In recent years, there is a trend of increasing the number of young breast cancer cases, coupled with the fact that some celebrities have suffered from this disease, as well as the misunderstanding and over-interpretation of the information in the media or books, such as “beware of breast cancer if you have lumps” and “be wary of breast enlargement becoming cancer”. As a result, many young women are overly fearful of breast cancer and blindly undergo various examinations. However, there are strict clinical procedures for breast cancer screening, and only by choosing the appropriate screening methods according to the actual situation can breast cancer screening be safe and effective. The screening measures for breast cancer include self-examination, clinical examination, ultrasound examination and imaging examination, so how to choose the appropriate examination means according to the patient’s situation? 1. Breast self-examination Breast self-examination can raise women’s awareness of cancer prevention and detect breast abnormalities in time. It is reported that in 2011, Yao Beina was diagnosed after she noticed a dimple-like mark on her left breast when she looked at herself in the mirror. Primary health care workers should teach women the method of breast self-examination once a month, and pre-menopausal women should be advised to choose 7-10 d after the onset of menstruation. Self-examination points: Girls who are >15 years old, who have had their first menstrual period and whose breasts have developed, should start breast self-examination. Keep in mind that the technique is “stroking”, not “grasping”. With fingers together, start stroking the breast from one side and use your fingers to feel for hard lumps or nodules. After stroking your fingers around the nipple, gently squeeze the nipple to see if there is any brownish-black or bloody discharge. For women of childbearing age, if the nipple squeezes out a clear, milky white discharge, there is no need to panic, it is a normal discharge. Tip: Self-examination after menstruation to prevent unnecessary panic Because women will have breast swelling and pain before and during menstruation, if they perform self-examination at this time, they will obviously feel that their breasts have become larger and can even reach some nodules (breast tissue), which is actually a normal phenomenon of breast tissue being affected by estrogen levels. Therefore, in order to avoid unnecessary panic, breast self-examination is best arranged for 3 to 5 days after the end of menstruation. 2.Clinical physical examination Breast clinical examination alone is not effective as a method of breast cancer screening, and there is no evidence to show that this method can improve the early diagnosis rate of breast cancer and reduce the mortality rate. Physical examination is generally recommended as a combined screening measure for breast cancer screening, which may compensate for the omission of mammography screening. 3. Breast ultrasound, the preferred method for young women In China and other Asian countries, high-frequency ultrasound has become the preferred ancillary screening method for breast disease in many young women. It is simple, fast, non-invasive, non-damaging and reproducible, especially suitable for the examination of pregnant and lactating women and the screening of breast diseases; especially for the diagnosis of breast lumps >1 cm in diameter with better specificity and accuracy; it is of high value for young women with dense breast tissue. 4. Mammography is not recommended for young women For young women, breast ultrasound is the preferred method of examination. If abnormalities such as lumps and cysts are found in breast ultrasound, we do not recommend mammography for women under 40 years of age to complete further confirmation, but rather to use magnetic resonance imaging (MR). This is because mammography is a radioactive test, and for young women, especially women of childbearing age in their 20s, the breast tissue is very dense and the glandular tissue has not degenerated. A lot of radiation will be absorbed by the gland. Mammograms and ultrasounds are not interchangeable, as each has its own strengths. It is generally recommended that women should start to undergo mammography combined with breast ultrasound at the age of 40, which can provide very accurate results for breast cancer diagnosis. Some people think that mammography is damaging to breast tissue and do not want to have this test, so can it be replaced by ultrasound? In fact, the two cannot be substituted for each other. Because for different lesions, mammography and breast ultrasound have different targets. Mammography is relatively more accurate for early stage breast cancer in the form of calcification. Ultrasound, on the other hand, has low discriminatory ability for breast cancer in the form of calcification, while it is better than mammography for cysts and lumps, especially for some specific tumors, such as papillomas. It is recommended that women over 40 years of age (married or not) should insist on mammography and ultrasound once a year, which is the most routine practice in all breast cancer treatment guidelines and is a very crucial method to screen for breast cancer. MRI can be used as a supplement to mammography, breast clinical examination or breast ultrasound for suspected cases, and can be used in combination with mammography for breast cancer screening in certain breast cancer high-risk groups. Definition of high-risk groups for breast cancer: those with obvious genetic predisposition to breast cancer; patients with previous moderate to severe atypical hyperplasia of breast ducts or lobules or lobular carcinoma in situ; patients with previous history of chest radiotherapy. 7. After menopause and the peak of incidence, it is still necessary to check Breast cancer incidence generally has two peaks, the first peak is from 45 to 55 years old, and the second peak is after 65 years old. Therefore, it does not mean that after menopause, there is no more risk of breast cancer, rather, after menopause at age 65, there will be another peak of breast cancer incidence. Therefore, it is especially important for women to insist on annual breast checkups after menopause.