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 tools are breast self-exams, clinical breast exams, and mammograms.
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. Women should work with their healthcare provider to assess their personal risk of developing breast cancer and to determine how often screening should be done. 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 20 and older may consider doing a breast self-exam every month. They should know how their breasts normally appear and feel and should report any changes to their healthcare provider.
- Women in their 20s and 30s should have a clinical breast exam by a health practitioner as part of their regular physical at least every three years.
- Women age 40 and over should have a yearly mammogram and a clinical breast exam.
- Women at high risk for breast cancer should have an MRI and a mammogram annually.
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
- Clinical breast exams every 1-3 years beginning at age 20
The American Medical Association adopted the policy that agrees with recommendations from the ACS and ACOG and 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.
For more information on self breast exams, go to the American Cancer Society web site.