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Breast screening guidelines webpage

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What is the aim of breast cancer screening?

Breast screening tests can detect breast cancer early, before it causes symptoms. Screening raises your chance of treating cancer and living longer. 

Who should have a breast screen?

The United States Preventive Services Task Force doctors recommend that women aged 50 to 74 years old and at moderate risk of developing breast cancer should have a mammogram every two years. Women aged 40 to 49 years old should talk to their healthcare provider about when to start screening and how often they should get a mammogram. In addition, women should consider the benefits and risks before getting mammographs before their 50.

Tests used for breast screening

The most popular breast cancer screening test is a mammogram. It is an X-ray examination of the breast. 

For many women, a mammogram is the best way to detect cancer before it is big enough to cause symptoms. Regular mammograms lower your risk of dying from breast cancer.

Another method, Breast Magnetic Resonance Imaging (MRI), uses magnets and radio waves to take a picture of the breast. It is used alongside mammography to screen women at higher risk for getting breast cancer.

A doctor or nurse can also make a clinical breast exam. They use their hands to feel for lumps or other changes.

Breast self-awareness is crucial. You can still find cancer by yourself. Knowing how your breast usually looks and feels can help you notice signs like lumps, pain, or changes that may be of concern. You can also find them during a regular breast self-exam

If you notice any unusual changes, report them to your doctor or healthcare provider immediately. Cancer may develop in mammogram intervals. Do not wait for the next checkup because cancer may progress quickly.

Unfortunately, cancers big enough to be found in clinical or self-exam are more advanced and give lower chances of survival. Cancers at higher stages of development frequently disseminate into other organs, thus complicating the treatment.

Benefits and risks of breast screening

Every breast screening test has its benefits and risks, so you should talk to your doctor and make a well-informed decision about which type of test is suitable for you and when.

Of course, the most significant benefit is finding cancer early when the chances to cure are higher.

The good news is that almost all women diagnosed at the earliest stages of the disease survive at least five years after diagnosis. 

Harms of the breast screening include:

  • False positive tests – when the doctor sees something that looks like cancer, but it is not. This may lead to unnecessary stress, painful and cost-consuming invasive diagnostics;
  • Overdiagnosis – when the doctor finds cancer that may go away on its own. 

In this case, radiation, hormone therapy, or surgical treatment may have side effects and cause more harm than cancer. But at this stage, we cannot distinguish which cancer will grow and cause further problems and which not.

  • Pain during the procedure. One mammogram is taken from the above and the other from the side of the breast. Machinery squeezes the breast to make a detailed mammogram.
  • Radiation exposure from the mammogram. Radiation used during mammography is small but may be harmful when repeated.
  • False negative test results – when cancer is missed on the mammogram, delaying cancer diagnosis and treatment.

What happens after I get the result?

You should get your results within two weeks. Usually, your doctor will tell you when to expect them.

Most women have a normal results. If you are in that happy group, set your next screening appointment for two to three years. Although, remember to report any unusual changes.

If the results are not clear or show any abnormal area, the clinic staff will call you back for more tests. You might need more X-rays, like a magnified mammogram showing the breast cancer area more clearly, lining the borders of any lump or thickened area. 

The examinations may include ultrasound scans or taking a sample of cells from the suspicious area. 

You might be worried now, but remember that around 4% of women have additional tests, and not all have cancer.

Screening for women under 40 at higher risk

If you are younger than 40 but had a family member who suffered or died from breast cancer, talk to your doctor. They may refer you to a genetic specialist, who will assess your disease risk based on genetic diagnostics for faulty gene versions.

Women at higher risk due to family history should have mammography yearly in their forties. If you are younger, you should take MRI scans annually from the twenties (TP53 mutation) or thirties (BRCA1, BRCA2 mutations).

Find your local breast screening unit

Making well-informed decisions is important. Consider all benefits and risks and register your visit by phone call +48 XXX XXX. Registration is open from 9 am to 5 pm, Monday to Friday.

Martyna Piotrowska

Resources:

Breast screening | Breast cancer | Cancer Research UK

What Is Breast Cancer Screening? | CDC

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