Breast Self-Exams Are No Longer Recommended — Here’s What to Do Instead

Many women believe in the importance of doing monthly self-exams of their breasts. Yet 15 years ago, the American Cancer Society recommended against teaching self-breast exams.

Anna Weiss, MD, Wilmot Cancer Institute’s director of the Comprehensive Breast Care Center at Pluta, explains why the guidelines changed and how to best screen for breast cancer now.

Why are self-breast exams no longer recommended?

To make a recommendation for the public, the American Cancer Society looks at:

• Prevalence of the disease
• Expense of screening
• Effectiveness of screening

Weiss explains, “To create a screening guideline, something has to be common enough that you want or need to screen for it, the screening should be relatively inexpensive, and the screening should work. Self-exams don’t work.”

One reason is that self-breast exams can give people a false sense of security. If you’re confident that your self-exams aren’t showing anything concerning, you may be less likely to schedule a mammogram or an annual exam with a primary care provider or OBGYN.

The opposite is also true—and also a problem. When self-exams were widely recommended, they led to more imaging and procedures than were necessary. People thought that they felt something abnormal and scheduled unnecessary appointments out of panic.

Still, it’s important to know your body, Weiss emphasizes.

This doesn’t mean you should never touch your breasts. If you notice anything unusual, it’s important to reach out to a provider. But you don’t have to formally examine every quadrant of each breast in the shower every month."

What screening is recommended instead of self-exams?

Mammograms are the most effective way to screen for breast cancer. Starting at the age of 40, women with average risk of developing breast cancer should receive a mammogram every other year. This recommendation was issued officially in April 2024 by the U.S. Preventive Services Task Force (USPSTF), lowering the recommended age when individuals should receive routine screening mammograms from 50 to 40.

Women should also have a breast exam performed by a health care provider annually. During a breast exam, your doctor will look for anything inconsistent, such as:

• Skin puckering

• Fixed masses

• Masses with irregular borders

• Nipple discharge

• Skin rashes

Annual exams are especially important because breast cancer can strike at any age. It can also occur while pregnant or breastfeeding.

“Breast cancer can happen for many reasons,” Weiss says. “It’s not only older people or people with inherited gene mutations who get it.”

If you have a family history of breast cancer, you do have a higher risk of developing it. Certain types of exposures can also increase risk, such as:

• Toxins/exposures

• Smoking

• Obesity

• Heavy alcohol use

Can men get breast cancer?

Yes. It is much less common, but they can. One in 8 women get breast cancer, while one in 1,200 men get it. Men have breast tissue just like women, but they have less of it. Men often are diagnosed with breast cancer later than women because they don’t think they can get it so they might not seek care immediately.

Genetic testing is important for men as well as women. There are genetic conditions that can cause multiple organs to be at risk for cancer. Men can have those conditions, and they can also inherit them and pass the genes onto their daughters or sons.

Is there anything I can do on my own?

It is very important that you schedule regular exams and screening mammograms with a health care provider. You should also try to maintain a healthy lifestyle.

Many post-menopausal breast cancers can be prevented by following these guidelines:

• 75 minutes of vigorous or 150 minutes of moderate exercise each week
• No more than three to five alcoholic drinks per week on average
• Follow a Mediterranean diet (veggies, fruits, healthy fats, and whole grains)