Screening Guidelines For Women At Average Breast Cancer Risk
MSK doctors recommend the following for women at average risk* of breast cancer:
- Women between the ages of 25 and 40 should have anannual clinical breast examination.
- Women 40 and older should have an annual mammogram in addition to anannual clinical breast examination.
- Ultrasound may be recommended for women with dense breast tissue.
- All women should consider performing a monthly self breast exam beginning at age 20 and become familiar with their breasts so they are better able to notice changes.
On The Kindest Thing That Someone Did For Them While They Were In Treatment:
“Having my friends put their lives and work on hold to take me to my appointments.”
“Having my sister take me to chemo and another sister-friend drive me home took the burden of traveling to and from treatments off of me. Chemo left me fatigued at the end of the day. Knowing I had a designated driver for the trip home allowed me to relax.”
“There are too many to count. A few examples include GoFundMe, organizing Christmas gifts for me and my kids, organizing a meal train, helping with childcare while I was at appointments, transporting my kids to school and activities, virtual retreats, family trips, prayers, and numerous letters and messages of support.”
“I love cards, so receiving cards of encouragement meant a lot. I also had friends who would occasionally drop off a dinner for me. Receiving phone calls also got me through I had a number of senior citizen friends who were constantly calling to check on me. There is also a blanket that two of my nieces sent me things like that were so comforting. Even small thoughtful actions like sending a fruit arrangement meant so much to me.”
Can Breast Cancer In Younger Women Be Prevented
For women with a family history that is suggestive of a hereditary predisposition for breast cancer, a referral for genetic counseling may be appropriate. Identifying such genetic conditions will allow for a more personalized discussion on screening and preventive treatment options. For example, screening in BRCA mutation carriers begins at the age of 25.
Measures that all women can take to reduce breast cancer risk include:
- Achieving and maintaining ideal body weight
- Limiting alcohol consumption
- Getting regular exercise
That being said, if breast cancer does develop, early detection and prompt treatment can significantly increase a woman’s chances of survival. More than 90% of women whose breast cancer is found in an early stage will survive.
Young women should be counseled on breast awareness and to report any breast changes to their healthcare provider. These changes can include:
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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 .
Diagnosis Of Breast Cancer
Diagnosis is the process of finding out the cause of a health problem. Diagnosing breast cancer usually begins when you find a lump in your breast or a screening mammography suggests a problem with the breast. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for breast cancer or other health problems.
The process of diagnosis may seem long and frustrating. Its normal to worry, but try to remember that other health conditions can cause similar symptoms as breast cancer. Its important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of breast cancer.
The following tests are usually used to rule out or diagnose breast cancer. Many of the same tests used to diagnose cancer are used to find out the stage . Your doctor may also order other tests to check your general health and to help plan your treatment.
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How Can I Detect My Breast Cancer Early
The best way for young women to find breast cancer early is to be breast self-aware. Become familiar with your breasts: their shape, size and what they feel like. Learn what is normal for you. Sometimes your breasts may change throughout your monthly cycle. If you are pregnant or nursing, your breasts will change even more dramatically. If you find anything unusual, see your doctor immediately and insist on a diagnosis. In general, women should have a yearly clinical breast examination by a doctor beginning at age 20 and start having annual mammograms beginning at age 45.
What Is A Her2 Receptor And How Does It Relate To Breast Cancer
Healthy HER2 receptors are the proteins that help manage how a breast cell grows, divides, and repairs itself. However, in about a quarter of all breast cancer patients, the HER2 gene isnt functioning properly. It makes an excess number of copies of itself in a process known as HER2 gene amplification. Then these extra genes instruct the cells to make too many HER2 receptors, which is called HER2 protein overexpression. The ultimate result is that breast cells grow and divide in an uncontrolled fashion.
The HER2/neu test can discover whether the sample is normal or whether it has too much of the HER2/neu protein or an excessive number of copies of its gene. If you have been diagnosed with invasive breast cancer or have had recurrent breast cancer, your doctor may recommend this test. It will help your oncology team determine your prognosis, characteristics of the tumor including how aggressive the tumor is likely to be, and the best treatment options.
This test is often ordered in conjunction with the hormone receptor test. Typically, the breast cancer tissue sample from a biopsy or the tumor removed during a mastectomy is used. This test can take about a week to get the pathology results back, whereas determining if the cells are cancer usually is known in just a day or two.
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If You Have A Family History Of Breast Cancer
UK guidelines recommend that women with a moderate or high risk of breast cancer because of their family history should start having screening mammograms every year in their forties.
If you are younger than 40 and have an increased risk of breast cancer, you should be offered yearly MRI scans from the age of 30 or 40. This depends on your level of risk.
Where To Get Screened
Women ages 50 to 74 can call the nearest Ontario Breast Screening Program location to make an appointment .
Women in the North West and Hamilton Niagara Haldimand Brant regions may be eligible for screening in one of our mobile screening coaches.
If you think you may be at high risk for breast cancer, talk to your doctor about a referral to the High Risk Ontario Breast Screening Program based on family or medical history.
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Should You Get Tested For The Breast Cancer Genes
Do you have a family or personal history of breast cancer? If so, it’s important to learn if and when you should get gene testing
Superstar Angelina Jolies shocking decision to obtain a preventative bilateral mastectomy drew great attention and headlines towards the gene cancer testing that more women are contemplating to prevent breast cancerthe most common cancer in women in the United States.
When my own sister was diagnosed with breast cancer several years ago, I watched her experience each phase of this taxing illness with a very different patient perspective. And yet, people are still confused surrounding breast cancer gene testing. My sisters general surgeon attempted to seek insurance approval for her to get gene testing, given her rather young diagnosis in her 40s, but was denied. My sister was baffled: why would the insurance companies deny such an importance piece of information that can possibly help her other three sisters given her young age of diagnosis with breast cancer?
Its not always so simple. Let me explain what the process of breast cancer gene testing really entails.
Screening Vs Diagnostic Mammogram
The type of machine used and the process to get the first four images is the same for a screening or diagnostic mammogram. More images may need to be taken in a diagnostic mammogram to look at a specifici area more closely, and different types of tools may be used to compress the tissue in different ways.
Benefits & Potential Harms
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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
How Do I Self
Lots of people talk about doing self-checks , to try and spot cancer early.
Its good to be aware of what your body is normally like, so its easier to notice if anything changes. But theres no good evidence to suggest that regularly self-checking any part of your body in a set time or set way is helpful. It can actually do more harm than good, by picking up things which wouldnt have gone on to cause you problems.
Self-checking is different to cancer screening read more about screening for cancer.
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What Are The Benefits Of Having A Mammogram
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.
Studies show that a small number of women who have mammograms may be less likely to die from breast cancer.
The risk for breast cancer goes up as you get older. In general, women younger than 50 are at a lower risk for breast cancer. Because of this, women ages 50 to 70 are more likely to benefit from having a mammogram than women who are in their 40s.
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.
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When Will I Be Offered Breast Screening
You will become eligible for breast screening once you reach the age of 50. Your first invitation will depend on when screening is available in your area. This will be within two years of your 50th birthday.
Your details should automatically be on our register. You can check that your name is on the register or update your details.
Check your name is on the register or Freephone
The risk of breast cancer increases as you get older, all women between the ages of 50 and 69 are invited to take a mammogram every 2 years.
The incidence and mortality from breast cancer in this age group means that it is effective to screen women between the ages of 50 and 69.
You will remain eligible for breast screening up to the age of 69. After this, you need to continue to be aware of any symptoms of breast cancer.
You should speak to your GP if you’re worried about symptoms of breast cancer. Screening is only for women who appear healthy or have no symptoms.
Do Not Be Afraid To Go To Your Screenings
“One thing I wish other people knew about breast cancer is that it’s treatable if caught early. It’s important not to be afraid to get your screening. When you go early and keep up your mammograms and screenings it makes things a whole lot easier. For me, I would get my annual mammograms like clockwork. Earlier this year, I went for my annual screening and it turned out I also needed an ultrasound and biopsy, all of which was done in three hours at New York-Presbyterian/Columbia University Irving Medical Center. A few weeks later, I underwent surgery followed by treatment. It all happened so quickly, but because it was caught so early, I knew that everything was going to be ok.”
“Everybody’s experience is not going to be the same. For me it was the early detection that made all the difference. I had already made up my mind that I was not going to go through this with a defeatist attitude. Instead, I found the positive aspect and latched on to that: it’s treatable and I am going to beat this.”
Michelle Robinson, diagnosed with breast cancer at 67
I had already made up my mind that I was not going to go through this with a defeatist attitude. Instead, I found a positive aspect and latched onto it: It’s treatable and I am going to beat this.”
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What Are The Breast Cancer Symptoms I Need To Look Out For
People of all ages should be familiar with the normal look and feel of their breasts. If you notice any of the following changes please see your doctor immediately:
- a lump, lumpiness or thickening of the breast
- changes in the skin of a breast, such as puckering, dimpling or a rash
- persistent or unusual breast pain
- a change in the shape or size of a breast
- discharge from a nipple, a nipple rash or a change in its shape.
What If You Have Already Had Breast Cancer
If you had early-stage breast cancer and have no signs that your cancer has returned, you may not need imaging or tumor marker tests. It is not likely that your cancer has returned. These tests usually do not help you live longer. And they can lead to a wrong diagnosis and unneeded treatments.
Usually, the best way to monitor your cancer is to have a mammogram each year and a physical exam every six months. And watch for symptoms, such as a new lump or pain in the breast. Studies show that most breast cancer that returns is found through symptoms, not imaging tests.
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What Are Genomic Tests
Genomic tests analyze a sample of a cancer tumor to see how active certain genes are. The activity level of these genes affects the behavior of the cancer, including how likely it is to grow and spread. Genomic tests are used to help make decisions about whether more treatments after surgery would be beneficial.
While their names sound similar, genomic testing and genetic testing are very different.
Genetic testing is done on a sample of your blood, saliva, or other tissue and can tell if you have an abnormal change in a gene that is linked to a higher risk of breast cancer. See the Genetic Testing pages for more information.
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 .
Learn more about Breastcancer.org’s recommendations on when to begin annual mammograms.
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