How Effective Are Screening Mammograms
Mammograms are the best way to find breast cancer early. But they are not perfect tests. Mammograms may miss some breast cancers. Also, some cancers develop in the time between screens. However, many studies have shown that regular mammograms reduce the risk of dying from breast cancer.
Some breast cancers that are diagnosed through screening may never cause symptoms in a woman during her lifetime . Therefore, some women may have surgery or treatment for a breast cancer that would not have become life threatening.
Not all cancers found at screening can be treated successfully.
To learn more about what happens during a mammogram and how to get ready for a mammogram, see the Mammogram FAQs.
How Does The Test Work
The testing lab typically uses a specialized staining process on the breast tissue sample to see if hormone receptors are present. The technical name for this procedure is an immunohistochemical staining assay or an ImmunoHistoChemistry . Findings will be included in a pathology report given to your doctor. If the cancer is deemed estrogen-receptor-positive , its cells have receptors for the estrogen hormone. That means that the cancer cells likely receive signals from estrogen to promote growth. About two out of every three breast cancers contain hormone receptors.
If the cancer is progesterone-receptor-positive , its cells have receptors for progesterone. This hormone could then promote the growth of the cancer.
The cancer cells being estrogen and/or progesterone receptor-positive is a good prognostic factor to have, usually leading to a better prognosis.
American College Of Obstetricians And Gynecologists Guidelines
The 2017 update of the American College of Obstetricians and Gynecologists guidelines on screening in average-risk women includes the following recommendations for practitioners :
- Use shared decision-making to select screening choices
- Clinical breast examination may be offered every 1-3 years for women aged 29-39 years and annually for women aged 40 years
- Start offering mammography at age 40 years initiate after counseling, if patient desires
- Recommend starting mammography screening by no later than age 50 years
- Mammography may be annual or biennial biennial screening is particularly reasonable after age 55 years
- Continue mammography until age 75 years, then discuss discontinuation, with the woman’s health status and longevity as considerations
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Limitations Of Genetic Testing
Like anything in life, there are limitations to genetic testing for breast cancer, specifically the commercially available tests women can take. One of the most common types of commercially available tests is from 23andMe, a genomics and biotechnology company, as well as tellmeGen and MyHeritage genetic tests.
Theres only a cadre of them that are approved and accurate and there can be both false positives and false negatives, so it really depends, Dr. Port says. If someone is suspicious of having one of these genes and gets tested through one of what we call the direct to consumer type tests, it is important that those testing results may need to be verified before doing something irreversible based on those results.
In other words, if you take one of these tests without your doctors knowledge, and you receive some concerning results, make sure you discuss those results with your doctor before taking your next steps.
American Cancer Society Guidelines
The 2015 update of the American Cancer Society guidelines includes the following recommendations :
- Women with an average risk of breast cancer should undergo regular screening mammography starting at age 45 years .
- Women aged 45 to 54 years should be screened annually .
- Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually .
- Women should have the opportunity to begin annual screening between the ages of 40 and 44 years .
- Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer .
- The ACS does not recommend clinical breast examination for breast cancer screening among average-risk women at any age .
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Why Thermography Is Your Best Breast Test Option
Every year when Breast Cancer Awareness Month comes around I am saddened and surprised that thermography hasnt become more popular. Part of this is my mindset. Id rather focus on breast health and ways to prevent breast cancer at the cellular level than put the emphasis on testing and retesting until you finally do find something to poke, prod, cut out, or radiate. I understand that most doctors are more familiar with mammography, and many still believe that a mammogram is the best test for detecting breast cancer early. But its not. Studies show that a thermogram identifies precancerous or cancerous cells earlier, produces unambiguous results which cuts down on additional testing, and doesnt hurt the body.
As you may know, thermography is a form of thermal imaging. My colleague, Philip Getson, D.O. has been a medical thermographer since 1982. Dr. Getson explains how thermography works this way:
It is widely acknowledged that cancers, even in their earliest stages, need nutrients to maintain or accelerate their growth. In order to facilitate this process, blood vessels are caused to remain open, inactive blood vessels are activated, and new ones are formed through a process known as neoangiogenesis. This vascular process causes an increase in surface temperature in the affected regions, which can be viewed with infrared imaging cameras. Additionally, the newly formed or activated blood vessels have a distinct appearance, which thermography can detect.
Clearer Results Fewer Additional Tests
In November 2009, the United States Preventative Services Task Force said it recommended that women begin regular mammograms at 50 instead of 40, and that mammograms are needed only every two years instead of annually between the ages of 50 and 74. The Task Force concluded that the risk of additional and unnecessary testing far outweighed the benefits of annual mammogramsand I couldnt agree more.
Even before 2009, when the U.S. Preventative Task Forces changed their recommendation for women to begin mammograms at 50 and to have them every two years instead of annually, Danish researchers Ole Olsen and Peter Gotzsche concluded, after analyzing data from seven studies, that mammograms often led to needless treatments and were linked to a 20 percent increase in mastectomies, many of which were unnecessary. Dr. Getson expounded, According to the 1998 Merck Manual, for every case of breast cancer diagnosed each year, five to ten women will undergo a painful breast biopsy. This means that if a woman has an annual mammogram for ten years, she has a 50 percent chance of having a breast biopsy.
If youve ever had an unnecessary biopsy or been scared by a false positive result on a mammogram, please consider getting a thermogram. You can always use it in conjunction with the mammogram to figure out your treatment options.
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Breast Cancer Deaths In Black Women
Breast cancer is the second leading cause of cancer death in Black women, with nearly 7,000 deaths each year.
More inclusive research is needed on the race-specific differences in the following:
- Tumor biology
- Treatment options
- Environmental factors
Fortunately, including Black women in research studies is a prime focus in the science community. As a result, there has been a large increase in the number of personalized treatments that Black women have access to. While cost remains a concern, Black women now, more than ever, have the opportunity to access the individualized care and treatment options that they need to beat breast cancer.
What Is Breast Screening
Breast cancer screening is a way of finding breast cancers early, when they are small. When breast cancer is diagnosed early, less treatment may be needed, and treatment is more likely to be effective.
The first stage of breast screening is a breast x-ray of each breast. About 96 out of every 100 women who go for screening have a normal result.
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A Word From Get Meds Info
When you have access to a test that can predict your chances of getting a serious diseaselike breast cancerit may seem hard to pass up that opportunity. However, at this point, an at-home test can only identify a few of the many breast cancer genes. Taking charge of your own health is an empowering step. Just be aware that you will need medical, social, and emotional support if you get positive results. And remember: A negative result should not be taken as reassurance that you will never get breast cancer.
How Common Are Breast Cancer Gene Mutations
Breast cancer gene mutations arent common in the general population, Dr. Eng says, but they are common in people who have breast cancer. About 10% to 15% of people with breast cancer have one of the breast cancer gene mutations.
You can inherit these gene mutations from either of your biological parents, and the cancers theyre linked to can affect both men and women so consider all your relatives when thinking about your family history.
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The Harms Of Mammography Include The Following:
False-positive test results can occur.
Most abnormal test results turn out not to be cancer. False-positive results are more common in the following:
- Younger women .
- Women who have had previous breast biopsies.
- Women with a family history of breast cancer.
- Women who take hormones for menopause.
False-positive results are more likely the first time screening mammography is done than with later screenings. For every ten women who have a single mammogram, one will have a false-positive result. The chance of having a false-positive result goes up the more mammograms a woman has. Comparing a current mammogram with a past mammogram lowers the risk of a false-positive result.
The skill of the radiologist also can affect the chance of a false-positive result.
False-positive results can lead to extra testing and cause anxiety.
If a mammogram is abnormal, more tests may be done to diagnose cancer. Women can become anxious during the diagnostic testing. Even if it is a false-positive test and cancer is not diagnosed, the result can lead to anxiety anywhere from a few days to years later.
False-negative test results can delay diagnosis and treatment.
When To Get Screened
Breast cancer was expected to be the most common cancer diagnosed in Ontario women in 2018. Screening mammography can find breast cancers when they are small, less likely to have spread and more likely to be treated successfully. Your age and family medical history help determine when you should get screened:
- If you are age 50 to 74, the Ontario Breast Screening Program recommends that most women in your age group be screened every 2 years with mammography. Find your nearest OBSP site by calling 1-800-668-9304 or visiting Ontario Breast Screening Program locations.
- If you are age 30 to 69 and meet any of the following requirements, talk to your doctor about referral to the High Risk Ontario Breast Screening Program:
- You are known to have a gene mutation that increases your risk for breast cancer
- You are a first-degree relative of someone who has a gene mutation that increases their risk for breast cancer
- You have a personal or family history of breast or ovarian cancer
- You have had radiation therapy to the chest to treat another cancer or condition before age 30 and at least 8 years ago
For every 200 women screened in the Ontario Breast Screening Program, about 18 are referred for further tests and 1 will have breast cancer.
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Characteristics Of The Multigene Tests Available In Italy
As mentioned, the available multigene tests provide different information and therefore are not interchangeable. Therefore, the choice of a test for the single patient should be made according to the question to be addressed and the characteristics of the different multigene assays. These differencies rely on the gene selection on the patient population used to validate the assays and importantly on their demonstrated clinical utility. The four tests available in Italy are described below.
Is There A Blood Test For Breast Cancer
No, but in a 2018 study, an experimental blood test called CancerSEEK that measures levels of certain proteins and genetic material was able to detect several types of cancer, including breast cancer. However, considerably more research will be needed to determine whether such a “liquid biopsy” is a viable way to test for breast cancer.
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Preparing For Your Appointment
In advance of your appointment, you may want to collect information about your family history. Specifically, our genetic counsellors will be asking about the types and ages at diagnosis of cancer for your relatives. There may be some information you do not know, but any information you provide can be helpful.
If your appointment is a telephone consultation, you will be called at the number provided on your referral at the date and time of your appointment. Please note, all hospital phone numbers display as private numbers.
If this appointment is scheduled in person, please arrive 10 minutes prior to your scheduled appointment with your valid OHIP card. The Familial Breast Cancer Clinic is in the main Mount Sinai Hospital building at 600 University Avenue. Take the Murray street elevators to the 12th floor, and check-in at the Marvelle Koffler Breast Centre reception desk.
Appointments typically take approximately 30-60 minutes.
Cancer genetic testing is a laboratory test that reads our DNA to search for mutations in genes that can cause a higher risk to develop cancer. . It is important to know that not all breast cancers are hereditary. In fact, most cancers happen sporadically – due to environmental exposures, lifestyle factors, or by chance. It is possible that genetic testing will not show a mutation in the genes tested.
Individuals who are eligible for entry into this program are:
Whether A Woman Should Be Screened For Breast Cancer And The Screening Test To Use Depends On Certain Factors
Women with risk factors for breast cancer, such as certain changes in the BRCA1 or BRCA2 gene or certain genetic syndromes may be screened at a younger age and more often.
Women who have had radiation treatment to the chest, especially at a young age, may start routine breast cancer screening at an earlier age. The benefits and risks of mammograms and MRIs for these women have not been studied.
Breast cancer screening has not been shown to benefit the following women:
- Elderly women who, if diagnosed with breast cancer through screening, will usually die of other causes. Screening mammograms for those aged 66 to 79 years may find cancer in a very small percentage of women, but most of these cancers are low risk.
- In women with an average risk of developing breast cancer, screening mammography before age 40 has not shown any benefit.
- In women who are not expected to live for a long time and have other diseases or conditions, finding and treating early stage breast cancer may reduce their quality of life without helping them live longer.
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Reasons Why I Recommend Breast Thermography
In addition to early detection and accurate test results, here are some other reasons I like thermography:
Can I Rely On Breast Self
Mammography can detect tumors before they can be felt, so screening is key for early detection. But when combined with regular medical care and appropriate guideline-recommended mammography, breast self-exams can help women know what is normal for them so they can report any changes to their healthcare provider.If you find a lump, schedule an appointment with your doctor, but dont panic 8 out of 10 lumps are not cancerous. For additional peace of mind, call your doctor whenever you have concerns.
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What Happens If Something Is Detected On My Screening Exam
Lumps, other abnormalities or questionable findings in the breast are often detected by screening tests. However, it is not always possible to tell from these imaging tests whether a finding is benign or cancerous. To determine whether there is a cancer present, your doctor may recommend that one or more of the following imaging tests may be performed:
- diagnostic mammography
- breast ultrasound
- breast MRI
If a finding is proven to be benign by its appearance on these exams, no further steps may need to be taken. If these tests do not clearly show that the finding is benign, a biopsy may be necessary. In a biopsy, a small amount of tissue is removed under local anesthesia so that it can be examined in a laboratory. One of the following image-guided procedures is used during a breast biopsy:
With early detection and improved treatments, more women are surviving breast cancer. If cancer is diagnosed, your doctor will discuss your treatment options and together you will determine your course of treatment. Today, women have more treatment options than ever before. For more information on treatment, see the Breast Cancer Treatment page.