Breast awareness and screening

A new breast or chest change needs checking even if your last mammogram was recent. Do not wait for your next screening invitation to discuss symptoms with your doctor, even if you have already been screened.

Look, feel and notice changes

Breast awareness means becoming familiar with how your breasts or chest look and feel, so you can notice a change. Their appearance and feel can vary across the menstrual cycle, during pregnancy or breastfeeding, and after menopause.

Look in a mirror with your arms down, then raised. Feel around each breast or side of your chest, up towards the collarbone and into the armpits, using light and firmer pressure without pressing hard enough to hurt. Include the nipples. The aim is to get familiar with how the area looks and feels.

Changes to get checked include a lump or swelling, skin dimpling, redness, a change in breast shape, a nipple turning inwards or a nipple rash. Nipple discharge when you are not pregnant or breastfeeding also needs attention. Redness can be harder to see on black or brown skin.

What a mammogram can and cannot do

A mammogram is an X-ray of the breasts. Screening can find cancer before you have noticed symptoms, including a cancer too small to see or feel. Screening is your choice; ask the service to explain its benefits and possible harms before deciding.

Mammograms can miss cancer. Screening can also find cancers that would never have become life-threatening, leading to treatment that would otherwise not have been needed. Weigh these limitations alongside the benefit of finding cancer earlier.

The screening schedule depends on where you live

UK and US advice differs. These are routine screening schedules, not a timetable for assessing a new symptom.

Programme	Routine invitation or recommendation
NHS	From 50 up to your 71st birthday, every 3 years. The first invitation is between 50 and 53.
US Preventive Services Task Force	Mammograms every 2 years from 40 to 74.

On the NHS, people aged 71 or over can ask their local breast screening service for screening every 3 years, although invitations stop. If you are trans or non-binary, ask your GP surgery about invitations and eligibility.

Dense breasts and family history

Breast density describes the balance of glandular, connective and fatty tissue seen on a mammogram. You cannot tell by touch. A radiologist assesses it from the image. Dense tissue contains relatively more glandular and connective tissue and less fat.

Dense breasts are associated with a higher chance of breast cancer and can make it harder to see on a mammogram. The USPSTF says there is not enough evidence to recommend for or against extra ultrasound or MRI screening for dense breasts. Ask your clinician whether an extra scan would be useful for you.

Tell your clinician about close relatives with breast or ovarian cancer and any known inherited gene change. The NHS may offer earlier or more frequent screening, or MRI, after specialist assessment. The routine USPSTF schedule does not cover certain high-risk histories, such as a known high-risk gene change or previous breast cancer.

Booking help for a change

Book a GP appointment in the UK, or see your doctor in the US or elsewhere, for a lump, nipple changes or breast or armpit pain that does not go away. Mention when you first noticed it and whether it has changed. Get it checked even if a recent screening appointment found nothing to follow up.

You could start with: “I have noticed a change here, and I would like it examined.” Bring any screening letters and family-history details you already have. Ask what happens next and who to contact while you wait.