What Is Breast Cancer Screening

What Are The Risks Of Mammography

Because mammography uses X-rays to produce breast images, patients are exposed to a very small amount of radiation during the procedure. However, the risk from this exposure is extremely low. For most women, the benefits of regular mammography outweigh the risks of radiation exposure.

Radiation exposure during pregnancy may lead to birth defects. If it is necessary for a pregnant woman to have mammography, special precautions must be taken to minimize radiation exposure to the fetus. She will typically have to wear a lead apron during the procedure.

Some discomfort may be felt because the breast is compressed against the X-ray plate during the procedure. However, this compression will not harm the breast.

Doctors do not advise mammography for pregnant or breastfeeding women. If necessary, they may advise other safer screening methods such as an ultrasound.

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:

A pathologist examines the removed tissue specimen and makes a final diagnosis. Depending on the facility, the radiologist or your referring physician will share the results with you.

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.

• The National Cancer Institute

What Does The Nhs Breast Screening Programme Do

The NHS Breast Screening Programme provides free breast screening every three years for all women aged 50 and over. Because the programme is a rolling one which invites women from GP practices in turn, not every woman receives an invitation as soon as she is 50. But she will receive her first invitation before her 53rd birthday. Once women reach the upper age limit for routine invitations for breast screening, they are encouraged to make their own appointment.

The programme is now phasing in an extension of the age range of women eligible for breast screening to those aged 47 to 73. This started in 2010 and is expected to be complete by 2016.

In September 2000, research was published which demonstrated that the NHS Breast Screening Programme had lowered mortality rates from breast cancer in the 55-69 age group1. In 2010, research undertaken by Stephen Duffy and others demonstrated that the benefit of mammographic screening in terms of lives saved is greater than the harm in terms of overdiagnosis. Between 2 and 2.5 lives are saved for every overdiagnosed case.

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Tips For Getting Ready For The Test

Check with your insurance provider before getting an MRI: Breast MRI can cost a lot, and it may need to be approved by your insurance company before the scan is done. Most private insurance plans that pay for mammogram screening also pay for MRI as a screening test if a woman is shown to be at high risk. It might help to go to a center with a breast health or high-risk clinic, where the staff has experience getting approval for breast MRIs.

Follow all instructions: You dont usually need a special diet or preparation before an MRI, but follow any instructions youre given.

If you have trouble with enclosed spaces: Breast MRI is most often done while you are lying on your belly with your arms above your head inside a long, narrow tube. If being in a tight space might be a problem for you, you might need to take medicine to help you relax while in the scanner. Talking with the technologist or a patient counselor or getting a tour of the MRI machine before the test can also help. Youll be in the exam room alone during the test, but you can talk to the MR technologist, who can see and hear whats going on.

Remove metal objects: Before the test, you’ll be asked to undress and put on a gown or other clothes without zippers or metal. Be sure to remove any metal objects you can, like hair clips, jewelry, dental work, and body piercings.

• An implanted defibrillator or pacemaker
• Clips used on a brain aneurysm
• A cochlear implant
• Metal coils inside blood vessels

Screening In Women Aged 75 Years Or Older

The USPSTF found insufficient evidence to assess the balance of benefits and harms of screening mammography in women aged 75 years or older. CISNET models suggest that biennial mammography screening may potentially continue to offer a net benefit after age 74 years among women with no or low comorbidity,7, 8 but no randomized trials of screening included women in this age group.2, 3

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Tests Are Used To Screen For Different Types Of Cancer When A Person Does Not Have Symptoms

Scientists study screening tests to find those with the fewest harms and most benefits. Cancer screening trials also are meant to show whether early detection helps a person live longer or decreases a persons chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage.

* You Are At Average Risk If You Have:

• no symptoms of breast cancer
• no history of invasive breast cancer
• no history of ductal or lobular carcinoma in situ
• no history of atypia
• no family history of breast cancer in a first-degree relative
• no suggestion or evidence of a hereditary syndrome such as a BRCA mutation
• no history of mantle radiation

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American Cancer Society Screening Recommendations For Women At Average Breast Cancer Risk

The COVID-19 pandemic has resulted in many elective procedures being put on hold, and this has led to a substantial decline in cancer screening. Health care facilities are providing cancer screening during the pandemic with many safety precautions in place. Learn how you can talk to your doctor and what steps you can take to plan, schedule, and get your regular cancer screenings in Cancer Screening During the COVID-19 Pandemic.

These guidelines are for women at average risk for breast cancer. For screening purposes, a woman is considered to be at average risk if she doesnt have a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation known to increase risk of breast cancer , and has not had chest radiation therapy before the age of 30.

Women between 40 and 44 have the option to start screening with a mammogram every year.

Women 45 to 54 should get mammograms every year.

Women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.

All women should understand what to expect when getting a mammogram for breast cancer screening what the test can and cannot do.

Clinical breast exams are not recommended for breast cancer screening among average-risk women at any age.

Breast Cancer By Ethnicity

Breast cancer is common in people of all ethnicities. While more common in White peple, it is more deadly in Black people.Between 2013 and 2017, the breast cancer death rate was 40% higher in Black people than White people.

The most dangerous subtype of breast cancer, triple-negative breast cancer, is more common in Black people. The prevalence of this more deadly type may cause some of the disparity in death rates, but it is not the only reason. Black women are also more likely to be diagnosed with more advanced disease due to inequalities in care.

Breast cancer in men is also more common and more dangerous for Black people. The incidence of breast cancer in Black men is 1 in 50,000, while the mortality is 1 in 200,000. In White men, these numbers are slightly lower: 1 in 77,000 are diagnosed with male breast cancer and 1 in 333,333 die from it.

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Benefit Of Mammographic Screening On Breast Cancer Mortality

Randomized controlled trials

RCTs that studied the effect of screening mammography on breast cancer mortality were performed between 1963 and 2015, with participation by over half-a-million women in four countries. One trial, the Canadian NBSS-2, compared mammography plus clinical breast examination to CBE alone the other trials compared screening mammography with or without CBE to usual care. Refer to the Appendix of Randomized Controlled Trials section of this summary for a detailed description of the trials.

The trials differed in design, recruitment of participants, interventions , management of the control group, compliance with assignment to screening and control groups, and analysis of outcomes. Some trials used individual randomization, while others used cluster randomization in which cohorts were identified and then offered screening one trial used nonrandomized allocation by day of birth in any given month. Cluster randomization sometimes led to imbalances between the intervention and control groups. Age differences have been identified in several trials, although the differences had no major effect on the trial outcome. In the Edinburgh Trial, socioeconomic status, which correlates with the risk of breast cancer mortality, differed markedly between the intervention and control groups, rendering the results uninterpretable.

How To Make Breast Self

Make it routine. The more you examine your breasts, the more you will learn about them and the easier it will become for you to tell if something has changed. Try to get in the habit of doing a breast self-examination once a month to familiarize yourself with how your breasts normally look and feel. Examine yourself several days after your period ends, when your breasts are least likely to be swollen and tender. If you are no longer having periods, choose a day that’s easy to remember, such as the first or last day of the month.

Get to know your breasts’ different neighborhoods. The upper, outer area near your armpit tends to have the most prominent lumps and bumps. The lower half of your breast can feel like a sandy or pebbly beach. The area under the nipple can feel like a collection of large grains. Another part might feel like a lumpy bowl of oatmeal.

Start a journal where you record the findings of your breast self-exams. This can be like a small map of your breasts, with notes about where you feel lumps or irregularities. Especially in the beginning, this may help you remember, from month to month, what is normal for your breasts. It is not unusual for lumps to appear at certain times of the month, but then disappear, as your body changes with the menstrual cycle .

Breast Self-Exam

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How To Enrol A Patient

Refer women who might be at high risk for breast cancer to the OBSP by completing the OBSP Requisition for High Risk Screening and faxing it to a high risk screening site in your area. To find High Risk OBSP sites, view Breast Screening Locations.

The form serves as a referral for women who require genetic assessment to determine their program eligibility. It also authorizes the High Risk OBSP to book appropriate screening tests and follow-up of abnormal results.

At The Screening Unit

A visit to a screening unit for breast screening takes about half an hour. The woman is greeted by a receptionist or female mammography practitioner who checks her personal details . The mammography practitioner asks the woman about any symptoms or history of breast disease, explains what will happen when the mammograms are taken, and answers any questions about breast screening. If the woman is happy to proceed, the mammography practitioner then takes the mammogram. She explains when and how the woman will get her results, and reminds her of the need to be breast aware between screening appointments. If it is the womans last routine screening invitation, the mammography practitioner also reminds her that she can ask for another screening appointment in three years time.

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Getting Your Test Results

Often, the hardest part of screening and testing isnt undergoing the tests themselves, but waiting for results to come back. If youre like most people, you will want your test results as soon as possible. With an emergency or just before a chemotherapy treatment, test results generally come back quickly. But when your doctor orders a non-emergency test which most breast cancer-related tests are the lab or radiology department may not send the results back as quickly. Your doctor isnt likely to know when the test actually gets done or if the results are available until the report comes into the office 3 to 7 days later. Meanwhile, you may think that your doctor has the results and isnt getting back to you.

Although there is no way to make test results come back any faster, there are steps you can take to feel more in control of the process. Simply asking about when to expect results and making arrangements with your doctor to get them can go a long way toward reducing anxiety. Another good way of taking control is to keep copies of all your test results in one place. That way, youll always have them in hand if you need to share the information with another doctor or refer to it yourself.

Breast Cancer Screening Patient Version

On This Page

Screening is looking for signs of disease, such as breast cancer, before a person has symptoms. The goal of screening tests is to findcancer at an early stage when it can be treated and may be cured. Sometimes a screening test finds cancer that is very small or very slow growing. These cancers are unlikely to cause death or illness during the person’s lifetime.

Scientists are trying to better understand whichpeople are more likely to get certain types of cancer. For example, they look at the person’s age, their family history, and certain exposures during their lifetime. Thisinformation helps doctors recommend who should be screened for cancer, whichscreening tests should be used, and how often the tests should be done.

It is important to remember that your doctor does not necessarilythink you have cancer if he or she suggests a screening test. Screeningtests are done when you have no cancer symptoms. Women who have a strong family history or a personal history of cancer or other risk factors may also be offered genetic testing.

If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests, rather than screening tests.

See the following PDQ summary for more information about cancer screening:

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When To Start Screening

Clinical trials, observational studies, and modeling studies all demonstrate that the likelihood of avoiding a breast cancer death with regular screening mammography increases with age, and this increase in benefit likely occurs gradually rather than abruptly at any particular age. In contrast, the harms of screening mammography either remain constant or decrease with age. For example, about the same number of breast biopsies are performed as a result of screening mammography in women aged 40 to 49 years as in those aged 60 to 69 years, but many more of these biopsies will result in a diagnosis of invasive cancer in the older age group. Thus, the balance of benefit and harms improves with age .

It is, however, a false dichotomy to assume that the only options are to begin screening at age 40 or to wait until age 50 years. As women advance through their 40s, the incidence of breast cancer rises. The balance of benefit and harms may also shift accordingly over this decade, such that women in the latter half of the decade likely have a more favorable balance than women in the first half. Indeed, the CISNET models suggest that most of the benefit of screening women aged 40 to 49 years would be realized by starting screening at age 45.7, 8

What Are The Benefits Of Screening

Early detection is the primary reason for screening. When breast cancer is detected through imaging and before it is clinically apparent , it is more likely to be small and more easily treated. Small cancers detected early can be removed and breast conserving surgery can be performed. Additionally, small cancers often do not require chemotherapy or radiation therapy.

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