Medically reviewed by Prof. Dr. Aamer Nadeem Chaudhary, M.B.B.S., D.M.R.D., F.C.P.S. (Diagnostic Radiology), Consultant, Al-Nasar Lab & Diagnostic Centre. Updated October 2026.
Quick answer: Screening means checking for breast cancer before any symptom appears. For most women, mammography is the main screening test and is generally discussed from age 40. Under 40, ultrasound is usually preferred because breast tissue is dense. Women with a strong family history often start about ten years earlier than the age at which their relative was diagnosed.
Book breast screening: call 0300 0341944. Mammography and ultrasound are performed at our main Johar Town campus.
Why does screening matter so much in Pakistan?
Breast cancer is the most commonly diagnosed cancer among women in Pakistan, and a large proportion of cases are found only once the disease is advanced.
The reasons are mostly social rather than medical. Awareness is limited, examination feels embarrassing to discuss, and there is a widespread and dangerous belief that a lump which does not hurt cannot be serious.
That last belief deserves correcting directly. Most breast cancers are painless in the early stages. Absence of pain is not reassurance, and waiting for a lump to start hurting is how early disease becomes late disease.
Breast cancer is also one of the cancers where early detection changes the outcome most. Found early, treatment is shorter, less aggressive and far more likely to succeed.
Which test is right for your age?
| Age group | Primary test | Why |
|---|---|---|
| Under 30 | Ultrasound if there is a lump or symptom | Routine screening is not normally advised. Tissue is very dense |
| 30 to 39 | Ultrasound, with mammography added if indicated | Dense tissue limits what mammography can see |
| 40 to 49 | Mammography, often with ultrasound | Tissue begins to change. Combining the two detects more |
| 50 and above | Mammography | Most effective in this group, and risk is highest |
| High risk at any age | Earlier and more frequent imaging, sometimes MRI | Decided individually with a specialist |
These are general patterns, not rules. Your doctor sets your personal schedule based on your history, your examination and your breast density.
Why age decides the test
It comes down to what each test can see through. On a mammogram, dense glandular tissue appears white, and so does a tumour. In a younger woman whose breasts are mostly dense tissue, finding a white lump against a white background is genuinely difficult.
Ultrasound does not have that problem, because it separates tissues by how they reflect sound rather than by density on an X-ray image.
After menopause, glandular tissue is gradually replaced by fat, which appears dark on a mammogram. A suspicious area then stands out clearly, which is why mammography becomes highly effective in exactly the age group where risk is greatest.
Our guide comparing breast ultrasound and mammography explains this in more detail.
What does mammography find that nothing else can?
Microcalcifications: tiny specks of calcium, far too small to feel and invisible on ultrasound.
Certain patterns of these specks can represent ductal carcinoma in situ, a very early cancer still confined inside the milk duct. At that stage there is no lump at all and nothing for any other test to detect.
This is the central argument for mammographic screening. It can find disease years before it would otherwise be noticed, at the point where treatment is least invasive.
Who is at higher risk?
- A mother, sister or daughter diagnosed with breast cancer, particularly if she was young
- A known BRCA1 or BRCA2 gene change in the family
- A previous breast cancer or certain previous biopsy findings
- Periods starting early or menopause arriving late
- No pregnancies, or a first pregnancy after 30
- Long term hormone replacement therapy
- Previous radiotherapy to the chest
- Obesity after menopause, and regular alcohol use
- Dense breast tissue reported on a previous mammogram
Two important points of balance. Most women who develop breast cancer have no family history at all, so a clear family history is not a reason to skip screening. And having risk factors does not mean you will develop the disease, it means screening matters more for you.
Warning signs that need a doctor now, at any age
- A new lump in the breast or armpit
- Discharge from one nipple, especially if blood stained
- A nipple that has newly turned inward
- Dimpling or puckering of the skin, or an orange peel texture
- Persistent redness, scaling or a rash on the nipple
- A change in the size or shape of one breast
- Persistent pain in one specific spot
These require assessment, not screening. Screening is for women with no symptoms. If you have any of the above, see a doctor promptly regardless of when your last scan was. Our guide on breast changes and self examination covers what to look for.
How to prepare for a mammogram
- Book the week after your period if you still menstruate. Breasts are least tender then and the compression is much more comfortable
- Do not use deodorant, antiperspirant or talcum powder on the day. Their fine metallic particles appear as white specks and can be mistaken for microcalcifications
- Wear a two piece outfit, since you undress from the waist up
- Tell the team if you are or might be pregnant, or are breastfeeding
- Mention breast implants, as additional views are needed
- Bring previous mammograms and reports. Comparing against older images is one of the most valuable parts of the assessment, because a finding that has been unchanged for years is reassuring in a way a single new image cannot be
Ultrasound needs no preparation at all.
What happens if something is found?
Most findings on screening turn out to be benign. Cysts, fibroadenomas and ordinary dense tissue are all common and harmless.
If an area needs further assessment, the usual sequence is additional mammographic views or an ultrasound, then if still uncertain a needle biopsy to obtain a definite answer. In selected cases a breast MRI is used.
Being recalled after a screening mammogram is common and is not the same as a diagnosis. It usually means the radiologist wants a clearer look.
Breast screening at Al-Nasar Lab
Al-Nasar Lab & Diagnostic Centre has served Lahore since 1996 and holds ISO 15189:2022 accreditation from the Pakistan National Accreditation Council. Mammography and ultrasound are both available at our Johar Town campus and reported by consultant radiologists, so where both are needed they can usually be completed in a single visit.
See our accreditations, find your nearest location, or contact us to book.
Frequently Asked Questions
At what age should breast cancer screening start?
Mammographic screening is generally discussed from age 40. Women with a strong family history often begin about ten years before the age their relative was diagnosed, after advice from a specialist.
Is a painless lump safe to ignore?
No. Most early breast cancers are painless. Any new lump needs assessment at any age, even though most turn out to be benign.
How often should I have a mammogram?
Commonly every one to two years once screening begins, though your doctor sets the interval based on your risk and breast density.
Why can I not wear deodorant for a mammogram?
Deodorants and talc contain fine metallic particles that appear as white specks on the image and can be confused with microcalcifications.
Does a normal mammogram mean I am clear?
It is reassuring but not absolute, particularly in dense breasts. Report any new lump or change to your doctor even if your last mammogram was normal.
This article is for general information and is not a substitute for medical advice. Please see a doctor promptly about any new breast lump or change.
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