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When To Get Screened For Breast Cancer

What Is Breast Cancer Screening

Get Screened for Breast Cancer

Screening can help find breast cancer early, when it is easier to treat.

Breast cancer screeningexternal icon means checking a womans breasts for cancer before there are signs or symptoms of the disease. All women need to be informed by their health care provider about the best screening options for them. When you are told about the benefits and risks of screening and decide with your health care provider whether screening is right for youand if so, when to have itthis is called informed and shared decision-making.

Although breast cancer screening cannot prevent breast cancer, it can help find breast cancer early, when it is easier to treat. Talk to your doctor about which breast cancer screening tests are right for you, and when you should have them.

Are Women Under 40 At Risk For Breast Cancer

Younger women generally do not consider themselves to be at risk for breast cancer. However, breast cancer can strike at any age: 5% of breast cancer cases occur in women under 40 years of age. All women should be aware of their personal risk factors for breast cancer.

There are several factors that put a woman at higher risk for developing breast cancer, including:

  • A personal history of breast cancer or a high risk lesion found by biopsy
  • A family history of breast cancer, particularly at an early age
  • A family history that is concerning for a genetic syndrome that may put them at a higher risk for breast cancer
  • History of radiation therapy to the chest
  • A known genetic mutation conferring a high risk for the development of breast cancer
  • Ashkenazi Jewish ancestry

Primary And Adjunctive Screening In Women With Dense Breasts

The USPSTF found insufficient evidence to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, MRI, DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram.

Epidemiology of Dense Breasts

In the United States, the most commonly used classification system for breast density is the American College of Radiologys Breast Imaging Reporting and Data System 4-category scale . Data from the BCSC indicate that about 25 million women aged 40 to 74 years are classified as having heterogeneously or extremely dense breasts. The proportion of women with dense breasts is highest among those aged 40 to 49 years and decreases with age.14

Increased breast density is a risk factor for breast cancer. Data from the BCSC indicate that, compared with women with average breast density, women aged 40 to 49 years with heterogeneously or extremely dense breasts have a relative risk of 1.23 for developing invasive breast cancer. For women aged 50 to 64 years with heterogeneously or extremely dense breasts, the RR is 1.29, and for women aged 65 to 74 years, it is 1.30.7 However, women with dense breasts who develop breast cancer do not have an increased risk for dying from the disease, after adjustment for stage, treatment, method of detection, and other risk factors, according to data from the BCSC.15

Primary Screening Test Performance Characteristics

Primary Screening Frequency


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Effectiveness Of Early Detection And Treatment

Primary Screening With Conventional Mammography

An updated meta-analysis by Nelson and colleagues of RCTs of screening mammography found similar RR reductions in breast cancer mortality by age group as the previous USPSTF evidence review. The combined RRs were 0.92 for women aged 39 to 49 years, 0.86 for women aged 50 to 59 years, 0.67 for women aged 60 to 69 years, and 0.80 for women aged 70 to 74 years.2, 3

None of the trials nor the combined meta-analysis demonstrated a difference in all-cause mortality with screening mammography.2

Observational studies of screening mammography reported a wide range of breast cancer mortality reduction rates. Recent meta-analyses from the EUROSCREEN Working Group showed an approximate 25% to 31% relative reduction in breast cancer deaths in women aged 50 to 69 years who were invited to screening. In comparison, meta-analysis of RCTs that used an intention-to-treat analysis found a 19% to 22% breast cancer mortality reduction in women in the same age range.2, 3

Primary Screening With DBT

No studies evaluated the effect of screening for breast cancer with DBT on important health outcomes, such as mortality, treatment-related morbidity, or quality of life.13

Adjunctive Screening in Women With Dense Breasts

No studies evaluated the effects of adjunctive screening with any method in women with dense breasts on breast cancer rates, quality of life, or mortality.17, 18

Get Screened For Breast Cancer: Erie County Cancer Services Program Urges Women To Get A Mammogram

When to Get Screened for Breast Cancer

Modified: September 30, 2021 3:16pm

Latest News

Archived Press Releases by Year:


ERIE COUNTY, NY In coordination with Breast Cancer Awareness Month, the Erie County Cancer Services Program is urging women to talk to their health care providers about scheduling their mammograms. The CSP helps uninsured and underinsured women get free mammograms.

The current pandemic doesnt change the fact that one in eight women will develop breast cancer at some point in her lifetime,said Commissioner of Health Dr. Gale Burstein. Delays in screening can mean that some breast cancers go undetected at earlier stages, when there are more treatment options and the potential for better outcomes. Make a plan to get a mammogram scheduled.

The CSP works with more than 50 health care providers to offer breast cancer screening to eligible women ages 40 and older without health insurance in Erie County. If any follow-up testing is needed, the CSP will provide those tests too. If cancer is found, the CSP will help enroll people who are eligible in the NYS Medicaid Cancer Treatment Program for full Medicaid coverage during treatment.

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What Are The Risks Of Having A Mammogram

Each time you have a mammogram, there is a risk that the test:

  • May miss some breast cancers. And some cancers that are found may still be fatal, even with treatment.
  • May show an abnormal result when it turns out there wasn’t any cancer . This means you may need more testssuch as another mammogram, a breast ultrasound, or a biopsyto make sure you don’t have cancer. These tests can be harmful and cause a lot of worry.
  • May find cancers that will never cause a problem . Some breast cancers never grow or spread and are harmless. You might have this type of cancer, but a mammogram can’t tell whether it’s harmless. So you may get cancer treatmentincluding surgery, radiation, or chemotherapythat you don’t need.
  • Will briefly expose you to very small amounts of radiation. While the risk from being exposed to radiation from a mammogram is low, it can add up over time.
Breast cancers found in women having annual mammograms over 10 years*

Ages 4049

About 19 out of 1,000 women
Ages 5059 About 30 out of 1,000 women
Ages 6069 About 44 out of 1,000 women

*Based on the best available evidence

*Based on the best available evidence

Breast cancer diagnosis

Mammograms can find some breast cancers early, when the cancer may be more easily treated. Often a mammogram can find cancers that are too small for you or your doctor to feel.

Take a group of women who have a mammogram every year for 10 years.footnote 3



Understanding the evidence

Cancer Screening Conversation Starters

Talking to loved ones about what they can do to stay healthy isnt always easy. Here are a few prompts to start the important conversation about cancer screening.

  • I care about you and your health. Are you getting regular cancer screening tests?
  • Did you know there are tests that can catch changes in your body before they become cancer?
  • My breast/colorectal/cervical cancer screening is coming up soon. Have you scheduled yours yet?
  • Regular cancer screening is important. Is there anything I can do to help you get screened, like get information, schedule an appointment, or help with childcare or transportation?

Cancer Screening 101

Print this quick reference guide to take with you to a doctors appointment or share with loved ones. The guide includes screening recommendations, questions to ask a doctor, and conversation starters.

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There Are Three Screening Methods

There are three types of tests that may be used to screen for breast cancer.

Clinical Breast Exam A CBE is a physical exam of your breast and underarm area by a health care provider. Its often done during your regular medical check-up. A CBE should be performed by someone whos trained in the techniquenot all health care providers have this training. If your doctor doesnt offer you a CBE at your check-up and you would like one, ask if he or she can perform one or refer you to someone who can.

MammogramMammography uses X-rays to make images of the breast . While some tumors in the breast are aggressive and grow quickly, most grow slowly. In some cases a tumor may have been growing for as long as 10 years before it creates a lump large enough to feel. Mammography can find cancers early, before you would have noticed any signs or symptoms. Thats why its often used as a screening test. It can also be used as a follow-up test . If youve noticed a change in your breast and are getting a mammogram, tell the technologist what you noticed before your exam. If you evernotice a change in your breasteven if youve had a mammogram recently and had normal resultsget checked out by a doctor asap. And if youve never had a mammogram before, heres everything you wanted to know .

The Debate About When To Start Screening Mammograms

Survivors Urge Women To Get Screened For Breast Cancer, Regardless Of BRCA Status

A number of large studies, including a review by the U.S. Preventive Services Task Force in 2009 and a study on the causes of death in the United Kingdom in 2013, have questioned the value of screening mammograms and ignited debate over when screening mammograms should start.

Public health experts who question the value of screening mammograms say that while mammograms do save lives, for each breast cancer death prevented, three to four women are overdiagnosed. Overdiagnosis means either:

  • a screening mammogram finds a suspicious area that would have been eventually diagnosed as cancer by other means, without any effect on prognosis
  • a screening mammogram finds a suspicious area that never would have affected a womans health if it hadnt been found or treated

False-positive results from screening mammograms also have helped fuel the debate about the value of breast cancer screening and when it should start. When a mammogram shows an abnormal area that looks like a cancer but turns out to be normal, its called a false positive. Ultimately the news is good: no breast cancer. But the suspicious area usually requires follow-up with more than one doctor, extra tests, and extra procedures, including a possible biopsy. There are psychological, physical, and economic costs that come with a false positive.

  • The American Cancer Society says:
  • Women age 40 to 44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so.
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    First Lady Dr Jill Biden Speaks Out On Her Mission To Get People Screened For Breast Cancer

    “There’s nothing more important than your health,” she said.

    Jill Biden shares why women shouldnt postpone breast cancer screenings

    First lady Dr. Jill Biden is speaking out about two causes close to her heart: access to community colleges and breast cancer awareness.

    In a new interview with Good Morning America co-anchor Robin Roberts, Biden, a professor of writing at Northern Virginia Community College, said she plans to continue to advocate to make community colleges more accessible to more Americans.

    Tuition-free community college was included in President Joe Biden’s social-spending package, but it is now reportedly one of the latest big-ticket items to be dropped from the package.

    When asked by Roberts what she would say to families who were hopeful about the prospect of free community college access, the first lady replied, “I would say we’re not giving up. We are not giving up. This is round one. This is year one. I’m going to keep going.”

    Biden, the country’s sole first lady to hold a job outside the White House, said she is also committed to another cause important to her — making sure breast cancer screenings are accessible to all Americans.

    During the coronavirus pandemic, many doctors saw a drop in cancer screenings due to limited non-essential, in-person visits and patients opting to put off routine examinations — including annual cancer screenings — to curb risky face-to-face interactions.

    Improving Access To Screenings

    As first lady, Biden said she is also working to make sure the federal government makes it a priority to provide access to mammograms to all women.

    Its the responsibility of the federal government to make sure that we have access, that all communities have access, Biden said. Whether thats urban, whether thats rural, so thats one of the things that we plan to do.

    Medical centers like Montefiore are also working to make sure their efforts to increase screenings reach all people, including those who face barriers when it comes to health care.

    We know that in communities of color, in communities where there’s less access to health care, we have barriers to overcome in terms of getting that population in for cancer screening, Rivera said. When you add a pandemic onto that, those disparities only grow further.

    Rivera said one of the ways Montefiore is reaching communities of color is through its clinical trials.

    As we learn through science, through research, we know that certain differences exist, Rivera said. Until we get more representation on those clinical trials, were not adequately assessing that patient population. So its very important to get more clinical trial enrollment from communities of color.

    According to federal guidelines, women ages 40 to 44 should have access to annual breast cancer screening with mammograms, while women ages 45 to 54 should get mammograms every year.

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    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.

    Update Of Previous Uspstf Recommendation

    Mammogram Guidelines

    This recommendation updates the 2009 USPSTF recommendation on breast cancer screening with an assessment of the most current available scientific evidence for mammography screening. In addition, this update also provides additional clarity on what is meant by the C recommendation for women aged 40 to 49 years. A C recommendation is not a recommendation against mammography screening in this age group it signifies moderate certainty of a net benefit for screening that is small in magnitude. A C recommendation emphasizes that the decision to screen should be an individual one, made after a woman weighs the potential benefit against the possible harms. This recommendation also notes that women aged 40 to 49 years with a first-degree relative with breast cancer may potentially benefit more than average-risk women in this age group from beginning screening mammography before age 50 years.

    This recommendation examines the evidence of the effectiveness of an emerging technologyDBTas a primary screening strategy. It also evaluates the effectiveness of adjunctive screening using ultrasonography, MRI, DBT, or other methods in women identified to have dense breasts on an otherwise negative mammogram.

    The scope of the evidence review supporting this recommendation statement was determined after public comment on the draft research plan.

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    If You Have A Normal Result

    You will receive a letter to let you know your mammogram does not show any signs of cancer. Your next screening appointment will be in 3 years time. Do contact your GP or local screening unit if you havent received an appointment and think you are due one.

    It is important to see your GP If you notice any symptoms between your screening mammograms.

    Va Encouraging Women Veterans To Get Screened For Breast Cancer

    FORT WAYNE, Ind. The VA Northern Indiana Health Care System is encouraging women veterans to get screened for breast cancer during October, Breast Cancer Awareness Month.

    VANIHCS encourages all women Veterans to speak with their health care providers about breast health and get checked and treated for breast cancer, said Michael Hershman, Director of VANIHCS. We recognize that some Veterans may have missed their regularly scheduled mammogram due to COVID-19 and encourage women Veterans to reach out to their VA health care provider to get one scheduled.

    During Breast Cancer Awareness Month, and throughout the year, VANIHCS said it offers high quality womens health care, including breast care services.

    VA leads the nations health care systems in providing mammograms to those who need them. Every VA medical center has a Women Veterans Program Manager to ensure women Veterans have access to appropriate care and treatment, VANIHCS said.

    Breast care resources available through VA include screening and diagnostic mammograms, breast ultrasound and MRI, genetic counseling and testing, cancer treatment and more. VA recommends regular breast cancer screening for women who are 45 years of age and older, though some women may choose to start screening with yearly mammograms as early as age 40. Women are encouraged to talk with their VA primary care provider team about what is best for them and schedule their mammogram.

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