Breast Cancer Screening Test

Q: When do I need to start getting screened for breast cancer?

A: According to the American Cancer Society;

• Breast self exam (BSE) is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any breast changes to their health professional right away.
• Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a periodic (regular) health exam by a health professional, at least every 3 years. After age 40, women should have a breast exam by a health professional every year.
• Women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health.
• Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.
• If MRI is used, it should be in addition to, not instead of, a screening mammogram.

Q: What is a mammogram?

A: A mammogram is an x-ray of the breast. Screening mammograms are used to look for breast disease in women who are asymptomatic; that is, they appear to have no breast problems. Screening mammograms usually take 2 views (x-ray pictures taken from different angles) of each breast. A diagnostic mammogram is used to diagnose breast disease in women who have breast symptoms or an abnormal result on a screening mammogram.

Q: Is a mammogram safe?

A: Modern mammogram equipment designed for breast x-rays uses very low levels of radiation. Strict guidelines ensure that mammogram equipment is safe and uses the lowest dose of radiation possible. Many people are concerned about the exposure to x-rays, but the level of radiation used in modern mammograms does not significantly increase the risk for breast cancer. To put dose into perspective, if a woman with breast cancer is treated with radiation, she will receive around 5,000 rads. If she had yearly mammograms beginning at age 40 and continuing until she was 90, she will have received 20 to 40 rads.

Q: What is a breast MRI?

A: For certain women at high risk for breast cancer, screening MRI is recommended along with a yearly mammogram. It is not generally recommended as a screening tool by itself, because although it is a sensitive test, it may still miss some cancers that mammograms would detect. MRI scans use magnets and radio waves (instead of x-rays) to produce very detailed, cross-sectional images of the body. Although MRI is more sensitive in detecting cancers than mammograms, it also has a higher false-positive rate (where the test finds something that turns out not to be cancer), which results in more recalls and biopsies. This is why it is not recommended as a screening test for women at average risk of breast cancer, as it would result in unneeded biopsies and other tests in a large portion of these women.