Jacqueline Eghrari-Sabet: Breast cancer is a disease we actually want to find before there are any symptoms. There are two main ways to find breast cancer and the first one is by mammography preferably, and the second one is by breast physical examination.

Mammography is used to find breast cancers before they are felt and we think that having the ability to find cancers earlier when they are smaller can actually improve your chances of surviving the disease process. Also it gives you increased number of treatment options. You don't necessarily have to have your breast removed if we can find it at a smaller stage.

So mammography is the really one proven method to decrease the number of deaths from breast cancer. Since mammography screening became available, the number of deaths from breast cancer have actually decreased by one-third. In addition, mammography doesn't cause breast cancer, it is very low dose x-rays. So, mammography is very safe. In fact since we have been using wide spread screening mammography here and in other parts of the world, the actual incidence of breast cancer has decreased slightly in addition to the death rate from breast cancer declining. So, mammography screening is an important tool.

Mammography, as some may already know, uses low dose x-rays and general compression of the breast to produce images on either a piece of film called film-screen mammography or more currently it actually puts it on a computer and that's called digital mammography. And what we are looking for are two things, micro-calcifications which look like small specks of salts on a mammogram or masses or we call them tumors or masses and they can be benign or malignant. We may further evaluate those with other imaging tests if those are found. So that's a breast imaging for screening when you don't have any sign of disease. Another important tool is regular physical examination by your health care professional. Now, just like mammography that should be an annual process beginning at age 40. What your health care professional is looking for are any changes in your breast. They may find a lump that they didn't recognized before, knowing that breast are generally lumpy structure, they are looking for something new or different than the other lumps in the breast. Also, they are looking for any area of thickening. It may not feel as doughy on one side as on the other and that increased thickening on one side or one area may be a sign of concern. They are looking for any changes in the skin, any dimpling. The nipple may show signs of inversion or pulling in. There may be a new rash on the nipple that's unexplained. So, those can be areas of concern. Your health care provider can also be looking in the armpit for any lumps as well. As fas as breast self examination, the American Cancer Society has stepped back from their rigid recommendation of monthly breast self-examination. It tended to produce a number of false alarms and didn't necessarily seem to contribute any decrease in number of deaths from breast cancer or improved detection rates. This is not to say that you should ignore your breast or any new findings in your breast. In fact, if you do detect a new lump, or a new thickening, or any change in your nipple, you should report it to your health care provider as soon as possible. The most important thing about breast cancer is to try and find it as early as possible. Your best bet is by annual routine screening mammography.