[HEALTHLINE] Recommendations for breast cancer screening

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Regular breast exams for signs of cancer are an important part of your health care. That’s because many breast cancer screening tests can find cancer early before you can notice symptoms yourself.

Breast cancer screening tests can detect small changes in your breast tissue from year to year. If a screening test identifies a problem, your health care team can probe deeper to see if the changes are caused by cancer or something else.

When breast cancer is found and treated at its earliest stages, treatment is often more successful.

The American Cancer Society reports that the 5-year relative survival rate for people with breast cancer detected at an early stage is 99%.

When breast cancer is detected at a later stage, treatment usually takes longer and the 5-year survival rate is lower. Keep in mind that these statistics, from 2010 to 2016, represent a general trend and the situation could have a more positive outlook.

Read on to learn more about breast cancer screening recommendations and procedures.

Guidelines for breast cancer screening?

Different health organizations recommend different approaches to breast cancer screening. Below is a summary of the guidelines published by several reputable organizations.

United States Preventive Services Task Force (USPSTF)

According to the USPSTF, the following recommendations are provided for people at average risk for breast cancer. According to the USPSTF, there is not enough evidence to recommend additional screening for people with denser breast tissue if mammograms do not show any signs of cancer.

American Cancer Society

The American Cancer Society recommends slightly different screening schedules, continuing to recommend annual screenings through the mid-50s. Similar to the USPSTF, the American Cancer Society has no specific recommendations. may be given to those with denser breast tissue, due to a lack of evidence to support additional screening.

American College of Obstetricians and Gynecologists (ACOG)

ACOG physicians emphasize shared decision-making between doctors and patients, along with counseling about the benefits and risks of different screening exams. If you have no symptoms and no risk factors other than denser breast tissue, ACOG does not recommend an alternative or additional test other than a mammogram, unless required by state law.

For people at high risk for breast cancer?

According to the Centers for Disease Control and Prevention (CDC), you may have a higher risk of developing breast cancer if you:

  • Have a mutation in the BRCA1 or BRCA2 . gene
  • Have thicker breast tissue
  • Have a close relative (grandparent, parent, sibling, child, aunt, uncle, or cousin) with the mutation BRCA1 . gene or BRCA2
  • Had radiation treatment in your chest area when you were 10 to 30 years old
  • Having a family history of cancer increases your risk of breast cancer
  • Having a family history of some rare disorders, including Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome

Talk to your doctor about your risk factors. You can also calculate your breast cancer risk using one of the CDC’s assessment tools.

If you have a higher-than-normal risk of breast cancer, the American Cancer Society recommends that you have a mammogram and an MRI scan every year, starting at age 30, as long as you’re in good health. It’s important to consider your doctor’s advice when you’re deciding when to start your annual screening.

According to the CDC, the National Comprehensive Cancer Network — a nonprofit group that includes 31 cancer centers — recommends that people at high risk begin having mammograms and MRI scans every 25 to 40 years. age, or at the earliest age when someone in their family was diagnosed with cancer.

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What methods are used to screen for breast cancer?

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Health care professionals can detect changes in your breast tissue, including early signs of possible cancer, with a number of different tests, including:

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Clinical breast examination

During a clinical breast exam (CBE), your doctor will examine your breasts manually to detect any palpable lumps or abnormalities. However, according to a 2020 review, research is unclear as to exactly how effective CBE is in preventing cancer deaths.

Some researchers, as in a 2016 study, indicate that doctors can detect certain types of cancer through CBE that might otherwise be missed on mammograms. However, for certain groups of people, CBE is of limited use as a diagnostic tool.

For others, the CBE process may not be too surprising, especially if they have a history of physical or sexual abuse, according to a 2017 study. The sensation of irritation during a breast exam can even make a woman uncomfortable. Women delaying or avoiding exams could save their lives.

If you have experienced trauma or abuse that made you feel vulnerable, helpless, or anxious during your clinical breast exam, you can discuss your concerns with your healthcare professional first.

You can request a different type of screening or request screening by a person of a specific gender. There may also be someone else in the room when you take the test.

Mammogram

Mammograms are the most widely accepted breast cancer screening method. It’s an X-ray of your breast, taken with an x-ray machine and read by a radiologist. Mammograms are covered by most health insurance plans, including Medicare and Medicaid.

3D mammogram

This type of mammogram, also known as a mammogram, provides a much clearer and more detailed picture of your breast tissue.

The American Cancer Society reports that a 3D mammogram can produce a clearer picture than a regular mammogram, and it may be more effective at locating breast cancer. possible cancer. 3D tests can also reduce your chances of coming back the next time.

Supersonic

An ultrasound uses sound waves to create pictures of the inside of your breast. It’s especially good for distinguishing between solid and fluid-filled lumps in your breast tissue.

During an ultrasound, a technician places a little gel on your breast and then moves a transducer around the surface of your breast to record an image created by the sound waves. This process is not harmful.

Magnetic resonance imaging (MRI)

An MRI uses energy waves and radio magnets to create a detailed picture of your breast tissue. An MRI scan can be especially helpful if you have thick breast tissue.

During an MRI, you lie on a table with space for your chest. This table can become a large tubular MRI machine. Scanning devices revolve around you. The scan isn’t noisy, but it’s not harmful.

If you’re uncomfortable in an enclosed space, an MRI can worry you. If your doctor orders an MRI, let them know if you are fearful or anxious. They can discuss ways to help you reduce anxiety. They may also prescribe muscle relaxants or anti-anxiety medications before the test.

What happens when you have a mammogram?

A mammogram is usually done at an imaging center or in a radiologist’s office. Here are some tips to help you prepare for your mammogram:

  • If possible, try to get X-rays at the same place every visit. That’s important because the radiologist must see how your breast tissue has changed over time. If you need to go to another center, ask the old center to send your old pictures to the new center.
  • If you get your period and feel fullness around your period, try to schedule your mammogram at a time that’s not close to your period. That’s because mammograms involve compressing your breasts, so it’s easier if your breasts aren’t tender yet.
  • Most centers advise against applying powders, deodorants, creams or lotions under your arms as it can make the image harder to read accurately.
  • If you are breastfeeding or you think you may be pregnant, tell your technician before the test.

When you arrive at the center, you will probably be given a robe to wear in front. When it’s time for the exam, the technician will help you place your breast between the two plates on the X-ray machine.

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Your breasts need to be as flat as possible for the camera to take a clear picture. Usually, the process feels tight and uncomfortable, but if you feel pain, you can tell the technician.

The technician will take pictures of each breast one at a time, usually from two different angles. Each image lasts only a few seconds, after which the pressure is released. Depending on the number of images needed, the entire mammogram can be completed in about 20 minutes.

After the exam, the radiologist will talk to the doctor who examined you about any findings. Your doctor will talk to you about the results, usually within a few days. If you don’t get a response from your doctor within a week, you have the right to call and ask to speak with your doctor and review the results.

What if the results are not as expected?

If your doctor or radiographer notices an area of ​​concern, you may need a second mammogram, called a diagnostic mammogram.

Your doctor may also recommend some additional tests, such as an ultrasound, an MRI scan, or a biopsy. During the biopsy, your doctor will take a bit of your breast tissue for further analysis.

These additional tests are not uncommon and they do not mean you have breast cancer. You may be called back because:

  • The picture is not clear enough to see your breast tissue.
  • Your breast tissue is denser.
  • Your doctor wants to take a closer look at the change in your breast tissue.
  • A closer look at a calcification, cyst, or spine is needed.

Most breast cancer screenings are not synonymous with a cancer diagnosis.

Are there any risks associated with breast cancer screening?

Almost every medical checkup has some risks, including screening for breast cancer. It is important to consider known risks when you are deciding when to start screening and how often you want to be screened.

Radiation-related cancer risk

Exposure to radiation can cause changes to your cells, some of which can increase your risk of cancer. You should know that radiation from mammograms is very low.

It’s lower than a regular chest X-ray and is comparable, with the amount of radiation you’d be exposed to in a typical environment over a period of about 7 weeks.

A 2016 study that analyzed breast cancer incidence in 100,000 people between the ages of 50 and 74 found that mammograms may play a role in the development of breast cancer between 0 and 10. .7% to 1.6% of cases.

If you are at high risk for breast cancer, you and your doctor should talk about how regular mammograms can affect your risk.

Other risks

Breast cancer screening can sometimes lead to:

  • False positive results
  • Overdiagnosis of breast tumors
  • Unnecessary biopsy of breast tissue

Overall, health professionals agree that the benefits of regular breast cancer screening, including early detection of cancer, far outweigh the risks of self-exams.

Key point

Breast cancer screening can be used to help your doctor find cancer when it is in its earliest stages. Early-stage cancers are often easier to treat than later-stage cancers.

The most common way to screen for breast cancer is with a mammogram, but ultrasound and MRI scans can also be effective tests.

Many cancer experts recommend that women begin yearly mammograms at age 40. When you reach age 50, you may choose to have mammograms every other year.

When you decide to start getting mammograms and when you decide to stop getting mammograms is a matter of talking to your doctor, as individual risk factors vary from person to person.

There are some risks to having breast cancer screening, but they are often considered quite small compared to the advantage of being able to detect and treat breast cancer at its earliest stages.

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