient/breast-screening-pdq [accessed on Feb 25, 2022]
2. https://medlineplus.gov/ency/article/007360.htm [accessed on Feb 25, 2022]
3. https://medlineplus.gov/ency/patientinstructions/000837.htm [accessed on Feb 25, 2022]
4. https://medlineplus.gov/mriscans.html [accessed on Feb 25, 2022]
5. https://www.nibib.nih.gov/science-education/science-topics/magnetic-resonance-imaging-mri [accessed on Feb 25, 2022]
6. https://www.fda.gov/radiation-emitting-products/mri-magnetic-resonance-imaging/what-patients-should-know-having-mri-exam [accessed on Feb 25, 2022]
7. https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/breast-mri-scans.html [accessed on Feb 25, 2022]
8. https://www.radiologyinfo.org/en/info/breastmr [accessed on Feb 25, 2022]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Breast Ultrasound

Breast Ultrasound

Also called: Breast Ultrasonography, Breast Sonogram, Ultrasound - Breast

A breast ultrasound is a noninvasive, painless, and risk-free imaging test in which an ultrasound machine is used to evaluate your breast tissue.

Breast Ultrasound

Also called: Breast Ultrasonography, Breast Sonogram, Ultrasound - Breast

A breast ultrasound is a noninvasive, painless, and risk-free imaging test in which an ultrasound machine is used to evaluate your breast tissue.

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Use the slider below to see how your results affect your health.
Your result is Normal.
A normal result means that no abnormalities or masses were found in your breast tissue.
Related conditions
Your doctor may want to order this test in the following situations:
- As the first test to examine young women (usually less than 35-year-old) who have breast symptoms, such as pain, lumps, or abnormal nipple discharge
- As a follow-up test if a clinical breast exam or mammogram has revealed an abnormality
- To evaluate breast tissue that is obscured by breast implants
- To evaluate breast tissue in pregnant women
- To guide the placement of a needle during breast biopsies
It is important to point out that a breast ultrasound is not usually done to screen for breast cancer because some early signs of cancer can be easily missed with this test.
A normal result means that no abnormalities or masses were found in your breast tissue.
An abnormal result indicates that a problem was detected, including but not limited to:
- Cysts, which are fluid-filled sacs
- Solid tumors, which can be cancerous or non-cancerous
- Fibroadenomas (non-cancerous solid growths)
- Lipomas (non-cancerous fatty tumors)
1. https://www.insideradiology.com.au/breast-ultrasound/ [accessed on Mar 12, 2019]
2. https://www.webmd.com/breast-cancer/breast-ultrasound [accessed on Mar 12, 2019]
3. https://www.hopkinsmedicine.org/healthlibrary/test_procedures/gynecology/breast_ultrasound_92,p07764 [accessed on Mar 12, 2019]
4. https://medlineplus.gov/ency/article/003379.htm [accessed on Feb 16, 2019]
5. https://ww5.komen.org/BreastCancer/Ultrasound.html [accessed on Feb 16, 2019]
6. https://www.health.ny.gov/diseases/cancer/breast/nys_breast_cancer_faqs.htm [accessed on Feb 16, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (7)

Diagnosing Breast Cancer

TheVisualMD

Tubular carcinoma of breast ultrasound

© Nevit Dilmen

Breast ultrasound

© Nevit Dilmen

Breast ultrasound

© Nevit Dilmen

Breast ultrasound

© Nevit Dilmen

Breast ultrasound

© Nevit Dilmen

Breast ultrasound

© Nevit Dilmen

Genetic Testing

Chances of Developing Breast Cancer by Age 70

Image by National Cancer Institute (NCI)

Genetic Testing for Hereditary Breast and Ovarian Cancer

Genetic testing is available for hereditary breast and ovarian cancer. Most breast and ovarian cancer is not caused by inherited mutations, so genetic testing will not help most women with a family health history of breast and ovarian cancer. Genetic testing will not identify the cause for some hereditary breast and ovarian cancers, because the genes affected in these cancers are not yet known.

Genetic counseling before genetic testing for hereditary breast and ovarian cancer is important to determine whether you and your family are likely enough to have a mutation that it is worth getting tested. Usually, genetic testing is recommended if you have:

A strong family health history of breast and ovarian cancer
A moderate family health history of breast and ovarian cancer and are of Ashkenazi Jewish or Eastern European ancestry
A personal history of breast cancer and meet certain criteria (related to age of diagnosis, type of cancer, presence of certain other cancers or cancer in both breasts, ancestry, and family health history)
A personal history of ovarian, fallopian tube, or primary peritoneal cancer
A known BRCA1, BRCA2, or other inherited mutation in your family

Genetic testing for hereditary breast and ovarian cancer looks for mutations in the BRCA1 and BRCA2 genes. Your doctor might suggest testing using a multigene panel, which looks for mutations in several genes at the same time, including BRCA1 and BRCA2. If you are of Ashkenazi Jewish or Eastern European ancestry, your doctor might suggest testing for three specific BRCA1 and BRCA2 mutations, called founder mutations. These are the most common mutations in people of Ashkenazi Jewish or Eastern European ancestry.

The BRCA1 and BRCA2 genes

The breast cancer 1(BRCA1) and breast cancer 2(BRCA2) genes are the genes most commonly affected in hereditary breast and ovarian cancer. Normally, the BRCA1 and BRCA2 genes protect you from getting certain cancers. But certain mutations in the BRCA1 and BRCA2 genes prevent them from working properly, so that if you inherit one of these mutations, you are more likely to get breast, ovarian, and other cancers. You and your family members are more likely to have a BRCA1 or BRCA2 mutation if your family has a strong history of breast or ovarian cancer. Because BRCA1 and BRCA2 mutations are inherited, family members with BRCA1 or BRCA2 mutations usually share the same mutation.

The genetic counselor can help you determine the best testing strategy for you and your family. Whenever possible, the first person tested in your family should be someone who has had breast, ovarian, or another BRCA-related cancer. If none of your family members who have had one of these cancers are available for genetic testing, then genetic testing can start with an unaffected person. However, the test results might not be as helpful.

Genetic counseling after genetic testing is important to help you understand your test results and decide the next steps for you and your family:

If you have a positive test result, the test showed that you have a mutation known to cause hereditary breast and ovarian cancer.
- What it means for you:
  - You can take steps to make it less likely that you will get cancer or to find cancer early if you do get it.
  - If you have already had breast or ovarian cancer, a positive test result can help guide your treatment decisions.
- What it means for your family:
  - If other family members decide to get genetic testing, their test should check for the same mutation you have.
  - Your parents, children, sisters, and brothers each have a 1 in 2 (50%) chance of having the same mutation.
If you have a negative test result, the test didn’t find a mutation. However, what this means for you depends on whether you have already had breast or ovarian cancer and whether another relative is known to have a mutation.
- If you have already had breast or ovarian cancer:
  - What it means for you:
    - A negative result means that the test did not find a mutation that caused your cancer.
    - Further testing might be available.
  - What it means for your family:
    - The breast and ovarian cancer in your family is less likely to be due to an inherited mutation, unless another relative is known to have a mutation.
    - Genetic testing in your family members who have not had breast or ovarian cancer is unlikely to be helpful, unless another relative is known to have a mutation.
    - In some cases testing might still be helpful for another family member who has had breast or ovarian cancer. This is because it is still possible that there is an inherited mutation in your family, but you did not inherit it.
- If you have not had breast or ovarian cancer:
  - What it means for you:
    - If a mutation has not already been found in another family member:
      - A negative test result is considered uninformative because the result could mean that:
        The breast and ovarian cancers in your family are caused by one of the mutations included in the genetic test but you did not inherit the mutation.
        OR
        The breast and ovarian cancers in your family were not caused by a mutation that was included in the genetic test.
    - - You are still considered at increased risk for the cancers that run in your family. The level of risk, appropriate screening and prevention options, and need for additional genetic testing will vary for each person and each family.
  - - If a mutation has already been found in another family member and the test showed you do not have the mutation:
      - You are not at higher risk than the average person for breast or ovarian cancer. You also cannot pass the mutation on to your children.
If you have a variant of uncertain significance (VUS) result, the test found a mutation in one of the genes associated with hereditary breast and ovarian cancer, but whether that specific mutation causes cancer is unknown. Some mutations prevent genes from working properly, while others have no effect. It is not always easy to tell whether or not a mutation in a gene has a harmful effect.
- What it means for you:
  - If you have already had breast or ovarian cancer, it is unclear whether the mutation found in the test caused your cancer. Further testing might be available.
  - Whether or not you have already had breast or ovarian cancer, you are still considered at increased risk for the cancers that run in your family. The level of risk, appropriate screening and prevention options, and need for additional genetic testing will vary for each person and each family.

Having a strong family health history of breast and ovarian cancer does not mean that you definitely have an inherited mutation. In fact, most women identified as being at increased risk for BRCA1 and BRCA2 mutations based on family health history do not have BRCA1 or BRCA2 mutations.

Using family health history information will not find everyone with BRCA1 or BRCA2 mutations. Not everyone with a BRCA1 or BRCA2 mutation has a strong family health history of breast and ovarian cancer. Some even have no known family health history of breast and ovarian cancer.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (4)

BRCA-1 and BRCA-2 Genes, Breast Cancer

More than 225,000 cases of invasive breast cancer are diagnosed annually in the U.S. and 40,000 die from the disease. In recent years, however, great strides have been made in early diagnosis and treatment. Imaging techniques have been refined to spot ever-tinier tumors, biomarkers have been developed to reflect physiological changes produced by cancer, and genetic tests such as those for the BRCA1 and BRCA2 genes have been devised to identify increased familial risk of breast cancer. The majority of breast cancers start in the mammary ducts; most of the remainder arise in the lobules. Breast cancers are divided into in situ and invasive cancers. In situ cancers remain confined to the duct or gland where they began. Invasive cancers break through the walls of the duct or gland and penetrate into the surrounding tissue.

Image by TheVisualMD

BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA.

The breast cancer susceptibility genes BRCA-1 and BRCA-2 normally help prevent cancer by repairing damaged DNA. Certain inherited mutations in these genes, however, can impair this function and result in a greatly increased risk of breast cancer or ovarian cancer (there are hundreds of different BRCA mutations, but are very rare or not linked with an increased risk of cancer). Of 200,000 women diagnosed each year with breast cancer and 20,000 diagnosed with ovarian cancer, 5-10% are due to BRCA mutations.

Image by TheVisualMD

This browser does not support the video element.

Breast Cancer Screening & Diagnosis

Breast cancer is one of the most common cancers among women in the U.S., with about 1 in 8 women developing the disease within her lifetime. Breast cancer is an uncontrolled growth of breast cells that has the potential to spread into the breast and possibly to other parts of the body. Early detection through screening saves the lives of thousands of women every year. If there is a history of breast cancer in the family, women should consider the BReast CAncer susceptibility test (or BRCA) to identify a gene that may indicate an increased risk of developing the disease. Women forty and over should be screened for abnormalities yearly to detect and evaluate changes in breast tissue. If an abnormality is found, a biopsy and pathological exam are necessary for a definitive diagnosis and prognosis. After diagnosis, your doctor may want to learn more about your specific cancer through immunohistochemistry (IHC) and HER2 protein tests. IHC testing can help determine if a specific abnormality is present in the cancer cells. HER2 tests can tell your physician if the breast cancer is turned on by the HER2 gene, and can help determine the best course of treatment. Knowing what type of breast cancer is involved, what stage the cancer is, and the characteristics of that specific cancer, allows a woman's physician to determine best possible therapy for her individual case.

Video by TheVisualMD

BRCA Genes and Breast Cancer

Video by Centers for Disease Control and Prevention (CDC)/YouTube

BRCA-1 and BRCA-2 Genes, Breast Cancer

TheVisualMD

BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA.

TheVisualMD

4:57

Breast Cancer Screening & Diagnosis

TheVisualMD

3:12

BRCA Genes and Breast Cancer

Centers for Disease Control and Prevention (CDC)/YouTube

BRCA Genetic Test

BRCA Genetic Test

Also called: BRCA Gene Mutation Analysis, BRCA1/2 Testing, BRCA Mutation Testing, BRCA Test, Breast Cancer Susceptibility Genes 1 and 2, Germline BRCA Testing

A BRCA gene test checks for certain changes (mutations) in your BRCA genes. BRCA1 and BRCA2 are called tumor suppressor genes. Certain BRCA mutations may put you at higher risk for getting breast, ovarian, prostate, and other cancers. Not everyone who has a harmful BRCA mutation will get cancer.

BRCA Genetic Test

Also called: BRCA Gene Mutation Analysis, BRCA1/2 Testing, BRCA Mutation Testing, BRCA Test, Breast Cancer Susceptibility Genes 1 and 2, Germline BRCA Testing

A BRCA gene test checks for certain changes (mutations) in your BRCA genes. BRCA1 and BRCA2 are called tumor suppressor genes. Certain BRCA mutations may put you at higher risk for getting breast, ovarian, prostate, and other cancers. Not everyone who has a harmful BRCA mutation will get cancer.

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Use the slider below to see how your results affect your health.
Your result is Negative.
A negative (normal) result means that the test didn't find any harmful changes in your BRCA genes. How this affects your cancer risk depends on whether you've already had cancer and whether a member of your family has a harmful BRCA variant.
Related conditions
A BRCA gene test uses a sample of your blood, saliva (spit), or cells from inside of your cheek to look for changes in your BRCA1 and BRCA2 genes that may increase your risk of cancer. Changes in your genes are called gene variants or mutations. Not all gene variants are harmful.
Genes are parts of DNA that you inherit from your parents. They carry information that controls what you look like and how your body works. BRCA genes repair damaged DNA in your cells and protect you from getting certain types of cancer. If you have a harmful variant in your BRCA genes, they may not work properly. This increases your risk of getting cancer.
The most common cancers linked to harmful BRCA variants are:
- Breast cancer. BRCA is short for breast cancer gene. The increased risk for breast cancer mostly affects females. But the breast cancer risk for males who have a harmful BRCA variant is higher than for other males.
- Ovarian cancer. This is cancer of the female reproductive glands where eggs form.
- Prostate cancer. This is cancer of the male reproductive gland that makes fluid for semen.
- Pancreatic cancer. This is cancer of the pancreas, an organ that helps you digest food and makes important hormones.
Not everyone who has a harmful variant in BRCA1 or BRCA2 will get cancer. And if you find out you have a harmful variant, you may be able to take steps to lower your risk and protect your health.
Harmful BRCA gene variants are rare. They affect only about 0.2 percent of the U.S. population. So, BRCA testing is not recommended for most people.
You and your family members are more likely to have a BRCA1 or BRCA2 variant if either side of your family has a strong history of breast or ovarian cancer. If you're concerned that you may have a harmful variant in the BRCA1 or BRCA2 gene, your health care provider or a genetic counselor can review your personal and family health history to see if you need this test.
In general, it's important to talk with a provider about BRCA testing if your personal or family health history includes:
- Breast cancer, especially:
  Before age 50
  In both breasts
  In a male
  Triple negative breast cancer which has limited treatment options, including chemotherapy and/or surgery
- Cancer of the ovaries, fallopian tubes (tubes connecting the ovaries to the uterus), or peritoneum (tissue that covers your belly organs).
- Prostate cancer that spreads to other parts of the body (metastatic cancer).
- Pancreatic cancer.
- Ashkenazi (Eastern European) Jewish ancestry. BRCA variants are much more common in this group compared with the general population. They are also more common in people from other parts of Europe, including Iceland, Norway, and Denmark.
- A relative already diagnosed with a harmful gene variant in BRCA1 or BRCA2.
When you think about your family health history, consider all breast, ovarian, prostate, and pancreatic cancers on both sides of your family. And consider the health of your grandparents, parents, aunts and uncles, siblings, half-siblings, nieces and nephews, and grandchildren.
Your provider or genetic counselor will need to explain how your results affect your risk for certain cancers. That's because the meaning of your test results depends on the exact type of variant you have and your personal and family health history.
In general, your results may be reported using these terms:
- A negative (normal) result means that the test didn't find any harmful changes in your BRCA genes. How this affects your cancer risk depends on whether you've already had cancer and whether a member of your family has a harmful BRCA variant.
- An uncertain result may also be called a "variant of uncertain significance (VUS)". It means that a variant in your BRCA genes was found, but researchers don't know whether that variant causes cancer.
- A positive result may also be called a "likely pathogenic variant." It means that you have a harmful gene variant that is known to increase the risk of certain cancers. But the test cannot tell whether you will develop cancer.
If your results show that you have a harmful variant in your BRCA genes, talk with your provider about ways to lower your cancer risk. You may discuss:
- Your schedule for cancer screening tests. Should you get tested for cancer sooner and more often than usual? These are important questions for all adults who have a harmful BRCA variant.
- Taking certain medicines and/or having surgery to reduce the risk of cancer. Surgery may include removing both breasts and/or the ovaries and fallopian tubes.
1. BRCA Genetic Test: MedlinePlus Medical Test [accessed on Dec 26, 2023]
2. BRCA Mutations: Cancer Risk and Genetic Testing Fact Sheet - National Cancer Institute [accessed on Dec 26, 2023]
3. BRCAssure BRCA1 and 2 Analysis [accessed on Dec 26, 2023]
4. BRCA Gene Mutation Testing - Testing.com. Nov 9, 2021 [accessed on Dec 26, 2023]
5. BRCA1 and BRCA2 gene testing: MedlinePlus Medical Encyclopedia [accessed on Dec 26, 2023]

Additional Materials (13)

Chances of Developing Breast Cancer by Age 70

Specific inherited mutations in the BRCA1 and BRCA2 genes increase the risk of breast and ovarian cancers.

Image by National Cancer Institute (NCI)

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BRCA-1 and BRCA-2 Genes, Breast Examination

Mammograms use low-dose X-rays to create images of the breast on film. Screening mammograms typically image the breast from above and from an angled side view. Yearly mammograms are recommended for women 40 and over. Women at high risk should have an MRI scan and a mammogram every year, beginning at age 30. Mammograms can also be used for diagnosis of cancer and to guide biopsy of suspicious lesions. The National Cancer Institute estimates that women with certain mutations in the BRCA1 and BRCA2 genes have a 60% lifetime risk of breast cancer, which is five times higher than the general population. Only 0.2% of women have these specific mutations. Women who test negative for high-risk mutations in the BRCA1 and BRCA2 genes still have a 12% lifetime risk of breast cancer and a 1.4% lifetime risk of ovarian cancer, which means the most of these cancers are caused by factors other than BRCA genes.

Image by TheVisualMD

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Breast Self-Exam (BSE)

When done correctly and regularly, breast self-exam (BSE) can help save lives. Women who perform BSE are more likely to be diagnosed with smaller tumors, and cancer is less likely to have spread to their underarm lymph nodes. An important part of BSE is self-awareness. Women should be aware of what their breasts normally feel and look like so that they notice any change, and they should bring that change to the attention of their doctor immediately.

Image by TheVisualMD

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BRCA: Breasts

In the 1990s, researchers discovered that certain inherited mutations of the genes increased a woman's risk of developing breast or ovarian cancer. But genes are not destiny; early detection, preventive surgery and drug therapies can also play roles.

Image by TheVisualMD

What is a BRCA Gene Mutation?

Video by Centers for Disease Control and Prevention (CDC)/YouTube

BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer

Video by JAMA Network/YouTube

BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer

Video by TheJAMAReport/YouTube

BRCA Genes and Breast Cancer

Video by Centers for Disease Control and Prevention (CDC)/YouTube

Understanding BRCA Mutations and Risk

Video by Dr. Susan Love Foundation/YouTube

BRCA Genes

The BRCA genes are tumor suppressor genes pictured here on their respective chromosomes. BRCA 1 has the cytogenetic location 17q21 or the q arm of Chromosome 17 at position 21. BRCA 2 has the cytogenetic location 13q12.3 or the q arm of Chromosome 13 at position 12.3. Both genes produce proteins that help repair damaged DNA, keeping the genetic material of the cell stable. A damaged BRCA gene in either location can lead to increased risk of cancer, particularly breast or ovarian in women.

Image by Tessssa13/Wikimedia

BRCA-1 and BRCA-2 Genes, Breast Cancer

More than 225,000 cases of invasive breast cancer are diagnosed annually in the U.S. and 40,000 die from the disease. In recent years, however, great strides have been made in early diagnosis and treatment. Imaging techniques have been refined to spot ever-tinier tumors, biomarkers have been developed to reflect physiological changes produced by cancer, and genetic tests such as those for the BRCA1 and BRCA2 genes have been devised to identify increased familial risk of breast cancer. The majority of breast cancers start in the mammary ducts; most of the remainder arise in the lobules. Breast cancers are divided into in situ and invasive cancers. In situ cancers remain confined to the duct or gland where they began. Invasive cancers break through the walls of the duct or gland and penetrate into the surrounding tissue.

Image by TheVisualMD

BRCA1 and BRCA2 gene mutations: autosomal dominant (AD) inheritance pattern

In hereditary breast cancer, the way that cancer risk is inherited depends on the gene involved. For example, mutations in the BRCA1 and BRCA2 genes are inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to increase a person's chance of developing cancer. Although breast cancer is more common in women than in men, the mutated gene can be inherited from either the mother or the father.

Image by YassineMrabet / NIH

BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA.

The breast cancer susceptibility genes BRCA-1 and BRCA-2 normally help prevent cancer by repairing damaged DNA. Certain inherited mutations in these genes, however, can impair this function and result in a greatly increased risk of breast cancer or ovarian cancer (there are hundreds of different BRCA mutations, but are very rare or not linked with an increased risk of cancer). Of 200,000 women diagnosed each year with breast cancer and 20,000 diagnosed with ovarian cancer, 5-10% are due to BRCA mutations.

Image by TheVisualMD

Chances of Developing Breast Cancer by Age 70

National Cancer Institute (NCI)

Sensitive content

This media may include sensitive content

BRCA-1 and BRCA-2 Genes, Breast Examination

TheVisualMD

Sensitive content

This media may include sensitive content

Breast Self-Exam (BSE)

TheVisualMD

Sensitive content

This media may include sensitive content

BRCA: Breasts

TheVisualMD

1:28

What is a BRCA Gene Mutation?

Centers for Disease Control and Prevention (CDC)/YouTube

4:39

BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer

JAMA Network/YouTube

2:20

BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer

TheJAMAReport/YouTube

3:12

BRCA Genes and Breast Cancer

Centers for Disease Control and Prevention (CDC)/YouTube

3:52

Understanding BRCA Mutations and Risk

Dr. Susan Love Foundation/YouTube

BRCA Genes

Tessssa13/Wikimedia

BRCA-1 and BRCA-2 Genes, Breast Cancer

TheVisualMD

BRCA1 and BRCA2 gene mutations: autosomal dominant (AD) inheritance pattern

YassineMrabet / NIH

BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA.

TheVisualMD

Self-Testing

23andMe DNA test

Image by Veverve

Taking a Genetic Test on Your Own: What You Need to Know

Have you heard about people taking a genetic test on their own and learning about genetic mutations that may raise their risk for breast cancer? This type of test, called a direct-to-consumer genetic test, can be taken at home. It can tell you about your ancestry and genetic traits, including limited information about your risk for diseases like breast cancer.

It’s important to know that this type of test may not give you a full understanding of your breast cancer risk, especially if breast cancer runs in your family.

What You Need To Know

For most women, a direct-to-consumer genetic test may not find if you have a higher risk for breast cancer.

The direct-to-consumer genetic test approved by the Food and Drug Administration (FDA) looks for 3—out of more than 1,000—BRCA gene mutations that can increase your risk for breast cancer.

Direct-to-consumer genetic tests do not take into account non-BRCA gene mutations or non-genetic factors that can increase breast cancer risk.

What To Do

If You Are Considering Taking a Test

A direct-to-consumer genetic test may not give you a complete understanding of your breast cancer risk, especially if breast cancer runs in your family. If you think you may be at higher risk for breast cancer, it is best to work with a doctor or genetic counselor who can assess your risk, interpret your results, and build an action plan.

Action Steps to Understand and Manage Your Breast Cancer Risk

Find out if any close relatives on either your mother’s or father’s side have had breast cancer, especially before age 45, or ovarian cancer at any age.
Tell your doctor about your family history.
Ask your doctor if you are at high risk because of your family history.
Ask your doctor about working with a genetic counselor to assess your genetic risk and build an action plan.
Practice healthy behaviors to lower your risk, like keeping a healthy weight and being physically active.

If You Tested Negative for a BRCA Mutation

A negative result on a direct-to-consumer genetic test does not rule out the possibility that you carry other genetic mutations that increase your risk, including other BRCA genetic mutations not found by the test you took. If you have a family history of breast cancer, do not rely on a direct-to-consumer genetic test to assess your risk. Talk to your doctor about your results and what to do next.

Action Steps to Understand and Manage Your Breast Cancer Risk

Find out if any close relatives on either your mother’s or father’s side have had breast cancer, especially before age 45, or ovarian cancer at any age.
Tell your doctor about your family history.
Ask your doctor if you are at high risk because of your family history.
Tell your doctor about your negative test result.
Ask your doctor about working with a genetic counselor to accurately assess your genetic risk and build an action plan.
Practice healthy behaviors to lower your risk, like keeping a healthy weight and being physically active.

If You Tested Positive for a BRCA Mutation

Discuss your test results with your doctor so that he or she can refer you for genetic counseling and you can create an action plan to manage your risk.

Action Steps to Understand and Manage Your Breast Cancer Risk

Find out if any close relatives on either your mother’s or father’s side have had breast cancer, especially before age 45, or ovarian cancer at any age.
Tell your doctor about your family history.
Tell your doctor you tested positive for a BRCA mutation.
Ask your doctor what your results mean and to refer you to a genetic counselor to confirm your test results and build an action plan.
Ask your doctor about working with a genetic counselor to assess your genetic risk and build an action plan.

If You’ve Taken a Test, but Haven’t Looked at the Results

If you are scared or worried, take your test results to your doctor, who is better able to assess your breast cancer risk. Remember that a direct-to-consumer genetic test may not give you a complete understanding of your breast cancer risk, especially if it runs in your family.

Action Steps

Find out if any close relatives on either your mother’s or father’s side have had breast cancer, especially before age 45, or ovarian cancer at any age.
Tell your doctor about your family history.
Take your results to your doctor, who can help you read them and understand what they mean.
Ask your doctor if you need to work with a genetic counselor to accurately assess your genetic risk and build an action plan.
Practice healthy behaviors to lower your risk, like keeping a healthy weight and being physically active.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (3)

BRCA PARP twohit

Hassan142/Wikimedia

7:14

Assessing Direct-to-Consumer Genetic Testing

Mayo Clinic Laboratories/YouTube

2:31

Direct to Consumer Genetic Testing and Genetic Counselling

WCSethics/YouTube

Treatment

Treating Cancer

Image by TheVisualMD

How Is Breast Cancer Treated?

Breast cancer is treated in several ways. It depends on the kind of breast cancer and how far it has spread. People with breast cancer often get more than one kind of treatment.

Surgery. An operation where doctors cut out cancer tissue.
Chemotherapy. Using special medicines to shrink or kill the cancer cells. The drugs can be pills you take or medicines given in your veins, or sometimes both.
Hormonal therapy. Blocks cancer cells from getting the hormones they need to grow.
Biological therapy. Works with your body’s immune system to help it fight cancer cells or to control side effects from other cancer treatments.
Radiation therapy. Using high-energy rays (similar to X-rays) to kill the cancer cells.

Doctors from different specialties often work together to treat breast cancer. Surgeons are doctors who perform operations. Medical oncologists are doctors who treat cancer with medicine. Radiation oncologists are doctors who treat cancer with radiation.

Clinical Trials

Clinical trials use new treatment options to see if they are safe and effective. If you have cancer, you may want to take part.

Complementary and Alternative Medicine

Complementary and alternative medicine are medicines and health practices that are not standard cancer treatments. Complementary medicine is used in addition to standard treatments, and alternative medicine is used instead of standard treatments. Meditation, yoga, and supplements like vitamins and herbs are some examples.

Many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. Talk to your doctor about the risks and benefits before you start any kind of complementary or alternative medicine.

Which Treatment Is Right for Me?

Choosing the treatment that is right for you may be hard. Talk to your cancer doctor about the treatment options available for your type and stage of cancer. Your doctor can explain the risks and benefits of each treatment and their side effects. Side effects are how your body reacts to drugs or other treatments.

Sometimes people get an opinion from more than one cancer doctor. This is called a “second opinion.” Getting a second opinion may help you choose the treatment that is right for you.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (10)

Treatment - Image-Guided Radiation Therapy (IGRT) for Breast Cancer

Image-Guided Radiation Therapy (IGRT)

Image by TheVisualMD

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Treatment

Image-Guided Radiation Therapy (IGRT)

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Tracey's Battle with Breast Cancer

U.S. Air Force Master Sgt. Tracey Drake, 60th Medical Operations Squadron undergoes chemotherapy for her treatment for breast cancer, Travis Air Force Base, Calif., Dec. 13, 2016. Drake was diagnosed with metastatic breast cancer during her retirement physical in July 2016, 3 weeks before starting terminal leave. Drake faces more chemotherapy, surgery, radiation, targeted infusion, and reconstruction surgery.

Image by U.S. Air Force/Louis Briscese

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Breast Cancer Surgery

Breast surgeon Dr. Nora Jaskowiak of The University of Chicago Medical Center explains how far mastectomies and other breast surgeries have come and the impact on the patient's life.

Image by TheVisualMD

Radiation for Breast Cancer

Radiation therapy is a common treatment for breast cancer. Here, breast surgeon Dr. Nora Jaskowiak explains standard prescription of radiation therapy in conjunction with lumpectomy surgery. Then dosimetrist Carla Rash walks you through part of a high-tech radiation treatment planning session. A dosimetrist is a member of the radiation oncology team who specializes in the physics behind radiation therapy treatment.

Image by TheVisualMD

Breast Cancer Treatment Regimen graph

A breast cancer treatment-regimen graph documenting one woman's medical treatment for breast cancer. The total duration of treatment was 8 months, 16 days. The first step in the treatment was contrast dye injection, followed by the initial surgery (December 13, 2007). Different parts of the treatment regimen, including chemotherapy and radiation therapy, are shown, along with their dates and duration. Therapy was completed on August 28, 2008, with the last radiation session. The patient was cured of cancer.

Image by TheVisualMD

If You Have Breast Cancer Watch This

Video by Doctorpedia/YouTube

Lumpectomy & Mastectomy for Treating Breast Cancer - SLUCare Breast Surgery

Video by SLUCare/YouTube

Hormonal Therapy for Breast Cancer: We Teach You

Video by Breast Cancer School for Patients/YouTube

Breast Cancer Surgery Lumpectomy Mastectomy Breast Cancer Care Manipal H Full HD

Video by Regnald Msangi/YouTube

Treatment - Image-Guided Radiation Therapy (IGRT) for Breast Cancer

TheVisualMD

Sensitive content

This media may include sensitive content

Treatment

TheVisualMD

Tracey's Battle with Breast Cancer

U.S. Air Force/Louis Briscese

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This media may include sensitive content

Breast Cancer Surgery

TheVisualMD

Radiation for Breast Cancer

TheVisualMD

Breast Cancer Treatment Regimen graph

TheVisualMD

1:17

If You Have Breast Cancer Watch This

Doctorpedia/YouTube

1:48

Lumpectomy & Mastectomy for Treating Breast Cancer - SLUCare Breast Surgery

SLUCare/YouTube

13:39

Hormonal Therapy for Breast Cancer: We Teach You

Breast Cancer School for Patients/YouTube

4:02

Breast Cancer Surgery Lumpectomy Mastectomy Breast Cancer Care Manipal H Full HD

Regnald Msangi/YouTube

Learn Your Family History

Possible inheritance of breast and ovarian cancer in a family

Image by Huijts, thanks to the initial pedigree made by Rozzychan

Learn Your Family History of Breast and Ovarian Cancer

Learning your family history of cancer, from both your mother’s and father’s sides, can help you know if you have a higher risk for getting breast or ovarian cancer at a young age.

Asking your relatives about their cancer histories can be hard. Here are some tips for talking with your family about this topic—

Explain that you are trying to create a record of your family’s history of cancer to protect your health.
Share that you have learned that breast and ovarian cancers can run in families. Women who know they have a family history of these cancers can do things to lower their risk.
Invite your family members to respond in a way and at a time that is most comfortable to them.
Word your questions carefully, be a good listener, and respect the privacy of others. Begin by asking your family members what they know about cancer in the family in general, and ask personal health questions later. Understand that some relatives may not want to share health information with you or they may not want you to pass on the information to others.
Write down what you learn.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (3)

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Centers for Disease Control and Prevention (CDC)/YouTube

2:12

The Role of Family History in Breast Cancer

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0:52

What Should I Know About My Family History of Breast Cancer?

Centers for Disease Control and Prevention (CDC)/YouTube

Genetic Testing

BRCA Genes

Image by Tessssa13/Wikimedia

Genetic Testing for BRCA Gene Mutations

Genetic testing is done with a blood or saliva sample. The sample is taken in a laboratory, doctor’s office, hospital, or clinic and sent to a laboratory that does the tests. It usually takes several weeks or longer to get the test results. Genetic testing can be helpful regardless of the result, but is most informative if a family member affected by cancer is tested first, if possible.

If you are tested for a known BRCA1 or BRCA2 gene mutation that runs in your family, a negative BRCA1 or BRCA2 test result may give you a sense of relief, since special screening, tests, or surgeries may not be needed. However, even if you test negative for a BRCA1 or BRCA2 gene mutation, you can still get breast or ovarian cancer. A genetics counselor can help you understand if you need further tests.
A positive BRCA1 or BRCA2 test result helps you better understand your personal risk of getting breast and ovarian cancers better. You can make choices about what to do to reduce your risk and about what screening is right for you. A positive test result does not mean you will definitely get breast or ovarian cancer, but it can help you and your provider make a plan to manage your risk.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (4)

8:31

BRCA1 & BRCA2 Genetic Testing Panel Overview | Ambry Genetics

Ambry Genetics/YouTube

0:45

How Does The Genetic Testing Process Work? Genetic Testing FAQ | Ambry Genetics

Ambry Genetics/YouTube

2:10

MedGenome BRCA - Breast Cancer Genetic Testing

MedGenome/YouTube

1:57

Genetic Counselor at Sanford Health Explains the Benefits to Genetic Testing

Sanford Health/YouTube

Genetic Counseling

Genetic counseling session

Image by United States National Institutes for Health, Center for Hearing and Communication Disorders

Genetic Counseling for BRCA Gene Mutations

Genetic counseling, from a health care provider trained in this specialty, is recommended before and after a genetic test. A genetic counselor usually will conduct risk assessments based on your personal and family medical history. He or she will then talk to you about things like—

If a genetic test is right for you.
The specific tests that might be used and the accuracy of these tests.
What happens if you have a positive or a negative test result.
The possibility that a test result might not give you all the information you need.
The emotional risks and benefits of genetic test results.
How genetic test results may affect other members of your family.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (5)

4:29

Early Onset Breast Cancer: Talking to Your Doctor and Genetic Counseling

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4:36

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AAMCNews/YouTube

1:24

Veritas FAQ: What is genetic counseling? And do I need it?

Veritas Genetics/YouTube

2:12

Why is genetic counseling important?

Michigan Medicine/YouTube

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Oncology genetic counseling and testing

AAMCNews/YouTube

Practice Healthy Behaviors

female patient filling our forms with male doctor in background

Image by NIMH Image Library

Practice Healthy Behaviors to Lower Your Risk of Getting Breast Cancer at a Young Age

While you cannot control your family health history, making healthy lifestyle choices like keeping a healthy weight, getting enough physical activity, and breastfeeding your babies can help you lower your risk of getting breast cancer.

You also can raise the chance of finding breast cancer early, when it’s easier to treat—

Know how your breasts normally look and feel. Talk to your health care provider right away if you notice changes in the size or shape of your breast, pain, nipple discharge, or other symptoms.
Talk to your doctor if you have a higher risk. If you have a family history of breast or ovarian cancer or other risk factors, you should talk to your doctor about ways to manage your risk.

Source: Centers for Disease Control and Prevention (CDC)

Additional Materials (5)

14:21

Why young women should learn how to do a breast self-exam | Betsy Nilan | TEDxHartford

TEDx Talks/YouTube

4:01

African American women reduce risk of breast cancer by breastfeeding

Roswell Park Comprehensive Cancer Center/YouTube

3:41

Breast Self Examination

Fortis Healthcare/YouTube

1:51

Self Breast Exam

Everyday Health/YouTube

2:50

How to Perform a Breast Self-Exam presented by City of Hope & The Pink Patch Project

City of Hope/YouTube

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