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Breast cancers in their early stages are usually painless. Often the first symptom is the discovery of a hard lump. Fifty percent of such masses are found in the upper outer quarter of the breast. The lump may make the affected breast appear elevated or asymmetric. The nipple may be retracted or scaly. Sometimes the skin of the breast is dimpled like the skin of an orange. In some cases there is a bloody or clear discharge from the nipple.

Self-Examinations. Women have been encouraged to perform a self-examination each month, but some studies have reported no difference in mortality rates between women who do self-examination and those who do not. This does not mean women should stop attempting self-examinations, but they should not replace the annual examination done by a health professional.

Many cancers, however, produce no symptoms and cannot be felt on examination. With an increase in the use of mammogram screening programs during the last several decades, more breast cancers are being discovered before there are any symptoms.

Breast lumps are common enough in women of all ages and may be caused by injuries, infections, non-malignant growth or cancer.

Routine breast cancer screening is carried out usually in healthy women above the age of 40 years with intent of detecting breast cancer even before the lumps appear.

Breast cancer deaths have declined in several parts of the world due to early detection and efficient treatment methodologies.

Once a breast lump appears it must not be neglected but subjected to medical examination to rule out cancer.
A breast lump is evaluated by taking the medical and family history of the patient, which is then followed by a physical examination. The risk factors associated with the patient are also observed.

Mammograms and breast scans are reliable screening tools.

Self-examination is not aggressively encouraged, as it tends to detect the cancer at a more advanced stage. The American Cancer Society now recommends it as a choice that can be exercised after the mandatory mammogram.

Given the confusion and recommendations, women, (particularly those in their 40s), should discuss the risks and benefits of mammography with their doctors, and then base their decisions on family history, general health, and personal values.

Since mammographies in younger women produce a relatively high rate of false-positive results (when the test falsely indicates breast cancer), there is a risk of radiation exposure and potentially unnecessary biopsies or surgeries. However, mammograms can help catch tumors while they are in their earliest and most treatable stages. The most deadly types of breast cancer tend to occur in women in their 40s.

In case of a family history genetic tests and breast MRI are also recommended.

After a woman reaches age 50, her risk for developing breast cancer increases. (Women over age 65 account for most new cases of breast cancer.) Women with risk factors for breast cancer, including a close family member with the disease, should consider having annual mammograms starting 10 years earlier than the age at which the relative was diagnosed.

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