Breast cancer screening
Breast cancer screenings can help find breast cancer early, before you notice any symptoms. In many cases, finding breast cancer early makes it easier to treat or cure. But screenings also have risks, such as missing signs of cancer. When to start screenings may depend on your age and risk factors.
Mammogram - breast cancer screening; Breast exam - breast cancer screening; MRI - breast cancer screening
A mammogram is the most common type of screening. It is an x-ray of the breast using a special machine. This test is done in a hospital or clinic and only takes a few minutes. Mammograms can find tumors that are too small to feel.
Mammography is performed to screen women to detect early breast cancer when it is more likely to be cured. Mammography is generally recommended for:
Mammograms work best at finding breast cancer in women ages 50 to 74. For women younger than age 50, the screening can be helpful, but may miss some cancers. This may be because younger women have denser breast tissue, which makes it harder to spot cancer. It is not clear how well mammograms work at finding cancer in women age 75 and older.
This is an exam to feel the breasts and underarms for lumps or unusual changes. Your health care provider may perform a clinical breast exam (CBE). You can also check your breasts on your own. This is called a breast self-exam (BSE). Doing self-exams may help you become more familiar with your breasts. This may make it easier to notice unusual breast changes.
Keep in mind that breast exams do not reduce the risk of dying from breast cancer. They also do not work as well as mammograms to find cancer. For this reason, you should not rely only on breast exams to screen for cancer.
Not all experts agree about when to have or start having breast exams. In fact, some groups do not recommend them at all. However, this does not mean you should not do or have breast exams. Some women prefer to have exams.
Talk with your provider about the benefits and risks for breast exams and if they are right for you.
MRI (Magnetic Resonance Imaging)
An MRI uses powerful magnets and radio waves to find signs of cancer. This screening is done only in women who have a high risk for breast cancer.
Women at high risk for breast cancer (greater than 20% to 25% lifetime risk) should have an MRI along with a mammogram every year. You may have a high risk if you have:
It is not clear how well MRIs work to find breast cancer. Although MRIs find more breast cancers than mammograms, they are also more likely to show signs of cancer when there is no cancer. This is called a false-positive result. For women who have had cancer in one breast, MRIs can be very helpful for finding hidden tumors in the other breast. You should do a MRI screening if you:
Benefits and Risks of Screenings
When and how often to have a breast screening test is a choice you must make. Different expert groups do not fully agree on the best timing for screening.
Before having a mammogram, talk to your provider about the pros and cons. Ask about:
Risks of screenings can include:
American Cancer Society website. Breast cancer early detection and diagnosis. www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection.html. Updated September 17, 2017. Accessed August 22, 2018.
American College of Obstetricians and Gynecologists (ACOG) website. ACOG statement on breast cancer screening guidelines. www.acog.org/About-ACOG/News-Room/Statements/2016/ACOG-Statement-on-Breast-Cancer-Screening-Guidelines. Updated January 11, 2016. Accessed August 22, 2018.
National Cancer Institute website. Breast cancer screening (PDQ) - health professional version. www.cancer.gov/types/breast/hp/breast-screening-pdq. Updated June 1, 2018. Accessed August 22, 2018.
Siu AL; U.S. Preventive Services Task Force. Screening for Breast Cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164(4):279-296. PMID: 26757170 www.ncbi.nlm.nih.gov/pubmed/26757170.
Wolff AC, Domchek SM, Davidson NE, Sacchini V, McCormick B. Cancer of the breast. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 91.
Review Date: 7/26/2018
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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