Living Proof That Screening Saves
Living Proof That Screening Saves

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Breast cancer is the second most common form of cancer in women, affecting one in every eight women in the United States. At Charlotte Radiology, we believe the key to beating this statistic and detecting breast cancer early is yearly, quality mammograms (starting at age 40), monthly self breast exams and regular clinical examination.

Recommendations for Early Detection

Charlotte Radiology stands firmly behind its recommendations of annual mammography starting at age 40, to ensure the maximum benefit from screening mammography. Our guidelines are in accordance with the American College of Radiology and Society for Breast Imaging. While both U.S. Preventive Services Task Force and the American Cancer Society have revised their screening mammography guidelines, their data still indicates that starting annual mammography at age 40 saves the most lives. Charlotte Radiology's local data of more than 1.1 million screening mammograms shows that 20% of the cancers detected by a screening mammogram were in women ages 40-49, further supporting the start of screening mammograms at the age of 40. Additionally 40% of the life years lost to breast cancer are in women diagnosed in their 40s.

Exam

Guidelines

Explanation

Benefits/Risks

Women at average risk

Mammography

Annually starting at age 40

Current evidence supporting mammograms is even stronger than in the past. Recent evidence has confirmed that mammograms offer substantial benefit for women starting in their 40s. Women can feel confident about the benefits associated with regular mammograms for finding cancer early.

Women can feel confident about the benefits associated with regular screening mammography. However, mammography also has limitations: it will miss some cancers, and it sometimes leads to follow up of findings that are not cancer, including biopsies.

CBE (Clinical Breast Examination)

Every three years for women 20-39; annually for women 40 and older

CBE should be part of a woman's periodic health examination, about every three years for women in their 20s and 30s and annually for women 40 and older.

CBE is a complement to regular mammography screening and an opportunity for women and their health care providers to discuss changes in their breasts, risk factors, and early detection testing.

BSE (Breast Self Examination)

Monthly starting at age 20

Women should report any breast change promptly to their healthcare provider. Beginning in their 20s, women should be told about the benefits and limitations of BSE. It is acceptable for women to choose not to do BSE or to do it occasionally.

Research has shown that BSE plays a small role in detecting breast cancer compared with self awareness. However, doing BSE is one way for women to know how their breasts normally feel and to notice any changes.

Older women and women with serious health problems

Additional research is needed.

There is no fixed age at which women should stop getting mammograms. Mammograms for older women should be based on the woman's health and whether or not she has other serious illnesses. Age alone should not be the reason to stop having regular mammograms. As long as a woman is in good health and would be a candidate for treatment if she developed breast cancer, she should continue to have screening mammograms.

There is a need to balance the potential benefits of ongoing screening mammography in women with limited longevity against the limitations. The survival benefit of a current mammogram may not be seen for several years.

Women known to be at increased risk

Women known to be at increased risk

Discuss guidelines with physician; yearly breast MRI screening in addition to annual mammogram.

Women at high risk (about 20% or greater lifetime risk based on family history or history of prior treatment with radiation) should get an MRI (magnetic resonance imaging) and a mammogram every year beginning at age 30. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.

While MRI is more sensitive than mammograms, it also has a higher false positive rate (where the test finds things that turn out to not be cancer), which would result in unneeded biopsies and other tests in a large portion of these women. If MRI is used, it should be in addition to, not instead of, a screening mammogram. This is because while an MRI is more likely to detect cancer than a mammogram, it may still miss some cancers that a mammogram would detect.