October 9, 2017
There is good news about breast cancer death rates! They're on the decline! Breast cancer deaths dropped nearly 40% between 1989 and 2014. The primary reason for the decline is an increase in breast cancer screening that helps detect breast cancer earlier. And that results in a higher survival rate.
If you're not sure what breast cancer screening is or if you should get it, here are some questions to ask your primary care doctor or OB-GYN:
1. At my age, do I need breast cancer screening?
If your breast cancer risk is average, meaning you don't have a family history of the disease, your doctor will explain the pros and cons of breast cancer screening based on your age. Different organizations have different recommendations. The American Cancer Society recommendations for screening are:
- Women between the ages of 40 and 44 considered at average risk of developing breast cancer should talk to their doctor about the pros and cons of mammograms and decide if they want to be screened.
- Women between the ages of 45 and 54 should get annual mammograms.
- Women age 55 and up can change to having a mammogram every two years -- or choose to continue annual screenings.
2. Are mammograms safe?
Yes. Mammograms are a type of x-ray image that does use a small amount of radiation that is considered safe for periodic use. Mammograms require less radiation than chest X-rays.
3. How accurate are breast cancer screening tests?
While breast cancer screening tests are the most reliable way to identify breast cancer, they are not foolproof. Ask your doctor to explain the risks of false negatives and false positives.
4. Do I need a 3D mammogram?
It’s not absolutely necessary, but if you have the option it may be something to consider since 3D mammograms typically produce fewer false positive results.
The images produced are clearer than a 2D mammogram which means that women with dense breast tissue may especially benefit because the images will be clearer.
5. If I am at increased risk of developing breast cancer do I need additional screening?
Ask your doctor to explain whether you have a heightened risk of developing breast cancer due to your family history, risk factors present in your lifestyle, dense breast tissue, and/or your age, race or ethnicity. They may suggest a visit with a genetic counselor if you have a family history and/or your doctor may also suggest earlier or more frequent mammograms. There is also a growing evidence that breast MRI, when combined with mammography, is better than only a mammogram to find breast cancer in certain women at higher risk¹²³.
Breast Cancer Detection and Diagnosis
If your primary care doctor or OB-GYN recommends that you be screened for breast cancer, you'll most likely be referred to a center that specializes in mammography to detect signs of cancer. If the mammogram indicates anything that may not be normal, other tests such as ultrasounds, MRIs or biopsies may be used to determine if cancer is present (often, breast lumps are not cancerous.) If cancer is detected, you'll need to see a cancer specialist to begin treatment. The sooner treatment begins, the better the likelihood of a positive outcome. Breast cancer screening is an important first step.
- Saslow D, Boetes C, Burke W, et al. for the American Cancer Society Breast Cancer Advisory Group. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 57(2):75-89, 2007.
- Warner E, Messersmith H, Causer P, Eisen A, Shumak R, Plewes D. Systematic review: using magnetic resonance imaging to screen women at high risk for breast cancer. Ann Intern Med. 148(9):671-9, 2008.
- Chiarelli AM, Prummel MV, Muradali D, et al. Effectiveness of screening with annual magnetic resonance imaging and mammography: results of the initial screen from the Ontario High-Risk Breast Screening Program. J Clin Oncol. 32(21):2224-30, 2014.