September 21, 2020
Breast cancer survival rates are improving. The average 5-year survival rate for women with invasive breast cancer is 90%. If the cancer is located only in the breast, survival rates are even higher, averaging 99%, five years after diagnosis. Breast cancer screening is vital for early detection and increasingly successful treatment of breast cancer.
Preparing for your first breast cancer screening can be an intimidating experience. However, it's important to follow your doctor's recommendations for all health screenings. Learning more about the process and what to expect can help ease any fears you have and help you feel more confident when your appointment arrives. Here are 5 common questions to ask your doctor about breast cancer screening.
- Do I need a breast cancer screening at my age?
- Are mammograms safe?
- How accurate are breast cancer screening tests?
- Do I need a 3D mammogram?
- If I'm at increased risk for breast cancer, do I need additional screening?
Questions to Ask Your Doctor About Breast Cancer Screening
Learning all the facts is the best tool for good health. Your primary care physician or OB/GYN can help you learn more about the breast cancer screening tests that you need. Asking these questions will help you learn more about the different screenings for breast cancer.
1. Do I need a breast cancer screening at my age?
Age is one factor in determining when you should begin having breast cancer screenings. Women over 25 should talk with their doctor about their risk level for breast cancer. Guidelines may vary based on other risk factors as well. The American Society of Breast Surgeons offers the following recommendations for breast cancer screening:
- Women with average risk of breast cancer:
- that have non-dense breasts should get a yearly screening mammogram starting at age 40
- that have increased breast density should get a yearly mammogram at age 40 and consider supplemental imaging
- Women with higher-than-average risk:
- that have genetic markers associated with higher cancer risk should start an annual MRI at age 25, then an annual mammogram starting at age 30
- that have had prior chest wall radiation from age 10-30 should start an annual MRI at age 25, then an annual mammogram starting at age 30
- with a risk of greater than 20% by any model, or a strong family history of breast cancer should start an annual mammogram and supplemental imaging starting at age 35 when recommended by your physician
- Women with a prior history of breast cancer age 50 or more should get an annual mammogram
- Women with prior history of breast cancer under age 50, or with dense breasts should get an annual mammogram and supplemental imaging when recommended by your physician
Additionally, it's recommended that all women should be provided with the known benefits and risks of breast cancer screenings and be familiar with the way their breasts normally look and feel so changes can be reported immediately.
2. Are Mammograms Safe?
Yes. A mammogram is a type of X-ray which means you will be exposed to a tiny bit of radiation. In fact, the amount of radiation from a mammogram is even less than that of a chest X-ray. The procedure lasts only about 20 minutes and discomfort is minimal for most women.
In the past, there have been suggestions that mammograms lead to the overdiagnosis of breast cancer since the screenings can find very small cancers that may never cause symptoms or problems. However, it's impossible to tell which breast cancers would never cause problems, and early diagnosis is vital in providing life-saving treatment for all women with breast cancer.
3. How Accurate Are Breast Cancer Screening Tests?
Breast cancer screening tests are the most accurate way to detect breast cancer. A mammogram is the most common type of breast cancer screening and is 87% accurate in correctly detecting breast cancer. Sometimes, mammography results in a false positive result which requires additional testing. About 13% of the time, a mammography results in a false negative result. This is why it is vital to follow up if your radiologist suggests additional tests.
Additional screenings include breast ultrasound and MRI. While follow-up testing is stressful, it's important to remember that a recommendation for these additional tests isn't necessarily a suggestion of a positive result. Sometimes dense breast tissue requires a closer look with additional screening.
4. Do I Need a 3D Mammogram?
It's not necessary to have a 3D mammogram, but it might be something recommended by your doctor under certain conditions. A 3D mammogram can provide dozens of images instead of approximately only a few that are usually produced with a typical mammogram. It may not be necessary to have 3D mammography if you are at average risk and your health insurance won't provide coverage. However, a 3D mammogram might be a good choice for women with dense breasts or those who have a personal history of breast cancer. Your doctor will help you understand your personal risks and recommend what type of mammogram you should get.
5. If I'm at Increased Risk for Breast Cancer, Do I Need Additional Screening?
It's important to talk to your doctor about whether you are at a higher risk of developing breast cancer. Your risk factors may be increased due to genetic factors or other reasons related to your lifestyle. Risk factors for breast cancer include:
Genetic Risk Factors
- Gender - Women are 100 times more likely to develop breast cancer.
- Age - Women over 55 are at a higher risk.
- Family history of breast cancer - Women with immediate family members who have been diagnosed with breast cancer may be at higher risk.
- Personal history of breast cancer - If you've previously had breast cancer, you may be more likely to develop it again.
- Dense breasts - Dense breasts make it more difficult to detect cancer on a mammogram.
Lifestyle Risk Factors
- Drinking alcohol
- Being overweight
- Certain types of birth control
Even in women with increased risks, a mammogram is the most common initial screening for breast cancer. However, your doctor may recommend that you begin screenings earlier and have them more often than women at average risk. Be sure to discuss any concerns you have about your risk for breast cancer with your regular doctor.
Breast Cancer Detection and Diagnosis
If your doctor recommends you begin breast cancer screening, you will most likely be sent to a center that specializes in Mammography and other methods of breast cancer detection and diagnosis. The most common screening for breast cancer is a mammogram. If the mammogram indicates abnormal or unclear results, other tests like a breast ultrasound or MRI will likely be recommended.
If breast cancer is detected, you will be referred to a cancer specialist (often called an oncologist) to begin treatment. Early detection leads to early treatment which is the best tool for a positive outcome. Breast cancer screenings play a vital role in the improved survival rate observed in breast cancer patients.
Originally posted October 2017. Updated September 2020.