October 25, 2021
October is Breast Cancer Awareness Month and a good reminder to talk with your doctor about whether it is time for your breast cancer screening. Of course, being aware of your breast health is important all year long. No matter what month it is, we hope this information will encourage you to talk to your doctor about your breast cancer risk and what you can do to stay healthy.
Breast cancer survival rates continue to improve. The average 5-year survival rate for women with invasive breast cancer is 90% 1. If the cancer is located only in the breast, the five-year survival rate is 99%. One of the reasons these rates are so high is because we are catching breast cancer earlier, when it's more treatable. This is thanks to screening tests like mammograms.
Preparing for your first breast cancer screening can be an intimidating experience. However, most women find that getting a mammogram is not a negative experience. How often you will need to get a mammogram depends on your age and health history. It's important to follow your doctor’s recommendations for all health screenings, including mammograms. Here are 5 common questions to ask your doctor about breast cancer screening.
- Do I need a mammogram at this time?
- 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?
Breast Cancer Screening Frequently Asked Questions
Your primary care physician or OB/GYN can help you learn more about your individual breast cancer risk and provide screening recommendations for you.
1. Do I need a mammogram at this time?
If you are over 25, you should talk with your doctor about your 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
In addition, all women should perform breast self-examinations 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. During a screening mammogram, typically two views of each breast are taken. Modern mammogram machines taking two views of each breast will expose you to about .4 millisieverts of radiation, which is less than a chest X-ray. For perspective, we are exposed to an average of 3 millisieverts of background radiation every year from our natural surroundings. The procedure takes about 20 minutes and discomfort is generally minimal.
In the past, it has been suggested that mammograms lead to the overdiagnosis of breast cancer since the screenings can find very small cancers that may never cause symptoms or problems. Given that it is impossible to tell which breast cancers would never cause problems, finding these early cancers saves countless lives.
3. How Accurate Are Breast Cancer Screening Tests?
Breast cancer screening tests are the most accurate way to detect breast cancer. A mammogram (the most common type of breast cancer screening) 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. Be sure to follow up if your radiologist suggests additional tests.
Additional tests may include breast ultrasound or MRI. While follow-up testing can be 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. Many women who undergo additional screenings do not receive a breast cancer diagnosis.
4. Do I Need a 3D Mammogram?
Most women do not need a 3D mammogram. A 3D mammogram provides more images than a typical mammogram; however, some health insurance plans won’t cover it. A 3D mammogram might be a good choice if you have dense breasts or 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. If you have a higher-than-average risk of breast cancer, your doctor may recommend that you begin screenings earlier and have them more often. Be sure to discuss any concerns you have about your risk for breast cancer with your doctor.
Breast Cancer Screening and Detection
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 is abnormal or results are unclear, other tests like a breast ultrasound or MRI will likely be recommended.
If breast cancer is detected, you will be referred to an oncologist to begin treatment. Early detection leads to early treatment which is the best tool for a positive outcome. With today’s treatment options, including access to clinical trials, many women with breast cancer are able to live long, healthy lives. The first step, however, is to schedule your mammogram!