Breast cancer screening saves lives. That's because early-stage breast cancer has no noticeable symptoms. But screening makes it possible to find breast cancer when it's small and easier to treat. The longer breast cancer remains undetected, the more challenging treatment becomes.
Mammograms are the go-to imaging tests for spotting any abnormal areas in the breast. However, for women considered at high risk for developing breast cancer, additional screening technologies may be used.
Breast cancer screening is not one-size-fits-all. The right timing is based on your risk level for developing breast cancer.
Remember, breast cancer screening is important for both those who were born female and for transgender women who have used estrogen hormone therapy for 5 years or more. This is because estrogen can play a role in the growth of breast cancer.
Women and transgender men considered at average risk for breast cancer have no personal history of the disease, no strong family history of breast cancer, and do not have any known inherited genetic mutations (such as BRCA1 or BRCA2) associated with an increased risk of developing breast cancer. There are other risk factors that can increase the likelihood of developing breast cancer such as having dense breasts, being overweight, having type 2 diabetes, smoking, never giving birth, and never breastfeeding. If you have more than one of these risk factors, you should talk to your physician about the right time to start breast cancer screening.
For those who are at average risk, the American Cancer Society recommends the following as of December 2023:
You may be considered at higher risk for developing breast cancer if you meet any of the following criteria:
Your doctor may suggest taking a breast cancer risk questionnaire to help identify your lifetime risk. If your results indicate a lifetime risk of 20% to 25% or greater, you will likely follow a screening plan specifically designed for high-risk individuals. These patients may start screening for breast cancer as early as age 30.
While mammograms are the standard screening test covered by insurance as preventative care, some patients may benefit from additional screening, such as breast ultrasound and breast MRI. Let's look at when each may be used.
Mammograms are X-ray images that can detect small lumps, microcalcifications, or other changes in breast tissue before they are physically noticeable. These changes may indicate cancer, precancerous cells, or other non-cancerous conditions. Today, most mammogram imaging produces digital images rather than film. There are two main types of mammograms:
Digital breast tomosynthesis, or 3D mammography, is increasingly common but not available everywhere. Studies show it reduces follow-up testing and detects more cancers, especially in dense breasts. If given a choice, a 3D mammogram would be a good option, although it will likely cost more than a 2D mammogram – if you're not using insurance for the screening test.
The American Cancer Society supports using either 2D or 3D mammograms and believes cost should not hinder access. If you have a preference, you can ask the breast imaging center about the options available when you book your appointment.
Mammogram results that show any abnormalities will require additional tests to determine if cancer is present.
Related reading: What Should I Expect at My First Mammogram?
Breast ultrasound utilizes sound waves to create images of the breast's internal structures. This non-invasive imaging technique can help identify changes, such as cysts, that are difficult to detect with mammograms. It can also determine whether a mass is solid or fluid-filled. While ultrasound is not typically a standard procedure for routine breast cancer screening, it may be beneficial as a secondary screening tool for women with dense breast tissue who have an abnormal finding on a mammogram.
A breast MRI is a highly sensitive imaging tool that uses radio waves and magnets to capture images that may not be detected by a mammogram. Due to its high sensitivity, this method offers a different look at the breast tissue and can more effectively identify abnormalities. If MRI is used, it should be in addition to, not instead of, a screening mammogram.
While an MRI is excellent at detecting cancer, it is important to note that it may miss certain cases that a mammogram could identify. This is why MRIs are typically used in conjunction with mammograms rather than as a standalone screening method. By combining these tools, healthcare providers can offer a more comprehensive evaluation of breast health, ensuring that any potential issues are thoroughly investigated.
Read this blog: When Do You Need a Breast MRI and What is the BI-RADS Score?
It's important to remember that not every abnormality found during breast cancer screening is a cause for concern. These screenings can also identify non-cancerous conditions. To determine whether an abnormality found through screening tests is cancerous, your doctor will recommend additional tests, which would most likely include a biopsy. If cancer is found in the tissue sample collected for the biopsy, you will need to consult with a medical oncologist who specializes in breast cancer. They will guide you through the next steps including surgery.
Related reading: What to Expect From Your Breast Biopsy
Taking care of your breast health is crucial, and the best way to do so is by scheduling regular screenings. You should also take note of your breasts, and what's normal for you. Familiarizing yourself with your breasts can help you easily detect any unusual changes or issues.
It is also important to discuss your breast cancer risk level with your primary care physician or gynecologist. Understanding your risk level will help them recommend the most appropriate type of screening and determine when you should start.
The team of breast cancer oncologists at Compass Oncology offers the latest treatment options and is dedicated to providing you with a personalized treatment plan that meets your needs. If you or a loved one in the Portland, Oregon, or Vancouver, Washington area was diagnosed with breast cancer following breast cancer screening, schedule a consultation with a breast cancer oncologist to learn more about your treatment options.