Breast cancer is one of the most common cancers in women, with around 1 in 8 women developing invasive breast cancer over the course of their lifetime. While breast cancer survival rates have improved dramatically over the past few decades, early detection through screening remains key for successful treatment and survival. This article will provide an overview of the different screening modalities available for breast cancer, when screening should begin, how often it should be performed, and the benefits and limitations of breast cancer screening.
Introduction
Breast cancer screening refers to the use of medical tests to detect breast cancer in asymptomatic women. The goal is to catch the cancer early when it is small, localized, and more treatable as opposed to later when the cancer has already spread. The two main screening tools used today include mammograms which use low dose x-rays to create images of the breast and clinical breast exams where a doctor or nurse feels for lumps or abnormalities. Other supplemental screening tests are sometimes used as well.
When to Begin Screening
All major medical organizations including the American Cancer Society recommend that women at average risk for breast cancer begin getting annual mammograms starting at age 40. Clinical breast exams every 1-3 years can begin in the 20s. Women at high risk due to family history or genetic factors should begin screening earlier, often in their 30s. Talk to your doctor about when to start screening based on your personal risk factors.
Screening Frequency
For women at average risk, experts recommend a mammogram every year starting at age 40 until at least age 50. After 50, women can switch to a mammogram every other year but should continue annual exams as long as they are in good health. Clinical breast exams every 1-3 years can supplement mammograms. Again, those at higher risk may need more frequent screening.
Benefits of Breast Cancer Screening
There are several important benefits that breast cancer screening provides:
- Earlier detection – Finding cancer when it is small and localized provides more treatment options like breast conserving surgery instead of full mastectomies. The 5-year survival rate for localized breast cancers is 99% compared to just 27% for metastatic disease.
- Reduced treatment intensity – Catching cancer early often allows for less aggressive treatment like lumpectomy and radiation versus mastectomy and chemotherapy.
- Reassurance – A normal mammogram offers peace of mind and assurance for another year or two.
- Improved survival – Randomized controlled trials and population data show reduced breast cancer mortality thanks to screening. Lives are saved when cancer is caught early.
Limitations of Screening
While breast cancer screening is beneficial, it also has some downsides:
- Overdiagnosis – Screening sometimes finds slow-growing cancers that would never have presented clinically. This can lead to unnecessary treatment. The rate of overdiagnosis is difficult to determine but estimated around 1-10%.
- False positives – Abnormal findings lead to additional testing that reveals there is no cancer present. This causes anxiety and discomfort for many women.
- Radiation exposure – While quite low, mammograms do involve radiation exposure that could potentially damage tissue and even contribute to cancer risk. This is minimized by starting regular screening at age 40.
- Cost – Screening mammograms cost over $100 and are not fully covered by all insurance plans resulting in out-of-pocket expenses.
Conclusion
Regular breast cancer screening starting at age 40 has been shown to significantly reduce deaths from breast cancer. The benefits of early detection far outweigh the potential harms for most women. Talk to your doctor about your breast cancer risk and at what age you should begin getting regular mammograms and clinical breast exams. Catching cancer early gives you the best chances for effective treatment and survival.
