Screening for Breast Cancer
The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.When to get screened for breast cancer can be confusing because there are several organizations that recommend different screening schedules. Below are 2009 recommendations from the United States Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), and the American College of Obstetricians and Gynecologists (ACOG).
Screening TestsBreast Self-examWhen doing a breast self-exam (BSE), you feel for anything new or different. You will be able to feel a particularly lumpy portion of the breast. Sometimes cysts appear and disappear. Masses that come and go are generally not cancerous. Other than new lumps, look for nipple discharge (either clear or bloody), dimpling of the skin, thickening of the skin, redness of the skin, pain, new lumps, or a fullness feeling in the armpit.There is a lack of evidence that breast self-exams can reduce your risk of death from breast cancer. The USPSTF does not recommend this self-screening, and the ACS views the exam as optional for women aged 20 and older. ACOG suggests that it is considered in high-risk women. If you are unsure as to whether you should do a breast self-exam, talk to your doctor. To learn how to do the exam, click here . Clinical Breast ExamDuring your routine physical exam, your doctor may do a clinical breast exam (CBE). Your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes. Both the ACS and ACOG recommend that women 20 to 39 years old have the exam every three years, and every year for women aged 40 and older.USPSTF has no recommendations for this exam.Mammogram A mammogram is a special x-ray of the breast that may be able to find tumors that are too small for you or your doctor to feel. Your doctor may suggest that you have a mammogram, especially if you have risk factors for breast cancer. Guidelines for getting a mammogram vary depending on the organization:
- 40 to 49 years old—the decision to have a mammogram every two years is an individual one. You should make your decision after you understand the risk and benefits that apply to you. Talk to your doctor.
- 50 to 74 years old—every two years
- ACS and ACOG
- 40 years and older—every year
- Are at high risk for breast cancer and cannot have an MRI scan
- Have dense breast tissue
Talk to Your DoctorTalk to your doctor about the right screening schedule for you. For example, if you are at high risk for breast cancer, you will need to start having mammograms at an earlier age.
American Cancer Society guidelines for the early detection of cancer. American Cancer Society website. Available at: http://www.cancer.org/Healthy/FindCancerEarly/CancerScreeningGuidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer. Updated June 23, 2011. Accessed August 12, 2011.
Breast cancer. National Cancer Institute website. Available at: http://www.cancer.gov. Accessed January 27, 2006.
Breast cancer screening: research and guidelines. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary. Updated November 2009. Accessed January 19, 2010.
Calvagna M. Breast self-exam (BSE). EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary. Updated May 2008. Accessed January 19, 2010.
Detailed guide: breast cancer. American Cancer Society website. Available at: http://www.cancer.org. Accessed January 27, 2006.
10/23/2009 DynaMed Systematic Literature Surveillance: http://www.dynamicmedical.com/what.php. Nothacker M, Duda V, et al. Early detection of breast cancer: benefits and risks of supplemental breast ultrasound in asymptomatic women with mammographically dense breast tissue. A systematic review. BMC Cancer. 2009;9:335.
1/19/2010 DynaMed's Systematic Literature Surveillance: http://www.ebscohost.com/dynamed/what.php. Lee C, Dershaw D, et al. Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. J Am Coll Radiol. 2010;7(1):18.
8/7/2011 DynaMed's Systematic Literature Surveillance: http://www.ebscohost.com/dynamed. Gotzsche PC, Jorgensen KJ. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2013 Jun 4;6.
8/12/2011 DynaMed's Systematic Literature Surveillance: http://www.ebscohost.com/dynamed. The American College of Obstetricians and Gynecologists. Practice bulletin: breast cancer screening. Obstetrics & Gynecology. 2011;122.
- Reviewer: Mohei Abouzied, MD, FACP
- Review Date: 12/2014
- Update Date: 12/20/2014