In today’s post we will go over the guidelines for breast cancer screening in average risk females including when to start and when to stop. We will also discuss the difference between 2D and 3D mammography, and briefly introduce the concept of breast awareness.

The facts: U.S. Women carry a 1 in 8 chance of developing breast cancer over their lifetime. White women are more likely to get breast cancer over their lifetime, however, young black women have a much higher chance of dying from breast cancer.

The bright side: Since the 90’s we have seen a steady decline in breast cancer-related mortality as well as an increase in the 5-year survival rate. These outcomes are largely attributed to

1. The increased use of mammography
2. Medical advancements in the treatment of breast cancer

The guidelines:

USPSTF (United States Preventative Services Task Force):  Women of average risk should start mammogram screening at age 40 and get one every 2 years until age 74.

ACOG (American College of Obstetrics and Gynecology): Women of average risk should start having mammograms at age 40 and get one every 1-2 years until age 74.

ACS (American Cancer Society): guidelines for average risk women

Women aged 40-44 may start mammography screening and should do it annually.
Women aged 45-55 should have annual mammography screening.
Women 55 and older may have mammograms annually or every 2 years.
Women may continue screening mammograms if they are in good health and have a life expectancy of 10 years.

What is a mammogram?

A mammogram is a low dose x-ray of the breasts designed to detect breast cancers, often before the development of clinical symptoms.

What is the difference between a 2D and a 3D mammogram (digital breast tomosynthesis)?

3D tomosynthesis confers a higher detection rate and a lower call-back rate. Studies have shown 3D mammography may be a better screening method for dense breast tissue.

CBE (Clinical breast exam) & breast self-awareness:

Nearly 50% of breast cancers in women 50 and older are detected by “breast self-awareness” while the number increases to over 70% for women under 50.

 A Clinical breast exam is performed by your physician to detect any lumps, changes in shape, redness or rashes and changes in skin texture such as puckering or dimpling all of which could indicate breast cancer. Per the ACOG this exam should be completed annually for women 40 and older and every 1-3 years for women 25-39.  In addition to a CBE women should have a good sense of their normal breast tissue to ensure timely follow up with their doctor in case they detect any changes in their breast tissue. This is referred to as “breast self-awareness”

To know your breasts is to love them. So, love them, and get them screened!

Sincerely,
Corsano MD- your friendly neighborhood PCP

Resources: yale medicine, American Cancer Society (ACS), American College of Obstetrics and Gynecology (ACOG)
Infographic: Breast Cancer – Signs and Symptoms – Dr Lal PathLabs Blog