In addition to annual mammogram screenings, women should have a clinical breast exam by a doctor or other health professional every year.

Many experts also recommend breast self-exams.

The annual clinical breast exam is done to identify a variety of abnormalities and warning signs.

"Patients need to understand, even if the mammogram is normal, they still need an annual clinical breast exam," breast surgeon Dr. Trudi Brown said in Joyce Murtha Breast Care Center at Chan Soon-Shiong Medical Center of Windber.

A family doctor or gynecologist can complete the exam during the woman's annual visit.

Windber gynecologist Dr. Reid Gentile says the clinical exam should be completed, even if the woman is doing monthly self-exams.

"We can find something early," he said at his office in Chan Soon-Shiong Medical Center at Windber.

Once promoted as a primary defense against breast cancer, monthly self breast exams are no longer recommended by many cancer groups.

"Although it seemed promising when it was first introduced, studies have shown (a monthly self-exam) doesn't offer the early detection and survival benefits of other screening tests," the Susan G. Komen organization says on its website.

The breast cancer advocacy nonprofit cites studies that show monthly exams made no difference in breast cancer survival, while creating false-positive results and unnecessary biopsies.

But Komen goes on to say, "It's important to become familiar with the way your breasts normally look and feel. This may help you notice a change in your breasts."

Local doctors also encourage women to know their bodies.

Breast cancer warning signs include changes in the look or feel of the breast, changes in the look or feel of the nipple and discharge from the nipple.

Breast surgeon Dr. Patti Stefanick said a number of her patients have discovered cancers before they showed up on mammograms.

"No one knows the breast like that lady, if she was doing those self-exams," Stefanick said.

"If she does self-exams, she knows what she's feeling."

The earlier a cancer is identified, the easier it is to treat, with less chance of major surgery, Johnstown plastic surgeon Dr. Paul Rollins said.

"I would emphasize the need for women to know themselves and not depend on the physicians to do the exams," Rollins said at Conemaugh Physician Group - Plastic Surgery offices in Conemaugh Medical Park in Johnstown.

"Early diagnosis means that, in most cases, patients may not need to have lots of extensive procedures done," he said.

Some women are reluctant to perform self-exams, breast surgeon Dr. Deborah Sims said at the Joyce Murtha center.

"They tell me, 'It all feels like lumps to me,' " Sims said.

"But we are trying to get them to know their own bodies. The breast self-examination is an integral part of self-care and breast care."

Checking regularly will help women notice changes, Sims said.

"There can be substantial changes in how the breast feels," she said.

"If you look at your breasts regularly, you are going to see that if there's a new mass. You are going to feel that.

"You have your hands every day. You see your doctor once a year."

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