Breast Health and Mammography

The breast is one of the few organs that you can feel yourself and that we can keep a close eye on together. Although breast cancer is the most common cancer among women (Cancer League), thanks to today’s treatments it is usually highly treatable and, especially when detected early, is rarely fatal. The vast majority of changes that women notice in their breasts are harmless anyway. And if there is something more serious behind them, the rule is: the earlier we find it, the gentler and more successful the treatment can be.

Breast Awareness Instead of Rigid Self-Examination

For a long time, women were advised to perform a monthly self-exam following a fixed routine. Today, we know from large-scale studies that this rigid ritual does not reduce breast cancer mortality but instead leads to many unnecessary tests for benign conditions and unnecessary worry (Thomas et al. 2002). What really matters is breast awareness: knowing what your breasts normally feel like—so that you’ll notice any changes. So you don’t need to keep a calendar. If you notice anything new, just contact us.

Mammography—the Most Important Form of Early Detection

A mammogram is an X-ray examination of the breast using a very low dose of radiation. The radiation exposure is so low that the benefits of early detection clearly outweigh the minimal risk (Cancer League). During the procedure, the breast is briefly compressed between two plates—this is uncomfortable for a moment but over quickly. It can reveal changes long before they can be felt by touch. Regular mammograms significantly reduce breast cancer mortality—by about one-fifth among women invited to screening and by about one-third among those who actually participate (Dibden et al. 2020).

At what age?

In cantons with an early detection program, women aged 50 to 69 are invited for a mammogram every two years (Cancer League). As a general guideline: As long as everything appears normal, a mammogram every two years is sufficient—in cases of abnormal findings or increased risk, we monitor more closely. Swiss professional associations now recommend starting as early as age 45, because breast cancer is increasingly affecting younger women as well (SGR-SSR, SGGG & SGS 2026). If there is a family history of the disease, starting even earlier may be advisable—we’ll discuss this on an individual basis.

An important note for our region: The Canton of Zurich currently has no organized screening program. This means you will not be automatically invited here, but must take the initiative yourself—we’re happy to help you determine the right time and approach. Regarding costs: Within a screening program, the mammogram is exempt from the deductible; only the 10 percent copayment applies. Outside of a program—which includes our services here in Zurich—basic health insurance does not cover mammograms performed solely for early detection; however, it does cover them in cases of a family history of breast cancer or a specific suspicion, though this is deducted from your deductible (Cancer League).

The Benefits of Screening—and Its Limitations

We want to be honest so that you can make an informed decision. The benefits are real: breast cancer is detected earlier and at earlier stages. At the same time, screening has its limitations. Sometimes an abnormality is detected that turns out to be harmless after further investigation—this can be unsettling, but it’s common. And some of the tumors detected would never have become dangerous during the patient’s lifetime (so-called overdiagnosis); estimates suggest that this applies to about one in seven cancers detected through screening (Ryser et al. 2022). The bottom line is that for most women, the benefits outweigh the risks—but the decision is yours, and we’d be happy to help you weigh the options.

What we can do in our practice

During your annual checkup, we perform a breast exam. If needed, we’ll perform an ultrasound right then and there during your appointment and, if necessary, arrange for a follow-up MRI. Most abnormal findings are benign; to confirm this, we can take a tissue sample (core biopsy) right here in our office under local anesthesia. We continue to monitor benign changes such as cysts or fibroadenomas ourselves. Only if a precancerous condition or breast cancer is confirmed will we refer you to a specialized breast center—and we’ll remain by your side as your trusted point of contact.

If there is a family history of breast cancer

If close relatives (mother, sister) have had breast or ovarian cancer, especially at a young age, your personal risk may be elevated. In that case, we’ll start screening earlier and more frequently—often supplemented by an MRI—and discuss whether genetic counseling is advisable. Please talk to us if your family history concerns you—together, we’ll find the right approach.

When You Shouldn’t Wait

Please don’t wait for your next routine appointment if you notice anything unusual: a new lump, a dimple or change in the skin, an inverted or weeping nipple, nipple discharge, or persistent, one-sided pain. These are usually harmless—but we’d be happy to examine them promptly.