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The Mammogram and Other Breast Cancer Screening Options

Screening for breast cancer and when to have a mammogram should be a conversation and joint decision between you and your physician. Learn more.

Is a screening mammogram right for you?

October is Breast Cancer Awareness Month, and an opportune time to discuss breast cancer screening, including the mammogram.

When should I start breast cancer screening? How often should I have breast cancer screening performed? Why did my friend’s doctor order a 3-D mammogram? 

These are a few very important questions that all women, and even some men, have to face when trying to stay on top of breast cancer screening. Just as we are individuals, there’s no one right answer for everyone. Screening for breast cancer should be a conversation and joint decision between you and your physician. What may be right for you may not be right for your best friend, your mother, sister, or daughter. 

What is a screening mammogram?

A screening mammogram is an X-ray of the breast, and the test that is ordered for most patients to screen for breast cancer. A mammogram can often find or detect breast cancer early, even before a lump can be felt. 

Screening mammograms are usually recommended every 1 to 2 years, beginning by age 50. However, some patients – together with their physicians – may decide to start at age 40. Although testing at an earlier age and more frequently may detect more cancers, it also detects more false-positive results. This can lead to further testing (call-backs) or procedures such as biopsies that may cause anxiety and discomfort for benign (or non-cancerous) findings. Screening after the age of 75 should be discussed further and balanced with an overall health assessment.

Your physician can use risk assessment tools to combine risk factors from your history to calculate your risk of developing breast cancer. This involves diving into your personal medical and family history thoroughly to include information such as the age you started your period, if you have ever been pregnant, your age when you had your first delivery, if you breastfed, if you’ve had family members with breast cancer, and much more. If you are at a higher than average risk of breast cancer, then your doctor may refer you to have genetic counseling, additional testing, more frequent testing or a different type of testing, such as 3-D mammography, instead of a screening mammogram. 

Although screening mammograms are overall safe, mammography exposes patients to a small amount of radiation. It is important to balance the appropriate benefit of detecting cancer with possible harm, and this discussion with your doctor should be an integral part of your individualized plan for screening. 

What about breast self-exams?

While breast self-exams have not been found to lower the risk of death from breast cancer, you should be aware of your own breast tissue, and contact your physician if you notice any changes such as lumps or pain.  

Screening tests to detect breast cancer have improved, and so has the treatment and overall prognosis for breast cancer. Fifty years ago, the 5-year survival rate for breast cancer was 75%, compared with the dramatic improvement of 90% as of 2013. Patients should have shared decision-making and agree on the best breast cancer screening plan for them, working with their physician to combine the relevant medical information and data with their own experiences, concerns and priorities. 

Breast cancer screening will not prevent breast cancer, but it can help find breast cancer early when it is easier to treat. Talk to your physician about which, if any, breast cancer screening tests are right for you.

Bich Tran, MD, UCR Women’s Health OB/Gyn.

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