With breast cancer, early detection is key. The earlier the disease is diagnosed the less it has progressed, and the better the outcome with treatment.
Screening for breast cancer
A screening mammogram (a type of breast X-ray) can identify the presence of cancer, often before symptoms arise. Women at high risk for breast cancer may also be screened with other imaging tests, like a breast MRI.
Medical organizations and breast cancer advocacy groups urge women to undergo routine screening to find and treat breast cancer early. But experts do not agree on exactly when to begin screening or how frequently women should be tested.
The National Comprehensive Cancer Network (an alliance of cancer centers) recommends annual screening beginning at age 40.
The ACS says women ages 40 to 44 should have the option to begin screening every year. It recommends annual screening for women ages 45 to 54. At 55, a woman can decide to continue annual screening or go for her mammogram every other year for as long as she is healthy and has 10 more years of life to live.
The U.S. Preventive Services Task Force advises women 40 to 49 to talk to their health care provider about when to start screening and how often to be screened. For women 50 to 74, it recommends a mammogram every two years.
Women at high risk of developing breast cancer should be screened earlier and more often. The ACS recommends annual mammograms and breast MRIs starting at age 30 for women with a higher-than-average risk of developing breast cancer, including those with a known breast cancer gene mutation or a first-degree relative with an inherited breast cancer gene mutation.
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Since men have less breast tissue and less breast cancer, they are not routinely screened for the disease. If there is a strong family history of breast cancer or a known breast cancer gene mutation in the family, a man might consider having genetic testing to see if he has a mutation that increases his risk for male breast cancer.
Men who are at high risk for breast cancer should talk to their health care provider about having their breasts examined during routine checkups and doing breast self-exams.
Male or female, it is helpful to know what your breasts normally look and feel like so that you can report any changes to your doctor. The American College of Obstetricians and Gynecologists recommends “breast self-awareness,” meaning knowing what’s normal for your own breasts and paying attention to any changes you may feel.
Regular breast self-exams are no longer recommended as a routine screening method for women because there isn’t sufficient evidence that they offer any early detection or survival benefits.
But should women still have their breasts examined by a doctor every year? Some medical groups see no clear benefit of a clinical breast exam, while others continue to recommend one every year as part of a routine checkup.
Diagnosing breast cancer
An abnormal finding on a screening mammogram or discovering a lump or other breast changes doesn’t necessarily mean you have breast cancer.
First, your doctor will need to perform follow-up testing using one or more types of scans. A diagnostic mammogram, which involves more X-rays than a screening mammogram, can offer a more detailed view of the area of concern. Two other tests, a breast MRI or a breast ultrasound, may be ordered to gather additional diagnostic information.
There is only one way to confirm a cancer diagnosis. You will need a biopsy to extract cells or tissue from the area of the breast that is causing concern. A fine needle may be used to remove cells or tissue, or you may undergo a surgical procedure to remove a piece of breast tissue.
A pathologist will use these specimens to look for cancer under a microscope and may perform additional testing on the tissue sample. The pathology findings can confirm whether or not you have breast cancer and what your chances of beating it–your prognosis–may be. This information can help your medical team (your doctor, your surgeon, your radiologist, and other providers) determine the best course of treatment.
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