Ask any of your friends or relatives if they know someone who has had breast cancer, and the answer will most likely be “yes.”
Women in the United States have a one in eight chance of developing breast cancer at some point in their lifetime; every year, more than 200,000 women learn that they have it. Except for skin cancer, breast cancer is the most common cancer among women.
Fortunately, when detected early, it is also one of the most treatable. Generally, the earlier breast cancer is detected and treated, the easier and more successful the treatment. According to the American Cancer Society, the five-year relative survival rate for women with stage 0 or stage I breast cancer — the earliest stages of the disease — is close to 100 percent. For women with stage II breast cancer, the five-year relative survival rate is about 93 percent.
That’s why annual screening mammograms, which look for changes in the breasts of women who do not have clinical signs of breast cancer, are so important.
“Annual screening mammograms can detect breast cancer at very early stages, before a patient or clinician can even feel a lump. The earlier the detection, the higher the chance of cure,” said Rebecca Hsu, MD, a diagnostic radiologist with the Emily Fenton Hunte Breast Care Center at Scripps Green Hospital.
Yearly screening mammograms play a major role in helping women who have breast cancer successfully fight the disease. The American Cancer Society reports that breast cancer death rates among women dropped 39 percent from 1989 to 2015, in part because of improved screening and early detection.
Most women who develop breast cancer don’t have known risk factors. Nearly 75 percent of breast cancer patients have no family history of the disease and no known gene mutations or other risk factors. In the United States, women of average risk have a 12 percent chance of developing breast cancer; if you have risk factors, your risk may be even higher.
Breast cancer screening exams help find breast cancer at an early stage. When found early, the chances for successfully treating the disease are greatest.
Along with regular exams, practice awareness. This means you should stay familiar with your breasts. That way you’ll notice changes, like a new lump or mass. Then, report them to your doctor without delay.
The screening recommendations below apply to most women.
Age 20 to 39
- Clinical breast exam every one to three years with a health care provider who checks for lumps or other changes.
Age 40 and older
- Clinical breast exam every year
- Mammogram every year
Women at increased risk
Women at increased risk have a higher chance of getting breast cancer. This doesn’t mean you will definitely get cancer. But, you may need to start screening at an earlier age, get additional tests or be tested more often.
You’re at increased risk for breast cancer if you fall under one or more of these groups.
- History of radiation treatment to the chest.
- Genetic mutation, including an abnormality in the BRCA 1 or BRCA 2 genes, CDH1, Bannayan-Riley-Ruvalcaba Syndrome.
- History of lobular carcinoma in situ.
- Five-year risk of breast cancer 1.7 percent or greater at age 35 or older, as defined by a Gail Model calculation. Calculate your risk using the Gail Model.
- A life-time risk of breast cancer 20 percent or greater, as defined by models dependent on family history. Women with a strong family history of breast cancer should consider speaking with a genetic counselor.
Mammograms do use very low doses of radiation to screen the breast tissue, but the benefits of screening outweigh any possible risks from radiation exposure.
“Most breast imaging departments, including those at Scripps, use digital mammography, which has replaced conventional film-screen mammography. Digital mammography offers better quality with less radiation,” said Dr. Hsu. “Many facilities, including some at Scripps, also offer tomosynthesis (or 3D mammography) which often decreases the need for additional imaging and may be beneficial in patients with dense breast tissue.”
During a mammogram, the breast is compressed between two plates before being X-rayed. The breast tissue must be as flat as possible in order to get a precise X-ray. Some women may find the compression uncomfortable. Let your mammography technician know if the position you’re in is painful; she may be able to change it or decrease the pressure a bit.
If you have health insurance under the Affordable Care Act and are age 40 or older, your annual mammogram is fully covered by your plan, even if you haven’t met your deductible. If you don’t have insurance, several national breast cancer organizations sponsor low-cost or free mammogram programs for eligible women. Our staff at Scripps Health can provide you with contact information for programs in your area. In addition, Scripps and many other breast care centers will set up a payment plan if you need it.