Breast cancer is one of the most commonly diagnosed cancers in women, but the good news is that it is also one of the most treatable. This high rate of diagnosis is partly because breast cancer has a relatively high lifetime risk: about 1 in 8 women (roughly 12%) will develop breast cancer at some point in their lives. However, thanks to advancements in screening, early detection, and treatment, breast cancer is highly curable, especially when caught early. In fact, the 5-year relative survival rate for localized breast cancer (when the cancer is confined to the breast) is nearly 99%.
Breast Cancer Screening Recommendations:
Screening guidelines help women navigate breast cancer screening based on age and personal risk factors. Different medical societies suggest slightly varying breast cancer screening guidelines due to differing interpretations of research, weighing the benefits and risks of screening, and considering individual patient factors. However, they all agree on the importance of regular screening for early detection.
In 2024, the United States Preventive Services Task Force (USPSTF) revised its mammography screening guidelines, recommending that women at average risk begin biennial (every two years) mammograms starting at age 40, as opposed to the previous guideline of beginning at age 50. This change was influenced by new evidence suggesting that starting screenings earlier can significantly improve early detection and outcomes, particularly in women in their 40s.
The American College of Obstetricians and Gynecologists (ACOG) issued a statement supporting the USPSTF’s updated guidelines, aligning with the growing consensus on the benefits of starting regular screening at age 40.
The American College of Radiology (ACR) and the Society of Breast Imaging (SBI) continue to recommend annual mammograms starting at age 40 for women at average risk. They argue that annual screening provides the highest level of early detection, offering the best chance to catch breast cancer when it is most treatable. The ACR also suggests that women at higher risk (e.g., those with a family history of breast cancer) may need to start even earlier and consider supplemental imaging like MRI.
ACOG Screening Recommendations:
- Ages 40-49: Begin yearly mammograms at age 40.
- Ages 50-74: It is advised to have mammograms every 1 to 2 years, depending on individual risk factors and after a shared decision-making process with a healthcare provider.
- Ages 75 and Older: Option to continue mammography screening for women in good health.
Screening Studies and Tests
Breast cancer screening primarily relies on imaging tests, with mammography being the gold standard. Here’s a closer look at the tests commonly used:
- Mammography: This is the primary screening method and the most effective way to detect breast cancer early. Digital mammograms provide detailed images, improving the detection of abnormalities, particularly in women with dense breast tissue. Early detection through mammography is key to the high cure rates we see today.
- Breast Ultrasound: Often used as a supplementary test for women with dense breasts. Ultrasound can help distinguish between solid masses and fluid-filled cysts, providing further clarity when mammogram results are inconclusive.
- Magnetic Resonance Imaging (MRI): Breast MRI is recommended for women identified as high-risk (e.g., genetic predispositions like BRCA mutations). While more sensitive than mammograms, MRIs may lead to false positives, making them more suitable for high-risk patients rather than general screening.
Risk Assessment: Identifying High-Risk Women
Risk assessment is an important tool in personalized breast cancer screening. Many imaging centers in Anchorage incorporate risk assessments as part of yearly mammograms. Imaging Associates provides your lifetime breast cancer risk utilizing the Tyrer-Cuzick (TC) model, which takes into account various factors, including:
- Hormonal factors
- Age and body mass index (BMI)
- Breast tissue density
- Family history and genetic factors
This comprehensive assessment helps identify women at higher risk of developing breast cancer. Women with an intermediate or high calculated lifetime risk may benefit from supplemental screening, such as ultrasound or MRI, which can detect cancers that may not be visible on a mammogram.
The Importance of Self-Breast Exams
While formal self-breast exams (SBEs) are not strictly recommended as a standalone screening method, they remain a vital part of breast self-awareness. Understanding what is normal for your breasts can help you notice any changes, such as new lumps or skin changes, which should prompt a visit to your healthcare provider. Here’s how to perform an SBE effectively:
- In the Shower: Use the pads of your fingers to explore your entire breast in a circular motion, checking for lumps or unusual thickening.
- In Front of a Mirror: Observe your breasts for changes in shape, size, or appearance. Look for any dimpling, nipple inversion, or skin changes.
- Lying Down: When lying down, the breast tissue spreads out more evenly. Use varying pressure as you feel around the breast and armpit areas, checking for abnormalities or changes.
#Be Breast Aware