Breast cancer screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jack Khouri, Mirdula Sharma, MBBS [2]

Overview

According to the the U.S. Preventive Service Task Force (USPSTF), screening for breast cancer by mammogram is recommended for women aged 50-74 years, twice a year.

Screening

Three tests are used by health care providers to screen for breast cancer:

Mammogram

• Mammography is the most common screening test for breast cancer. A mammogram is an x-ray of the breast. This test may find tumors that are too small to feel. Mammograms are less likely to find breast tumors in women younger than 50 years than in older women. This may be because younger women have denser breast tissue that appears white on a mammogram.
• The following may affect whether a mammogram is able to detect (find) breast cancer:

• The size of the tumor.
• How dense the breast tissue is.
• The skill of the radiologist.

• Women aged 40 to 74 years who have screening mammograms have a lower chance of dying from breast cancer than women who do not have screening mammograms.

Clinical breast exam

• A clinical breast exam is an exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual. It is not known if having clinical breast exams decreases the chance of dying from breast cancer.
• Breast self-exams may be done by women or men to check their breasts for lumps or other changes. It is important to know how your breasts usually look and feel. If you feel any lumps or notice any other changes, talk to your doctor. Doing breast self-exams has not been shown to decrease the chance of dying from breast cancer.

MRI

• MRI is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). MRI does not use any x-rays.
• MRI is used as a screening test for women who have one or more of the following:

• Certain gene changes, such as in the BRCA1 or BRCA2 genes.
• A family history (first degree relative, such as a mother, daughter or sister) with breast cancer.
• Certain genetic syndromes, such as Li-Fraumeni or Cowden syndrome.

• MRIs find breast cancer more often than mammograms do, but it is common for MRI results to appear abnormal even when there isn't any cancer.

The New Recommendations

• Women should begin yearly mammogram by the age of 45 years.
• At age 55 years, women should have mammogram every other year should continue as long as the women is in good health.
• Breast exams are no longer recommended.

References

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