Why screen for breast cancer?
One in eight women will be diagnosed with breast cancer, making it the second most commonly diagnosed cancer in women in the United States after skin cancer. Fortunately, detecting breast cancer early through screenings can help improve outcomes and quality of life. In fact, when breast cancer is detected early and is in a localized stage, the 5-year survival rate is 99%. Of note, most of these women will live much longer than 5 years past their diagnosis.
What is breast cancer screening?
Breast cancer screenings are recommended for individuals who are currently not exhibiting signs of cancer. They are not meant to prevent breast cancer, but to look for it early on and help increase survival rates.
Screening guidelines
GenesisCare physicians follow the American Society of Breast Surgeons recommendations for breast cancer screening:
- Women 25 and younger should undergo a formal breast cancer risk assessment
- Women with average risk of developing breast cancer should begin annual screening mammograms at age 40
- Women at high risk of developing breast cancer should have yearly mammograms, as well as additional imaging based on their individual risk factors
Women considered to be at high risk of developing breast cancer include those who have a strong family history or heritable genetic mutation (i.e., BRCA 1 or 2), or who had radiation to the chest wall between the ages of 10 and 30 years old.
Talk to your provider about your individual situation and when you should begin breast cancer screenings.
Breast screening tests may include mammograms, ultrasounds or magnetic resonance imaging (MRI). The type of breast cancer screening and combination of tests recommended for you will depend upon your individual situation and risk factors. In addition to yearly screening mammograms, some women also choose to perform self breast examinations to help detect palpable breast cancers.
A mammogram is a technique using low-dose x-rays to create an image of the inside of your breast to identify early changes and cancers in the breast tissue, even ones that are too small to feel. A digital mammogram converts an image into digital form on a computer. Advancements in technology now allow many healthcare providers to offer 3D digital mammograms, also known as tomosynthesis, which uses multiple x-rays to create a 3D picture of your breast. 3D digital mammograms are especially helpful to detect breast cancer in women with dense breast tissue or implants.
Typically, two images of each breast are taken during a mammogram – one from the top to bottom and one from side to side. The screening test on average takes 10 to 15 minutes.
Using the images received from the mammogram, your radiologist can spot small calcifications, masses or distortions. Sometimes calcium or distortions found in the breast tissue may be a sign of pre-cancerous changes or early breast cancer.
While mammograms remain the gold standard for breast cancer screenings, ultrasounds may be used if you have dense breast tissue, if you are pregnant or if you are symptomatic (i.e., you have a lump, bump, nipple discharge, or skin changes). Breast ultrasounds are different from mammograms as they help radiologists tell the difference between fluid filled benign cysts and solid masses with or without blood flow. Additionally, they are often used if there is an abnormal finding on the mammogram and to help guide biopsies.
Breast ultrasounds create sound waves, which create pictures by bouncing off breast tissue. During an ultrasound, a radiology technologist will move a wand/probe over your breast. You will likely feel pressure in the breast, but this should not be extremely painful. The test on average takes between 15 and 30 minutes.
An MRI is an imaging technique that uses large magnets and radiofrequencies to look for breast cancer. Breast MRIs are done by laying ‘belly down’ in an MRI machine for about 30 to 40 minutes. MRIs are typically reserved as screening tools for high-risk women, a problem-solving tool for an inconclusive mammogram or after a breast cancer diagnosis.
During an MRI, pictures are taken from multiple angles of the breast using magnets and radio waves to construct images in different anatomical planes.
MRIs require a contrast dye to be injected via an IV line prior to the test. This helps make any abnormalities in your breast easier for the radiology team to view. You will be asked to lie on your stomach on a table with your arms above your head and your breasts hanging down in an open area underneath you. You may be asked to hold your breath during certain parts of the test and keep as still as possible. Typically, the test takes 30 to 45 minutes.
Forty percent of breast cancers diagnosed are found by women who noticed a lump. It is important to be familiar with how your breasts typically look and feel, and let your doctor know if you notice any changes.
While breast examinations are no longer recommended by several organizations for breast cancer screening, they may help you better determine if there are any noticeable changes over time.
Your health care provider will discuss your results after your screening test. If your mammogram shows any abnormalities, you may be requested to do additional tests, such as a diagnostic mammogram, ultrasound or MRI. In the event there is concern for a breast cancer, you may likely undergo a biopsy.
If there are no abnormalities found in your screening tests, it is important to remain aware of changes in your breast between mammograms and talk to your doctor about any concerns.
Should you be diagnosed with breast cancer, talk to your care team about your treatment options. Treatment will vary depending upon your type, location, stage and biologic makeup of the cancer.