Early diagnosis is the key to a greater chance of long-term survival of breast cancer. Many doctors are now recommending a three-pronged screening plan to help catch breast cancer earlier, before it has spread to other areas of the body.

The screening plan steps.

•  Breast self examination (BSE)
You should perform this examination every month just after your period. If you're not sure how, ask your doctor or nurse to teach you how to perform the self-examination. See also the 'How to do a breast self-examination' guide from the NSW Breast Cancer Institute in the list below.

As you become more familiar with the look and feel of your breasts, you will soon be able to pick up any changes or irregularities. But remember, a change doesn't necessarily mean there is something wrong—your periods, weight changes and age, among other things, can cause a change in breast tissue. Check with your doctor if you have any concerns.

•  Clinical breast examination
Your doctor may ask a number of questions about your own self-examinations, family history of breast cancer and whether or not you've been pregnant or had any type of breast surgery.

He or she will then do a breast examination, in much the same way as you examine yourself.

The effectiveness of clinical breast examination is still under discussion, but there is evidence that this type of examination has been successful in finding cancers that have been missed by mammography in women with no symptoms of breast cancer. Ask your doctor to perform this manual examination yearly.

•  Mammography
A mammogram is an X-ray picture of the breast. The breast is compressed between plates of the X-ray machine for a few seconds and a picture is taken first from above and then from the side. In most women, this will cause only slight discomfort, but is worth it as a mammogram can detect some cancers that are so small, they can't even be felt.

This means that if the cancer is detected in these early stages, it can usually be treated successfully before it has a chance to spread.

NSW Breast Cancer Institute Executive Director Professors say that routine screening diagnoses about 30 per cent of all breast cancers in Australia . The remainder, are detected by clinical breast examination (usually by a woman's general practitioner) or detected by accident by the patient.

They agree that in screening for breast cancer, mammography is effective.

‘It diagnoses most breast cancers. However, one cannot totally trust a clear mammogram particularly if the patient has a symptom. If a patient has a lump, she needs a diagnosis not just a mammogram. Women with a lump need clinical assessment, imaging (usually ultrasound and mammography) and often a biopsy.'

But when asked if Australian women, in general, are aware of the importance of breast care and early diagnosis they say: ‘Yes and no. Mammography needs to be performed regularly. The Government funds this every 2 years for women over 40 through the BreastScreen Australia programme. Mammography needs to be of high quality and radiologists and radiographers need ongoing training and feedback with measurement of their performance'.

‘If you are over 40, have a mammogram at least every 2 years.