Early Detection—Screening for Breast Cancer
Early breast cancer detection has a strong influence on breast cancer survival. For example, when breast cancer is found in the early, localized stage, 98.5% of those people survive for at least five years after diagnosis. The primary early detection tool is a mammogram.
The medical community recognizes the value of breast cancer screening and mammography, but there is no universal consensus on how often it should be done or when it should be started. Most health organizations agree, however, that women should work with their healthcare provider to assess their personal risk of developing breast cancer and to determine what is best for them. Considerations can be given to the benefits of screening as well as the harms. While screening can detect cancer early when it is most treatable, it may also lead to false-positive results and unnecessary follow-up procedures, such as biopsies.
The American Cancer Society (ACS) recommends that:
- Women age 40 be given the option to begin screening with a mammogram
- Women age 45 to 54 have a yearly mammogram
- Women age 55 and older have the option to switch to screening with a mammogram every other year or continue with mammograms every year and for as long as they are healthy and expected to live more than 10 years
- Women at high risk for breast cancer may choose to have an MRI in addition to an annual mammogram beginning at age 30 and for as long as they are in good health
The U.S. Preventive Services Task Force:
- Recommends routine mammography every 2 years for women ages 50-74
- Recommends against screening mammograms for women under the age of 50
- Discourages teaching breast self examination
- Concludes that there is insufficient evidence for or against recommending MRI screening
The American College of Obstetricians and Gynecologists (ACOG) recommends that:
- Mammography screening be offered annually to women starting at age 40
- Women age 40 and older have an annual clinical breast exam by a health practitioner
- Women in their 20s and 30s have a clinical breast exam every one to three years
- Women may consider doing a breast self-exam; they should know how their breasts normally appear and feel and should report any changes to their healthcare provider.
The American Medical Association adopted the policy that says that women age 40 and older should have access to screening mammography if they choose and their healthcare providers agree. That replaced their early guidance that supported screening mammograms in all asymptomatic women older than 40.
Women with certain risk factors may be advised to begin screening at an earlier age and may be advised to be screened more frequently, with additional testing such as imaging scans.