Breast cancer screening: what, when?

In October, pink ribbons are everywhere. In February, nobody asks when you last checked your breasts. Yet breast cancer screening runs all year: in Germany, from 30 you are entitled to a clinical breast exam at your gynaecologist once a year, and from 50 to 75 to mammography screening every two years, both covered by statutory health insurance. For the other eleven months, three dates are enough: one fixed day a month to check, one appointment a year at the practice and one letter every two years that you do not leave lying around (from 50).

Prevention or early detection? What the exams can do

Most people call it breast cancer prevention. Strictly speaking, it is early detection, because none of these exams stops breast cancer from developing. Their job is to find it while it is still small and easier to treat.

According to Germany's Centre for Cancer Registry Data, 75,090 women and 770 men in Germany were diagnosed with breast cancer in 2023. Roughly one in eight women develops it in the course of her life, and roughly one in six of those affected is diagnosed before turning 50. The relative five-year survival rate for women is 88%.

Breast cancer screening by age: what you are entitled to and when

Early detection in Germany is staggered by age. This overview applies to people with statutory health insurance and no particular family risk. If you have had breast cancer yourself, you follow your own aftercare plan, agreed with your doctor.

In Austria, the early detection programme invites women aged 45 to 74 to a mammogram every two years, and from 40 you can sign up yourself. In Switzerland, most cantons run a screening programme for women from 50, also every two years.

Age	Exam	How often	Cost
under 30	no programme, get to know your breasts	regularly, yourself	none
from 30	clinical exam of breasts and armpits at your gynaecologist	once a year	covered by statutory insurance
50 to 75	mammography screening	every two years	covered by statutory insurance
increased family risk	intensified early detection, from 25 depending on findings	individual	often covered after counselling
any age, no symptoms	ultrasound as an extra exam	on request	self-pay

Under 30: get to know your breasts

There is no early detection programme for young women, because breast cancer is rare at this age. You can still do something. If you know how your breasts normally feel, you are more likely to notice a change. How to go about it is explained further down. And if something feels off, see a doctor at any age, whether or not a programme appointment is due.

From 30: a clinical breast exam once a year

From 30 you are entitled to an exam of your breasts and armpits at your gynaecologist once a year. It is usually part of your annual cancer screening appointment. Use the chance to ask them to show you how to check your breasts yourself.

The Cancer Information Service of the German Cancer Research Center is open about this: whether regular breast exams actually save lives has not been proven so far. It is still a fixed appointment where someone with experience looks at your breasts.

From 50 to 75: mammography screening every two years

Between 50 and 75 you receive an invitation to mammography screening by post every two years, with a suggested appointment near you. Taking part is voluntary and free of charge for you. Since July 2024 the age limit has been 75, and since January 2025 women aged 70 to 75 have also been invited automatically.

If no invitation has arrived, you can contact the central office in your federal state yourself, provided your last screening mammogram was at least 22 months ago. If the suggested date does not suit you, you can reschedule it there as well.

Newly decided: on 15 October 2026, Germany's Federal Joint Committee decided to extend screening to women from 45. From 1 August 2027, you are expected to be able to sign up with the central office from 45, with personal invitations to follow from 2028.

Increased family risk: earlier and more often

If several women in your family have had breast or ovarian cancer, especially at a young age, or a man has had breast cancer, your risk may be hereditary. Raise this with your gynaecologist or GP. They can refer you to one of the centres of the German Consortium for Hereditary Breast and Ovarian Cancer.

There, your risk is assessed. If it is increased, an intensified early detection plan is drawn up, which can start as early as 25 depending on the findings, for example with ultrasound and MRI. Health insurers often cover counselling and genetic testing when there is a justified suspicion.

Ultrasound: when insurance pays and when it does not

For women without symptoms and without a family risk, breast ultrasound is not part of the early detection covered by statutory insurance. Many practices offer it as a self-pay service, usually for up to 60 euros. The IGeL-Monitor rates its benefit as unclear, because meaningful studies are missing.

With an abnormal finding, however, ultrasound and further exams are part of the diagnostic work-up, and your insurance pays.

Breast self-checks: what they can and cannot do

Checking your breasts teaches you how they normally feel. That way you are more likely to notice when something changes, and to see a doctor sooner. It does not replace an exam, and there is no proof that it saves lives. We say this so clearly because October often suggests otherwise. What is proven: if a tumour is found early, before it has spread, the chances of a cure are considerably higher.

When in the month to check

Breast tissue changes with your cycle. Before your period it often feels firmer, lumpier or more tender. The days shortly after your period are a good time, roughly one week after bleeding starts.

If you no longer have a cycle, simply pick a fixed day each month, for example always the first. What happens when your period stops early is covered in our article on early menopause.

How to do it

Ideally, have your gynaecologist show you once. As a rough guide:

Look at your breasts in the mirror, with your arms down and then raised. Pay attention to shape, skin and nipples.
Standing up, for example in the shower, feel each breast with the flat of your fingers in small circular movements, section by section.
Repeat this lying down. The tissue then spreads out flatter and is easier to feel.
Do not forget your armpits and the area up to your collarbone.

It is normal for your breasts to feel different from each other or to be different sizes. Size and shape also change over your life, with your cycle, your weight and your age. When you check, what matters is not how your breasts are, but whether something new has changed.

Changes to get checked

See your gynaecologist or GP promptly if you notice any of these, and do not wait for your next screening appointment:

a new lump or hardening in your breast or armpit
a new dimple, indentation or change in the shape of your breast
reddened skin that does not go away
a nipple that has newly turned inwards or has changed
fluid coming out of the nipple
swollen lymph nodes in your armpit

Many changes are harmless, such as cysts or benign lumps. Get them checked anyway, precisely because the answer is often reassuring.

Men can get breast cancer too

Breast cancer in men is rare. In 2023, 770 men in Germany were diagnosed with it. There is no early detection programme for men. The main warning signs are a one-sided hardening, fluid from the nipple, an inverted or inflamed nipple and swollen lymph nodes in the armpit. The first point of contact is a GP. If you have a partner, father or brother: pass it on.

At discovering hands, blind and visually impaired women carry out breast exams. They are trained there as Medical Tactile Examiners, MTUs for short, and use their trained sense of touch for a systematic tactile breast exam in partner practices and clinics. The tactile breast exam does not replace a mammogram, it complements early detection.

More than 40 statutory health insurers cover the cost, private insurers depending on your plan. You can find a practice near you using the practice finder on discovering-hands.de.

Your plan for the other eleven months

Breast Cancer Awareness Month is a good reason to start. But early detection only works if it also happens in February, in June and in August. Three dates are enough:

One fixed day a month: Set the reminder now, before you put your phone down, shortly after your period or always on the first. A few minutes in front of the mirror are enough.
One appointment a year: From 30, the breast exam is part of your annual gynaecologist appointment. Book the next one at reception on your way out.
One letter every two years: From 50, the screening invitation arrives by post. Put the date in your calendar as soon as the letter arrives, or reschedule it if it does not suit you.

And pass it on. Maybe your sister does not know she is entitled to a breast exam from 30. Or your mother's screening letter has been lying unopened on the kitchen table for weeks.

Frequently asked questions

When should I start breast cancer screening?

From 30 you are entitled to a clinical breast exam at your gynaecologist once a year, and from 50 to 75 also to a mammogram every two years in the screening programme. From August 2027, screening is expected to be available from 45. If your family risk is increased, early detection can start from 25. Have changes to your breasts checked at any age.

How much does breast cancer screening cost?

For people with statutory health insurance, the annual breast exam from 30 and mammography screening from 50 to 75 are free. An ultrasound without symptoms is a self-pay service, usually up to 60 euros. More than 40 statutory health insurers cover the tactile breast exam by discovering hands.

How often is a mammogram done?

In the screening programme every two years, for women aged 50 to 75. The invitation arrives by post. If your family risk is increased or you have an abnormal finding, your doctor will set different intervals.

When in my cycle should I check my breasts?

Ideally shortly after your period, around one week after bleeding starts. The tissue is then usually softer and less tender. Without a cycle, pick a fixed day each month.

Is ultrasound better than mammography?

For early detection in women without symptoms, mammography is the exam used in the programme. There are no meaningful studies on the benefit of an additional ultrasound in women without findings, and the IGeL-Monitor rates it as unclear. Ultrasound is, however, used specifically to investigate a finding and for women with an increased family risk.

What is breast cancer detection by blind women?

discovering hands trains blind and visually impaired women as Medical Tactile Examiners. They examine breasts systematically in partner practices and so complement early detection by doctors. More than 40 statutory health insurers cover the cost.

Can men get breast cancer?

Yes, though rarely: in 2023, 770 men in Germany were diagnosed. There is no screening for men. Men should have a one-sided hardening, fluid from the nipple or an inverted nipple checked by their GP.