One in eight American women gets breast cancer, but the diagnosis is not a death sentence. More than 2 million women in the U.S. today have survived breast cancer – largely due to screening techniques that detect the disease early.
Early detection allows for additional treatment options and a better outcome. Read on to learn what screening techniques may work best for you.
Mammography: A Proven Tool
Women who get mammograms (X-rays of the breast) every 1-2 years have a lower risk of dying from breast cancer – about 20% lower for women in their 40s and about 25% lower for women in their 50s and 60s. Among breast cancer screening techniques, only mammography has been proven to reduce death rates from the disease.
Though there is some controversy on how frequently women should get mammograms, annual screenings for women age 40 and above (as recommended by the American Cancer Society) seem most beneficial.
Why Annual Screenings?
- Though greater in older women, the death rate reduction due to mammography is still substantial in women ages 40 to 49.
- Cancers in women under age 50 often grow faster and are deadlier than those in older women.
- The needle biopsy used to confirm or exclude a mammogram’s findings usually is minimally invasive, takes less than 30 minutes and leaves only a tiny scar.
With computer-aided detection (CAD) mammography, computer software analyzes a digital (rather than film) mammogram, marking suspicious areas. It is now offered by about 30% of mammography centers.
There is some controversy with CAD mammography as well. A study in the New England Journal of Medicine found that CAD resulted in 31% more callbacks for additional tests and 20% more biopsies. Often, additional testing revealed no abnormalities. However, doctors still recommend the procedure for the following reasons:
- CAD increases detection of ductal carcinoma in situ, perhaps cancer’s earliest stage.
- CAD can spot various breast abnormalities. Some may or may not be cancer, but all deserve follow-up testing.
Ultrasound: The Next Step
This innovative test is routinely performed after a suspicious area is found. It uses sound waves to create a picture (sonogram) that shows if the area is a harmless fluid-filled cyst or a solid mass that should be biopsied. Ultrasound is safe, painless, widely available, relatively inexpensive and usually covered by insurance. Ultrasound may help distinguish between normal dense breast tissue and dense cancerous tissue.
MRI: A Newer Recommendation
Magnetic resonance imaging (MRI) uses a magnetic field and radio waves to generate detailed pictures revealing cancers that mammograms may miss. Any woman recently diagnosed with breast cancer in one breast should have an MRI of the other breast. The American Cancer Society recommends that women with the highest risk for breast cancer – 20% or greater – receive a yearly mammogram and yearly MRI. Any one of the following criteria places a woman in this group (of highest at-risk):
- Testing positive on genetic tests for the BRCA1 or BRCA2 gene, which are linked to breast cancer
- Having a first-degree relative (mother, sister or daughter) who tested positive for either gene
- Having two or more first-degree relatives with breast cancer
- Having had chest radiation treatment for Hodgkin’s disease (a cancer of the lymphatic system)
MRI is very expensive, and insurance may not cover it. Women with a moderate 15% to 20% lifetime risk should talk to their doctors about the most appropriate screening method for them. This group includes women with dense or fibrocystic (lumpy and often dense) breasts and women who have had a biopsy that showed lobular carcinoma in situ (LCIS), an irregular growth of noncancerous cells. Cancer is 3 to 5 times more likely to develop in dense breasts.
Several other breast cancer screening methods show promise, including gamma camera, which is similar to and much cheaper than MRI, and positron emission tomography (PET), which scans the entire body to determine if cancer has spread.