The importance of early and regular screening for breast cancer
First, the sobering news: One in eight women in the United States will develop breast cancer at some point in their lives, per the National Breast Cancer Foundation. Next to skin cancer, it's the most common cancer that affects American females.
The good news? According to Cancer.net, the average five-year and 10-year survival rates for women with invasive breast cancer are 91% and 84%, respectively. Best of all, the five-year relative survival rate can be 99% if breast cancer detection occurs early.
The operative word here is "detection," which puts the onus on women to get screened regularly and as recommended for breast cancer, the experts agree.
"The importance of having regular interval screenings is to catch breast cancer at its earliest stage before it is palpable," says Dr. Rebecca Yang, medical director of breast surgery at Overlook Medical Center in Summit, New Jersey. "Early detection translates to long-term survival as well as minimization of medical and surgical treatments."
Today's recommended screening methods involve high-tech tools as well as careful self-exams.
"The most common screening test is digital mammography, which has virtually taken the place of film technology," says Dr. Cecily Havert, a board-certified family medicine physician who practices in Alexandria, Virginia. "It still uses X-ray technology, but the digital images are stored in computers and are easier for the radiologist to manipulate and interpret."
An advanced type of X-ray mammography that has increased in popularity is tomosynthesis, which takes multiple breast images from various angles.
"Breast MR is an additional tool best used for high-risk screening and newly diagnosed cancers. It uses the power of a large magnet to create exceptionally detailed images of the breast and is extremely sensitive, detecting close to 100% of invasive cancers," explains Dr. Paul Friedman, radiologist and medical director at Morristown Medical Center in Morristown, New Jersey.
Sonography (also known as ultrasound), a technology that employs high-frequency sound waves to create images, is another method doctors rely on to help screen the breasts.
"I had a mammogram, ultrasound and biopsy done earlier this year to confirm the reason for a lump discovered in my left breast. Luckily, it was benign," says Nadia Malik, a 36-year-old mother of three from Dallas. "Getting screened early is highly recommended. Go with your gut, because nobody knows your body better than you."
Breast cancer screening has become quite confusing for patients as the guidelines differ from organization to organization, says Dr. Monisha Bhanote, founder and CEO of Integrative Medicine Well-being in Jacksonville Beach, Florida.
For example, the American Cancer Society recommends getting your first mammogram by age 45, repeat annually between ages 45 and 54, then repeat every one to two years if you're older than 55. The American College of Radiology/Society of Breast Imaging advocates starting mammography by age 40 and repeating yearly for the rest of your life. And the American College of Obstetricians and Gynecologists advises initiating mammograms at age 40 and repeating every one to two years, stopping by age 75.
If in doubt, it's best to follow your doctor's advice.
"The recommended age for women to start breast cancer screening is often a controversial topic," Friedman says. "But it's pretty universally agreed upon that you begin to start mammograms approximately 10 years prior to when a primary relative was first diagnosed with breast cancer. So if your mom had breast cancer at 45 that means you should start screening at 35."
Havert says years ago, all women were recommended to have a baseline mammogram at age 35.
"But this fell out of favor about 10 years ago, and the intervals have lengthened somewhat from annual screenings to every one to two years for low- to average-risk women," says Havert. "The reason the intervals and recommended starting age changed was that mammograms, especially in younger women, were often picking up on many false-positive abnormalities, necessitating more invasive diagnostic procedures to evaluate benign lesions. The act of going through additional testing caused more stress and lower quality of life in some patients."
Additionally, don't overlook the importance of manual breast exams that you and your doctor can conduct.
"Women should try and get familiar with their breasts by performing self-breast exams daily or every other day," says Bhanote.
First, inspect your skin for indurations (hardening of soft tissue) or reddening, checking your nipples for discharge or retraction, and observe the symmetry of your breasts, Bhanote advises.
"Then, palpate each breast while lying down or in the shower. Use two fingers from your hand that's opposite the breast; start in the center and proceed clockwise, feeling for any nodules, lumps or bumps," she says. "Palpate into your armpits, too, to check for enlarged lymph nodes."
If you're preparing to schedule and receive a breast exam or screening procedure in a hospital or medical office, note that you'll need to take pandemic-related precautions, even if coronavirus concerns are lessened by the time you read this article.
"You'll likely need to wear a mask to your visit and have your temperature checked," says Bhanote. "Follow the CDC recommended guidelines for precautions and any local protocols given by your hospital or doctor."