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Breast Cancer Screening & BRCA Testing

July 26, 2021
Sarah Falcone RN

Breast cancer is now the most common cancer in the world. In fact, 12% of all new cancer cases in 2021 will be breast cancer. As a result, chances are you know someone who has faced this terrible disease. And it is likely you have wondered about breast cancer screening.

Currently, there are several recommendations about breast cancer screening. There are benefits to screening and early detection, but there are also potential problems. Your doctor should help you decide which tests you need based on your history and risk. For high-risk men and women with a family history of cancer, BRCA genetic testing is invaluable.

Breast cancer screening is a great way to take charge of your health. Here's what you need to know about breast cancer screening.

breast cancer screening

When to Get Breast Cancer Screening

According to the National Cancer Institute, screening means looking for the disease before there are any signs. Hence, the best time to get checked is before you have symptoms.

Screening is looking for abnormalities. It may find cancer at an early stage. Because of advanced detection, doctors can more easily treat the disease. Patients also have better odds at survival. Each type of cancer has unique guidelines for screening.

Current Recommendations and Guidelines

Overall, current guidelines and recommendations say that most women should have a mammogram to detect tissue changes beginning at age 40.

Men are also affected by breast cancer. However, most guidelines do not include them in the recommendations. A doctor can give male patients personalized guidelines for screening. 

Here are the most current routine recommendations for women starting at age 40.

OrganizationWomen Age 40-49Women Age 50-74 
US Preventive Services Task Force (USPSTF)Individualized to the patientDigital mammogram every 2 years
American College of Obstetricians and Gynecologists (ACOG)Offer annual mammogram Mammogram every 1-2 years until age 55, then every 2 years
National Cancer Institute (NCI)Mammogram every 1-2 years Mammogram every 1-2 years 
American Cancer Society Offer annual mammogram until age 45, then mammogram every year Mammogram every year age 50-55, then every two years after age 55
American College of Radiology (ACR)AnnualAnnual

Screening for High-Risk Cases

Some men and women worry about breast cancer because they have a family history of cancer. 

Women with a personal or family history of some cancers could have changes in their genes. These mutations are known as BReast CAncer gene 1 (BRCA1) or BReast CAncer gene 2 (BRCA2) changes. They may mean a higher cancer risk. 

High-risk patients should see a doctor or specialist. They will need a risk assessment, genetic counseling, and in some cases, lab testing. Mutations in the BRCA1/2 genes may lead to:

  • 45-65% increased risk of breast cancer 
  • 10-39% increased risk of ovarian, fallopian tube, or peritoneal cancer
  • Increased risk of other cancers

Genetic testing for BRCA1/2 requires a special blood test that your doctor can order. The doctor can explain the details. They can also answer questions you might have.

According to the National Cancer Institute, many women with ovarian and breast cancers are not receiving these genetic tests, even though they have become inexpensive and easily accessible.

Now with telemedicine, it is easier than ever to get this valuable testing done. An online provider such as a virtual gynecologist or virtual physician can tell you if you need it and when or how to get it.

My Virtual Physician offers consultations about this important BRCA gene testing. For little or no out-of-pocket cost, they can arrange for you to have your blood drawn. They make it easy. They work with many local LabCorp or Quest outpatient testing centers who can provide this service for you.

Other Screenings Used for Breast Cancer

Like much in healthcare, tests may not be “one risk fits all.” That is why you should talk to your doctor about what is best for you. He or she will consider factors such as lifestyle, family history, and other health concerns. Then they can help you decide what to do.

Your doctor can recommend one of these methods below. If you do not have a doctor, a virtual doctor online can be a great place to start.

Mammography

The most common test for breast cancer is called mammography. It is ordered by a doctor. Mammograms look for early changes in the tissue that could be dangerous.

A mammogram is a special type of X-ray that shows the breast tissue. Sometimes, doctors can see lumps on the images that they cannot feel. 

Magnetic Resonance Imaging (MRI)

Women who have a high risk of cancer or have dense breast tissue may require magnetic resonance imaging. 

The MRI test is more sensitive and can detect finer irregularities. MRI images also give a clearer picture of the breast tissue. Unfortunately, this screening method is much more expensive and therefore is not used for routine exams.

Other Screening Tests

Breast cancer testing is an active area in clinical research. Other methods include:

Physicians can explain the options to patients. And they can help them make informed choices about each type of screening. 

Doctors can help guide a patient to the best choice. Physicians also tell their patients about risks that they need to consider. 

Breast Cancer Screening Risks

Your doctor should tell you when to get screened for breast cancer. Talking to a board-certified physician about the right time for you to have a cancer screening may prevent problems.

Specialists caution patients that there are risks involved with all medical tests, including cancer screening. Some of them include:

  • Finding irregular growths that would not grow into cancer
  • Treatment that is not needed and costs a lot
  • Stress and anxiety
  • False-positive results
  • More costly tests

This is why you should talk to your doctor when you are thinking about breast cancer screening.

Connect with Our Physicians

My Virtual Physician offers a full line of virtual physician services. To talk with one of our board-certified physicians, click to book now. Our caring experts can talk with you about a screening plan that is best for you. 

If you have suggestions for other topics you want to read about, let us know! Don’t forget to follow us on social media.

Sources:

Breast Cancer Overtakes Lung As Most Common Cancer - WHO. Reuters. Feb 2, 2021. https://www.reuters.com/article/health-cancer-int/breast-cancer-overtakes-lung-as-most-common-cancer-who-idUSKBN2A219B

Cancer Screening Overview (PDQ®)–Patient Version. National Institute of Health. National Cancer Institute. Aug 19, 2020. https://www.cancer.gov/about-cancer/screening/patient-screening-overview-pdq

Breast Cancer Screening. U.S. Preventative Task Force. Jan 11, 2016.https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening

Breast Cancer Risk Assessment and Screening in Average-Risk Women. American College of Obstetricians and Gynecologists. Practice Bulletin. Number 179. July 2017. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/07/breast-cancer-risk-assessment-and-screening-in-average-risk-women

American Cancer Society Guidelines for the Early Detection of Cancer: Breast Cancer. American Cancer Society. Jul 30, 2020. https://www.cancer.org/healthy/find-cancer-early/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html

New ACR and SBI Breast Cancer Screening Guidelines. American College of Radiology. Apr 4, 2018. https://www.acr.org/Media-Center/ACR-News-Releases/2018/New-ACR-and-SBI-Breast-Cancer-Screening-Guidelines-Call-for-Significant-Changes-to-Screening-Process

BRCA Overview. Basser Center for BRCA, Penn Medicine. Accessed Jul 24, 2021. https://www.basser.org/brca

Chen, S., Parmigiani, G. (2007). Meta-Analysis of BRCA1 and BRCA2 Penetrance. Journal of Clinical Oncology,  25(11), 1329-1333. https://doi.org/10.1200/JCO.2006.09.1066

Fewer Women with Ovarian, Breast Cancer Undergo Genetic Testing than Expected. National Cancer Institute. Apr 9, 2019. https://www.cancer.gov/news-events/cancer-currents-blog/2019/ovarian-breast-cancer-testing-inherited-genetic-mutations

BRCA1 and BRCA2 Testing. BreastCancer.org. Sep 21, 2020.https://www.breastcancer.org/symptoms/diagnosis/brca

Pediconi, F., & Galati, F. (2020). Breast cancer screening programs: does one risk fit all?. Quantitative imaging in medicine and surgery, 10(4), 886–890. https://doi.org/10.21037/qims.2020.03.14

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