The short answer: No, not as a formal monthly routine for women at average risk. Two large randomized trials taught women a structured self-exam and found no drop in breast cancer deaths. A Cochrane review of those trials counted almost twice as many biopsies with benign results in the taught groups. Medical groups now advise breast self-awareness: know how your breasts normally look and feel, and report a change promptly.

What do the major medical groups say now?

The groups use different words, but none of them recommends a taught monthly self-exam for women at average risk.

  • American College of Obstetricians and Gynecologists (ACOG). Practice Bulletin 179, which ACOG reaffirmed in 2025, says breast self-examination is not recommended in average-risk women. The reasons it gives are a risk of harm from false-positive results and a lack of evidence of benefit. ACOG tells clinicians to counsel women about breast self-awareness.
  • American Cancer Society. The society's screening page, last revised in July 2026, says self-exams and clinical breast exams are not sufficient for cancer screening. It adds that people should be familiar with how their breasts normally look and feel and should report any changes right away.
  • U.S. Preventive Services Task Force (USPSTF). In its 2009 statement, the task force recommended against teaching breast self-examination. That was a grade D, its rating for a service with no net benefit. The current 2024 statement covers screening mammography and does not address self-exams.
  • National Cancer Institute. Its evidence summary for health professionals rates the magnitude of benefit from self-exam as no effect.

These positions apply to women at average risk. Women with a known gene mutation or a strong family history should ask their own doctor what to do.

What did the randomized trials of self-exam find?

Two trials tested the idea directly. Both compared women who got formal instruction with women who did not.

Shanghai. The Shanghai trial assigned 266,064 women from 519 textile factories to a self-exam group or a control group. The instruction was intensive. Women got initial training, reinforcement sessions at 1 and 3 years, and supervised practice at least every 6 months for 5 years. After 10 to 11 years, 135 women in the instruction group had died of breast cancer. The count in the control group was 131. The risk ratio was 1.04, which is no difference.

St. Petersburg. A Russian trial with the World Health Organization trained 57,712 women aged 40 to 64 and followed 64,759 others as controls. The final report found that the program did not affect mortality.

The Cochrane review pooled both trials, with 388,535 women and 587 breast cancer deaths. The relative risk of death from breast cancer was 1.05. The reviewers concluded that the data do not suggest a benefit and do show evidence of harm.

One limit applies. The Shanghai trial tested self-exam instruction in women who did not have mammogram screening. Its authors still drew a plain conclusion: women who choose to do self-exams should know the benefit is unproven and the chance of a benign biopsy may go up.

What is the harm in checking every month?

The harm is more testing for lumps that are not cancer.

  • In the pooled trials, the self-exam groups had 3,406 biopsies with benign results. The control groups had 1,856. That is a relative risk of 1.89.
  • In the Russian trial, 7.5% of the self-exam group had a reason for a needle or surgical biopsy. The figure for the control group was 3.5%.
  • In the early Shanghai results, doctors found 1,457 benign breast lesions in the instruction group and 623 in the control group. The cancers were not smaller or found at an earlier stage.
  • The National Cancer Institute summary puts the biopsy rate at 1.8% with self-exam instruction and 1.0% without.

A biopsy has costs: a needle or a cut, a wait for results, and worry. Our guide to breast biopsies explains the procedure.

A self-exam also misses many cancers. The 2009 task force statement put its sensitivity at 12% to 41%, lower than a clinician's exam or a mammogram.

How is breast self-awareness different from a self-exam?

ACOG defines both terms. A breast self-examination is an inspection of the breasts on a regular, repetitive basis to detect cancer. Breast self-awareness is a woman's awareness of the normal appearance and feel of her breasts.

Self-awareness has no schedule and no set technique. You do not need a calendar reminder or a fixed pattern of finger movements. You notice your breasts in daily life, such as when you shower or dress, and you act when something changes.

The reason for the advice is that women find many cancers themselves. ACOG reports that women detect about 50% of breast cancers in those aged 50 and older. For women younger than 50, the figure is 71%. ACOG also notes that no United States study has directly tested self-awareness, so the advice rests on those detection figures.

The American Cancer Society does not forbid self-exams. Its page says some people might do them to keep track of how their breasts look and feel. That is a personal choice. It does not replace a mammogram, as our mammogram myths post explains.

Do you still need a breast exam from a clinician?

For screening, the groups disagree. For a symptom, they do not.

  • American Cancer Society. Its 2015 guideline does not recommend clinical breast examination for screening in average-risk women at any age.
  • ACOG. A screening exam may be offered after a shared decision. ACOG calls intervals of every 1 to 3 years reasonable for ages 25 to 39, and every year from age 40.
  • USPSTF. The 2009 statement found the evidence insufficient to judge the exam's added benefit beyond mammography.

The exam has limits. The National Cancer Institute summary reports that 17% to 43% of women with cancer have a negative clinical exam. Between 1% and 12% of exams give a false-positive result.

One trial tested the clinician exam where mammograms are not widely available. The Mumbai trial followed 151,538 women for 20 years. Trained health workers examined one group every two years. Fewer cancers in that group were stage III or IV at diagnosis (37% compared with 47%). The 15% drop in breast cancer deaths was not statistically significant.

ACOG states that a clinical exam is still a recommended part of care for high-risk women and for women with symptoms.

Which breast changes should prompt a call to your clinician?

The American Cancer Society says the most common symptom of breast cancer is a new lump or mass. Most breast lumps are not cancer. The society lists these other possible symptoms:

  • Swelling of all or part of a breast, even if you feel no lump
  • Skin dimpling, which can look like an orange peel
  • Nipple or breast skin that is red, dry, flaking, or thickened
  • Breast or nipple pain
  • A nipple that turns inward
  • Nipple discharge other than breast milk
  • Swollen lymph nodes under the arm or near the collarbone

Call even if your last mammogram was normal. The society notes that mammograms do not find every breast cancer. A new symptom calls for a diagnostic exam, not a routine screening visit. Our post on screening and diagnostic mammograms covers the difference. For other symptoms that are hard to judge, symptom.md has plain-language guides.

The bottom line

A formal monthly self-exam is no longer recommended for women at average risk. Two trials with more than 388,000 women found no fewer breast cancer deaths and almost twice as many benign biopsies. The current advice is breast self-awareness: know what is normal for you and report a new lump, skin change, or nipple change promptly. Keep your mammogram schedule. Our guide on when to start mammograms covers the timing.

Last updated: October 2026. This article is for informational purposes only and does not constitute medical advice. Talk with your doctor about any breast change and about the screening plan that fits your own risk.