A variety of methods are available for examining the breast for breast cancer. They vary depending on the age of the patient.
The most common examinations are
Magnetic resonance imaging (MRI) is used less frequently.
The aim of each procedure is to detect changes in the breast tissue, such as a lump, at an early stage. This allows doctors to begin treatment as quickly as possible in the event of a malignant tumor.
The statutory health insurance funds cover the costs of a number of early detection methods:
- Patients between the ages of 20 and 29: Women in this age group very rarely develop breast cancer. For this reason, the statutory health insurance benefit catalog does not yet include an explicit breast cancer screening. However, the health insurance does cover an annual gynecological examination for general cancer screening by a gynecologist.
- Patients aged between 30 and 49 and over 70: Health insurance covers the cost of an annual breast palpation examination.
- Patients between the ages of 50 and 69: In addition to the annual palpation examination, women in this age group receive an invitation to participate voluntarily in a mammography screening every two years.
- Patients at risk: If the patient has a family history of breast cancer, she is considered a high-risk patient. Previous radiotherapy in the breast area also leads to an increased risk of developing breast cancer. In such cases, intensified breast cancer screening is recommended. How this is organized should be discussed with the treating gynaecologist in each individual case.
The primary purpose of early detection of breast cancer through regular screening is to reduce tumor-related deaths.
Small tumors can be treated much more successfully and gently than at a later stage. The earlier breast cancer is detected, the better the chances of a complete cure.
Tumors diagnosed at an early stage usually do not require extensive surgery. This means that the breast can often be preserved.
The palpation examination
The gynaecologist examines the mammary glands and the lymph nodes
- in the armpits,
- on the collarbone and
- breastbone
by palpation. The shape and size of the breasts and nipples are also checked.
Careful squeezing of the nipple is also part of the check-up. This is done to check for fluid leakage.
Mammography screening
Mammography screening is an X-ray of the breast. Electromagnetic waves are sent through the breast. Depending on the type of tissue, the X-rays are attenuated to varying degrees.
This produces a very detailed image of the breast. Even very small, non-palpable tumors are visible at an early stage.
Mammography screening is carried out by specially trained radiographers. The images of the breast are then assessed independently by two different radiologists.
The patient receives the examination results by post within around seven working days. Further comprehensive information on the mammography screening program for women aged between 50 and 69 can be found at mammo-programm.de.
Of course, mammography is also an option for women in other age groups if breast cancer is suspected.
The breast ultrasound examination (mammasonography)
During the ultrasound examination, sound waves are sent into the breast tissue with the help of a transducer. Because the tissue reflects the sound to different degrees depending on the type, an image of the breast structure is created. Fatty tissue, for example, tends to appear darker, while glandular or connective tissue is significantly lighter.
Overall, however, breast sonography is somewhat less accurate than mammography screening. It is particularly difficult to detect small tumors or the calcifications typical of precancerous lesions. For this reason, breast ultrasound is mainly used in addition to mammography if abnormalities indicate a tumor.
Breast ultrasound is not included in the statutory health insurance benefit catalog as the sole preventive examination. However, some health insurance companies cover the costs as an additional preventive service.
What can I do myself?
The personal risk of developing breast cancer can be minimized through a healthy lifestyle:
- Regular exercise,
- a balanced diet and
- a normal body weight
have a significant influence on individual health. Alcohol should only be consumed rarely and tobacco should be avoided if possible.

Regularly examine your breasts yourself for changes to prevent breast cancer © anna.stasiia | AdobeStock
Regular self-examination of the breasts is also an important part of preventive care. This will give you a better feel for your own body. If you notice any worrying changes, you can consult a doctor immediately.
One week after the start of your period, your breasts will be particularly soft. This is the right time for a self-examination. Feel your breasts yourself every month.
Carry out the examination in good lighting conditions in front of a mirror and also while lying down. You can find more specific tips on this in the breast examination guide from the Tübingen Women's Clinic.
Be sure to see a gynecologist if you notice any of the following symptoms:
- Lump in the breast
- Sudden redness that does not go away on its own
- Changes to the nipple, for example inflammation, skin changes or retraction of the nipple
- Leakage of fluid from the nipple
- New differences in the breasts, for example in size, shape or behavior when lifting the arms
Note: Many cases of breast cancer are first discovered during a self-examination. However, self-examination is not enough! Make sure you take advantage of all breast cancer screening opportunities.
Ideally, the various methods of early detection should be coordinated with each other.
A tumor is not always automatically malignant. If changes in the breast are detected during the screening examinations, a "false alarm" may well sound. This frightens the patient and puts her under psychological strain. This is one of the disadvantages of breast cancer screening, in addition to the radiation dose that the patient is exposed to during a mammogram.
Nevertheless, breast cancer can often be cured if detected early. Many patients can gain many years through immediate therapy. In this respect, it is worthwhile for every woman to consider regular breast cancer screening and take advantage of the services on offer.