NCCN Guidelines for Patients®: Breast Cancer Screening and Diagnosis, 2025

Overview

The NCCN Guidelines for Patients provide clear explanations of breast cancer screening and diagnosis recommendations. This document aims to help patients and caregivers understand the importance of regular breast cancer screening, the types of tests available, and what to do when symptoms are present.

Breast Cancer Screening

• Why is breast cancer screening important? Early detection of breast cancer through regular screenings can significantly improve treatment outcomes and reduce mortality rates.
• What are the parts of the breast? The breast consists of milk ducts, fat, nerves, lymph and blood vessels, ligaments, and connective tissue.
• Where does breast cancer start? Most breast cancers originate in the cells of the lobules or milk ducts.
• What can you do to get the best care? Advocate for yourself by asking questions, making shared decisions with your care team, and understanding your care options.

Screening and Diagnostic Tests

• General health tests include medical history, family history, and clinical breast exams.
• Mammogram is an x-ray image of the breast that helps detect abnormalities.
  • Types of mammograms: Screening mammogram (annual preventive exam), diagnostic mammogram (for symptoms or abnormal findings), and tomosynthesis mammogram (3D imaging).
• Other breast imaging tests include breast MRI, contrast-enhanced mammogram (CEM), and breast ultrasound.
• Mammogram results are interpreted using the Breast Imaging Reporting and Data System (BI-RADS), which categorizes findings and breast density.

Risk Assessment for Screening

• What is breast cancer risk? Your chance of developing breast cancer, influenced by personal and family health history.
• How is breast cancer risk calculated? Through risk assessment models based on factors such as age, family history, genetic testing, and prior biopsies.
• Average risk individuals should start annual screening mammograms at age 40.
• Increased risk individuals may start mammograms and breast MRIs at a younger age, depending on specific risk factors.

Testing During Pregnancy and Breastfeeding

• During pregnancy and breastfeeding, breast changes can make detection more challenging. Regular clinical breast exams and mammograms are recommended.
• Signs and symptoms to report include lumps, pain, skin changes, nipple discharge, and nipple changes.

What to Do When You Have Symptoms

• Signs and symptoms include breast pain, lumps, nipple discharge, and nipple changes.
• Diagnostic tests may include ultrasound, mammogram, and biopsy.
• Biopsy is the removal of tissue for testing, with various types available depending on the situation.

Other Resources

• Additional support and information are available through various organizations and resources listed in the document.
• Breast cancer resources provide further guidance and assistance for patients and caregivers.

Words to Know

A glossary of key terms related to breast cancer screening and diagnosis is provided for reference.

NCCN Contributors and Cancer Centers

The document acknowledges the contributors and the NCCN Cancer Centers that support the guidelines.