Breast awareness and screening

A new change in your breast or chest needs checking, even if you had a mammogram recently. Don’t wait for your next screening invite to talk to your doctor about symptoms, even if you’ve already been screened.

Look, feel and notice changes

Breast awareness means getting to know how your breasts or chest normally look and feel, so you can spot a change. How they look and feel can vary through your menstrual cycle, during pregnancy or breastfeeding, and after menopause.

Look in a mirror with your arms down, then with them raised. Feel around each breast or side of your chest, up to your collarbone and into your armpits. Use light and then firmer pressure, but don’t press hard enough to hurt. Include your nipples. The aim is to get to know how the area looks and feels.

Changes to get checked include a lump or swelling, dimpled skin, redness, a change in breast shape, a nipple that turns inwards, or a rash on the nipple. Fluid from the nipple when you’re not pregnant or breastfeeding also needs checking. 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’ve noticed any symptoms, including cancer too small to see or feel. Screening is your choice. Ask the service to explain the benefits and possible harms before you decide.

Mammograms can miss cancer. Screening can also find cancers that would never have become life-threatening. This can lead to treatment that wouldn’t otherwise have been needed. Weigh up these limits alongside the benefit of finding cancer earlier.

The screening schedule depends on where you live

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

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

With the NHS, invites stop at this age. But if you’re 71 or over, you can still ask your local breast screening service for screening every 3 years. If you’re trans or non-binary, ask your GP surgery about invites and whether you’re eligible.

Dense breasts and family history

Breast density describes the mix of glandular, connective and fatty tissue seen on a mammogram. You can’t tell by touch. A radiologist (a doctor who reads scans) judges it from the image. Dense breasts have more glandular and connective tissue and less fat.

Dense breasts are linked with a higher chance of breast cancer, and can make cancer harder to see on a mammogram. The USPSTF says there isn’t enough evidence to recommend for or against extra ultrasound or MRI scans for dense breasts. Ask your clinician whether an extra scan would help you.

Tell your clinician about any close relatives who’ve had breast or ovarian cancer, and any known inherited gene change. After a specialist check, the NHS may offer screening earlier or more often, or an MRI scan. The routine USPSTF plan doesn’t cover some high-risk histories, such as a known high-risk gene change or having had breast cancer before.

Booking help for a change

Book a GP appointment in the UK, or see your doctor in the US or elsewhere, for a lump, changes to your nipple, or pain in your breast or armpit that doesn’t go away. Say 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’ve noticed a change here, and I’d like it examined.” Bring any screening letters and family history details you have. Ask what happens next and who to contact while you wait.