In the past, many books or media would tell readers to be alert to breast lumps to be on the alert of breast cancer, causing a misconception that breast cancer is only when there are lumps. Breast lumps are only the manifestation of breast cancer to a certain level of development, and most of them are not really early stage cancer. Breast cancer cells are relatively slow to divide among all kinds of cancer cells, and it usually takes about 2-3 years on average for them to grow to 2 centimeters, that is, when they can be touched. However, during this two to three year period, there are many ways to check for it instead of waiting for the cancer to grow slowly until we can feel it. Breast cancer is a common malignant tumor in women and is currently the leading killer of women’s health in major cities. According to the World Health Organization, there were 500,000 new cases of breast cancer worldwide in 1979, 1.2 million in 2004, and the number is expected to reach 1.4 million in 2010, which is an unusually rapid trend. The situation in China is equally bleak, with the incidence of breast cancer in Shanghai rising from 17 per 100,000 in the 1970s to 67 per 100,000 in 2004, and similarly in other central cities such as Beijing and Guangzhou. Despite the increasing number of breast cancer cases, the current treatment outcome of breast cancer is relatively satisfactory, mainly due to the concept of integrated treatment combining surgery, chemotherapy, radiotherapy and biologically targeted therapy, but mainly because people pay attention to breast cancer screening, early detection, early diagnosis and early treatment are the most direct and fundamental way to improve the efficacy of breast cancer. In the United States, large-scale screening for breast cancer began in the 1980s, and the latest technologies and drugs have been used in treatment, but the mortality and incidence of breast cancer still increased in parallel before 1990. It was not until the 1990s that there was an encouraging downward trend in breast cancer mortality among women in the United States, and scientists attribute this to the fact that mass screening led to a dramatic increase in the detection of early breast cancer, including 21% of ductal carcinoma in situ. In 2008, the American Cancer Society released the latest information showing that the 5-year survival rate for stage 0 (breast cancer without a lump) and stage 1 breast cancer can reach 100%, 80-92% for stage 2, and 49-62% for stage 3 breast cancer. However, stage 4 breast cancer still has not improved much compared to previous years, only 20%. I remember 5 years ago, I attended a breast cancer patients’ meeting in the United States, and I still remember the words of a breast specialist, Professor COX, that a strong nation needs a strong people, a strong people needs a stable family, and a stable family needs a healthy woman. Women’s health is related to family harmony and social harmony. The incidence of breast cancer is getting more and more early. The youngest breast cancer in our center was a 17-year-old girl from Luoding, and it was very late when she was diagnosed, and her father fainted several times when he learned of the situation. Early prevention and early treatment to keep breast cancer away. We should detect breast cancer earlier and should find more breast cancers that cannot be felt as a lump, instead of going to the hospital only when a lump is found. Screening is undoubtedly the best way. The Department of Health of Guangdong Province attaches great importance to women’s health and has proposed the project of maternal and child wellness, in which the prevention and treatment of malignant tumors for women mainly falls on the screening of cervical cancer and breast cancer. The Breast Disease Center of Guangdong Provincial Maternal and Child Health Hospital, as the technical guidance center for breast cancer screening in the project, proposes to establish breast cancer screening and early diagnosis technology based on the secondary prevention model of breast cancer, and promote it to the demonstration bases of maternal and child institutions in the province, so as to improve the detection rate and survival rate of early breast cancer in each base and improve the health level of women in the province. However, screening and detection of stage 0 breast cancer is not an easy task. There are many non-invasive screening tests for breast cancer, but are they all suitable for mass screening? The answer is of course no. Each screening test has its own suitable population and limitations, but a good combination of them can often detect breast cancer earlier. For example, the use of mammography has significantly increased the detection rate of early breast cancer and is particularly suitable for fluoroscopic imaging of soft tissues with low radiation. Especially for women over 40 years old, most of the breast gland is degenerated and less sensitive to radiation and less affected. With clear imaging, outstanding features and high sensitivity, mammography has become the most effective means recognized today for early diagnosis of breast cancer, which can not only detect cancer at least 1 year earlier than clinical detection, but even be able to detect cancer tumors smaller than 5 mm. Generally women over 40 years old; women with high-risk factors (family history of breast cancer, atypical hyperplasia, carcinoma in situ of the breast, etc.) should undergo mammography every 1 to 1.5 years; for young women under 40 years old, too frequent examinations will cause damage to their breast tissue. However, when a highly suspicious malignant lesion is encountered, continuous examinations for a certain period of time are not uncommon. This is because the value of early detection of breast cancer far outweighs the risks associated with radiation. Ultrasound examination should be done for suspected breast lumps Ultrasound examination is easy, quick, non-invasive, non-damaging and reproducible, especially for pregnant and lactating women and breast disease screening; it can accurately locate the lesion, especially for the diagnosis of breast lumps >1cm in diameter with better specificity and accuracy. It has high value for young women and those with denser breast tissue. It has limited ability to identify masses less than 1 cm in diameter, and for some lesions with only structural changes in the breast, other tests are needed to supplement it for diagnosis. It is suitable for women of all age groups and different physiological cycles, especially for oriental women and young women. Ductoscopy is an examination method that uses a 0.9 mm outside diameter endoscope to enter the lumen of the lesion and observe the location and shape of the lesion, similar to the principle of gastroscopy. Lactation ductoscopy with cytological examination is more accurate in diagnosis. It is mainly suitable for patients with nipple discharge during non-lactation period, especially for patients with bloody and plasma nipple discharge and clear water discharge from a single hole. Among more than 3,000 patients with nipple discharge examined in our breast center, 40% were bloody discharge, half of which were caused by benign papilloma, while 10% were caused by breast cancer. MRI is now beginning to be used on a large scale in Europe and the United States for breast screening, and is even approved as a screening tool for people with high-grade breast cancer in some countries in Europe and the United States. MRI is not affected by the density of the breast and can detect very small lesions, suitable for every age group. It can show well the situation in the milk ducts and can check nipple overflow. It is mainly suitable as a screening tool for women at high risk of breast cancer; women in pregnancy, breast cancer patients with a desire to preserve their breasts and patients with nipple overflow. Due to its high price, widespread use is clearly not economical enough. How to further confirm the diagnosis or remove some lesions that cannot be felt as lumps are found? Indeed, in the past, surgeons relied more on a dexterous hand, and only palpable lumps were indicated for surgery. However, advances in technology have given surgeons many hands and many eyes. The introduction of the vacuum-assisted biopsy system (McMurdo) in 1994 allows for more accurate and convenient biopsy and excision of these inaccessible lesions with less trauma and no scarring, ensuring the appearance of the female breast. A patient in her 60s in Jiangmen had a left-sided intramamammary duct papilloma found 6 years ago and underwent surgery. Annual reexaminations were unremarkable. At the end of last year, she was examined in our center, her breast was flaccid without any abnormality, her mammogram was abnormal, and ultrasound scan revealed multiple 3 mm-sized nodules in the left breast, which were found to have unsmooth borders after magnification of the image, and it was decided to perform McMurdo vacuum-assisted biopsy under ultrasound guidance, which was finally confirmed as ductal carcinoma in situ. We performed this minimally invasive procedure on 254 cases of lumps that were considered “benign” on ultrasound and could not be felt. 82% of them were found to be fibroids and 10% were cysts, however, 3 cases of early breast cancer were also found. Seven years ago, a 31-year-old patient from Shenzhen, who had blood in her nipples and no palpable lumps in her breasts, underwent ductoscopy at our center and found multiple tumors in the ducts, with stiff ducts and necrotic tumor surfaces, and was considered malignant. The patient found it difficult to accept and did mammogram, ultrasound and even PET scan which was very expensive at that time in many hospitals in Shenzhen and Guangzhou without finding any abnormality. Finally, she came back to our center uneasy and underwent surgery. Due to the preoperative localization of breast ductoscopy, we quickly found the lesion and did excision, which was confirmed to be intraductal breast cancer with local infiltration, and successfully preserved her breast due to the limitation of the lesion. Advances in breast imaging have overturned the previous clinical understanding of breast cancer, and lumps are no longer necessary for breast cancer diagnosis. Instead, proactive screening or mass screening allows us to detect more microscopic breast cancers that can only be seen with a radiograph or various scans.