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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.
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.
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.
| Organization | Women Age 40-49 | Women Age 50-74 |
| US Preventive Services Task Force (USPSTF) | Individualized to the patient | Digital 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) | Annual | Annual |
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:
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.
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.
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.
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.
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.
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:
This is why you should talk to your doctor when you are thinking about breast cancer screening.
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.
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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
As temperatures cool and leaves begin to change, we are beginning to see the colors of fall all around us. The golds, deep reds, and pink signal that October is upon us. The pink ribbon has become an international symbol for breast cancer awareness. And this month serves as an annual campaign to promote action in the fight against the disease. To kick off breast cancer awareness month, here is some important information on the importance of breast cancer screening, that could even help save a life.
Breast cancer screening is routine testing for healthy people that are not showing any symptoms or having any problems. There are different types of screening tools and tests, and your physician can help determine what is best for you.
There are several different screening tests that providers can use to check for breast cancer. For example, clinical breast exams are sometimes part of annual wellness visits. Another example is thermography which uses an infrared camera to view heat patterns and blood flow in body tissues. A third example of a breast cancer screening test is mammography. This is the type that most people are familiar with. So what exactly is mammography?
Mammography is a procedure that uses a low dose x-ray to show the inside breast tissue. It gives us a mammogram, similar to a photograph of the internal breast tissue. Mammography can visualize lumps that cannot be felt by physical exam. Furthermore, in some cases, mammography may detect changes in the breasts that could be cancerous years before symptoms would appear.
Mammography is a somewhat newer technology. It was introduced in the United States in the 1980s. Notably, since that time, deaths from breast cancer among women have decreased by 30%.
The recommendation for routine screening varies from person to person. Breast cancer can affect men but the risk is low. The vast majority of women are at average risk of developing breast cancer. This means that their risk is less than 15 percent of developing breast cancer in their entire lifetime. Still, others might be considered high risk. For this reason, it is important to talk with your healthcare provider about what is right for you. When you talk with your physician, they will discuss your screening options.
Recent studies warn against overdiagnosis. Overdiagnosis may represent 20% or more of all breast cancers among screen-detected cancers. Overdiagnosis leads to overtreatment and inflicts considerable physical, psychological, and economic harm to many women.
This term overdiagnosis refers to cases where breast changes discovered during examination are diagnosed as cancer, but would never have caused any problems or evolved, had they not been found on screening. This is an example of why it is vital for individuals to understand the risks and benefits of screening. There are risks and limitations for every test.
Because the incidence of cancer in women under the age of 40 is so low, it is recommended to avoid testing before that time. This is one way that overdiagnosis can be mitigated. Newer studies show that cancers diagnosed at an earlier age can be more aggressive. Therefore early detection is important. The American Cancer Society recommends annual screening starting at age 40.
Although there are some risks with screening as we mentioned, routine screening offers important benefits including early detection and early intervention. It is recommended that women without any risk factors should still be screened. This is because up to 75% of breast cancer cases are diagnosed in women who have no risk factors at all.
Early detection is important. Firstly, early detection helps with a diagnosis before symptoms appear. Secondly, the risk of dying from cancer goes down by 25-30% or more with early detection. Without early detection, tumors can grow and possibly spread to other parts of the body. As you see, early detection is important and can lead to early intervention.
With an early diagnosis, patients have the opportunity for early intervention. This is important because cancer is usually easier to treat early in the disease process. Furthermore, treatment usually requires less aggressive therapy. More advanced cases may need extensive treatment including chemotherapy, surgery, and radiation.
Another benefit of early detection and early intervention is the lower cost associated with treatment. This is because the treatment may be less extensive or invasive. Also, treatment plans may be shorter and require fewer therapies. The prognosis is often better too.
So now that you understand what a mammogram is and why it is important, there are just a few more tips you should know when talking to your provider about this important screening test.
Firstly, it is a relatively painless and quick test. It only takes around 20 minutes. Some patients experience mild discomfort because, during the test, breast tissue is pressed between two plates. But if you are prepared and know what to expect this should not worry you.
Secondly, you may have options. In some cases, you can choose between a 2D or a 3D mammogram. 3D mammography, also known as digital breast tomosynthesis, has become more common. Yet, it is still not available everywhere. As with all tests, there are pros and cons. One benefit of this newer technology is that it may be more helpful in showing changes in women who have denser breast tissue. Individuals who choose 3D mammography may have a lower risk of being "called back" for re-examination in the case of an unclear result. However, one reason that a 3D mammogram may not be the preferred choice is a cost consideration. This newer exam can cost more and additional health insurance plans may not fully cover it.
Thirdly, some centers offer same day results. If you might be one to worry over your test findings, choosing this type of provider might be best for you.
So as you can see, the mammogram is a relatively simple, quick, and painless test for breast cancer screening. The benefits of early detection and early intervention should be weighed with the risk of overdiagnosis as you talk to your provider. Armed with the information you have now, you can confidently talk to your healthcare provider about your screening options.
If you still have questions or you would like to talk about your risk and the screening options available, MyVirtualPhysician has doctors available for consultation. If you have any suggestions for additional topics you want to read about please let us know! Don’t forget to follow us on social media.
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