Breast Cancer Screening


Breast cancer occurs when the normal cells in the breast start growing rapidly and spreading locally.  If left untreated, these cells can travel to other parts of the body and continue to grow.  Besides skin cancer, breast cancer is the most common type of cancer and it is the second leading cause of cancer-related deaths in US women (lung cancer is the first). Preventing breast cancer is not possible in most cases, but thanks to a few simple breast cancer screening tests, we can detect breast cancer in its initial stages, when treatment is more successful.

Breast cancer mortality is decreasing for black and white women, especially among younger women. However, even though death rates are going down, we need to do more to level the field.

How do we Screen for Breast Cancer?

You may hear about other ways to screen for breast cancer, but for average-risk women, screening mammography is the gold standard of care.

National Cancer Institute - Bill Branson (photo)

Breast cancer screening – National Cancer Institute – Bill Branson (photo)

A mammogram is an X-ray image of the breast that allows us to detect cancer at early stages, often when it is still too small to notice by touch.  Currently, this is the most widely used and accepted screening method.  While the other imaging techniques below may offer additional information, they should only be reserved for special circumstances and not for general screening purposes.

Magnetic Resonance Imaging (MRI):

MRIs use magnetic waves instead of X-rays to image the breast tissue.  MRI detects breast cancers better than the mammogram, but because of its tendency to also over-diagnose cancer in healthy breast tissue, it leads to unnecessary, more invasive testing in people who do not need it.  For this reason, a mammogram is still the gold-standard screening tool.

Ultrasonography (US):

Ultrasounds use real-time sound waves to visualize the breast tissue and are also not recommended for general screening.  It can be useful as a follow-up to an abnormal mammogram, or in women with dense breast tissue.

Breast Self-Awareness:

Women should also be aware of their normal breast tissue.  If they notice any changes that are unusual or concerning, they should discuss them with their doctor.

Evidence shows that women who have regular screening mammograms are less likely to die from breast cancer than those who do not.

When does the breast cancer screening Begin?

Recommendations can vary slightly depending on the source you read, so it is always a good idea to talk to your doctor about your risk factors and determine the best option for you.

As a general rule:

National Cancer Institute - Rhoda Baer (Photographer)

Breast cancer screening – National Cancer Institute – Rhoda Baer (Photographer)

  • Some low-risk women may have the option to delay mammograms for several years until the age of 45 or 50.
  • All women by age 50 should have had at least one mammogram, regardless of risk.
  • Screenings should continue every 1-2 years until at least the age of 74.

If cost is an issue, the CDC has resources to provide low-cost woman’s health services including mammograms.  Check out their website to see if you qualify.

What does my Test Result Mean?

An abnormal mammogram result does NOT mean you have breast cancer.  In fact, most women who are recalled for additional testing after an abnormal mammogram are found they do not have cancer.  No screening test is perfect, and the mammogram is no different.

In most of these cases, we perform a diagnostic mammogram where additional images are taken of the breasts focusing on the area(s) of concern.

“On average, 10% of women will be recalled from each screening examination for further testing, and only 5 of the 100 women recalled will have cancer.”

A normal mammogram result also does not guarantee that you are cancer-free.  Studies estimate that mammograms can miss early cancers in up to 20% of cases.  

That is a scary thought, but it sheds some light on why it is important to continue scheduling your mammogram every year even if yours have all been normal.  Each subsequent mammogram decreases the likelihood of missing early cancer exponentially — The odds drop to 4% after the second mammogram, and are just 1% after the third.

If you have been putting off that mammogram this year, now is a good time to call and schedule it.

What’s Next?

  • Over the age of 40? Then it is time to talk to your doctor about breast cancer screening.
  • Already had your yearly mammogram?  Head over to the Insights Page to check that off your To-Do list!

About the Author

Dr. Josh is an Osteopathic Physician currently living in Ohio. He manages the medical records as well as the Concierge Service for Heads Up Health.
2 Responses to "Breast Cancer Screening"
  1. Carole says:

    I’m wondering why you don’t include thermography as a screening tool for breast health. With breast cancer diagnosis occurring at much younger ages, thermography can safely be started in late teens/early 20’s for anyone, but especially for with those with worries about a family history of breast cancer. Used as a screening tool, thermographic changes can show breast cancer growth at it’s earliest stages; often early than standard screenings.

    Using radiation as a screening method can actually CAUSE breast cancer. I started mammograms at age 33 with the “guidance” of my OB/Gyn after a good friend of mine died of metastatic breast cancer at 34. At 47, I was diagnosed with DCIS after 18 mammograms (some years required a double check, especially as digital technology improved to show calcifications earlier). I am 11 years cancer free and switched to annual thermograms along with self-checks to monitor my breast health. If an issue occurs, I can alway get further diagnosis with mammogram, ultrasound, and/or MRI.

    • Linda says:

      I was one of the misguided people who believed in mammography. I am 69 and as a dutiful follower of the standard of care at the time, I got my first mammogram at 35. As a Navy family, we moved frequently, so I don’t have all the reports, but I can verify at least 10 mammograms and probably had upward of 20 as I believed in doing it every year. I have dense breasts, but the last mammograms I got over a 10 year period showed no changes with normal breasts. Lo and behold a year ago despite a normal mammogram and ultrasound, I was diagnosed with Invasive Lobular cancer involving a 7cm mass. Lobular cancer is sneaky; it does not form a lump, but sends out weblike tentacles that intermingle with breast tissue. It is often not palpable; mine was not and only when the breast swelled was I aware that there was a problem. The radiologist that read the tests almost sent me away without an MRI with contrast. I am told given the size of the mass which enveloped 50% of the breast that it had probably been growing for 10 maybe even 15 years. Imagine how many times mammograms irradiated and compressed those tumors cells and common sense would suggest that mammograms promoted the cancer. I firmly believe that early, less controlled radiation from mammograms damaged my DNA and later radiation caused the damage to become invasive. I have no family history, not overweight, an exerciser, and very health conscience. Women beware. Lobular cancer is on the rise. Wish mammograms were not so heavily promoted for people my age. We were the guinea pigs in a dangerous experiment.

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