For the average women of breast cancer screening age, an annual mammogram is the primary tool needed for detecting malignant and benign breast concerns. Certain women, however, may need additional types of screening.
“Depending on a women’s risk factors and personal or family history, we can also turn to other imaging tools to diagnose breast cancer,” says Annie Zeug, a General Surgeon specializing in breast surgery. “Other tools include ultrasounds and MRI.”
Staying on top of routine screening is critical. Breast cancer is the second-most common kind of cancer in women, trailing only skin cancer. An estimated one in eight women will develop the cancer in their lifetime.
“Individuals should talk with their medical provider about what type of screening is right from them,” Dr. Zeug says. “Factors to consider include family history of breast cancer, dense breast tissue, certain genetic conditions, prior chest radiation or prior mammogram findings, and past breast biopsies with atypical findings.”
Types of Screening
Clinical and Self-Exams
Experts traditionally recommended clinical breast exams and breast self-exams as initial screening tools for breast cancer.
During a clinical exam, a health care provider uses their hands to feel for lumps or other changes. Women use breast self-exams to feel for any lumps or watch for any visible changes, such as nipple discharge.
In recent years, the American Cancer Society (ACS) and other groups have cast doubt on the effectiveness of clinical and breast self-exams. The recommendation now is for women to practice breast self-awareness. That entails knowing their “normal” and watching for changes.
“Research has not shown a clear benefit of regular physical breast exams done by either a health professional (clinical breast exams) or by women themselves (breast self-exams),” the ACS states. “There is very little evidence that these tests help find breast cancer early when women also get screening mammograms.”
Mammogram
Beginning between the ages of 40 and 44, women should begin having annual mammograms. Recommendations on when to begin and how often to have the test vary. Women can talk to their primary care provider for individualized guidance.
Mammogram is the most popular diagnostic tool to diagnose cancer since it’s used in women who have no signs or symptoms of cancer, according to the Centers for Disease Control and Prevention.
Mammogram is an X-ray image of the breast. It can detect tumors that are too small to feel. It also can check for cancer after discovery of a lump or other breast cancer symptom.
Most mammograms today are 3D. A 3D mammogram combines multiple breast X-rays to create a 3D image. This provides a clearer picture of the breast tissue.
A mammogram is an important tool. Research shows that women who have regular mammograms are more likely to have breast cancer found earlier and are less likely to need aggressive treatments, according to the ACS. They’re also more likely to be cured.
Despite their usefulness, mammograms can miss some cancers, especially in women with dense breast tissue. In addition, if a mammogram reveals a concern, women likely will need another type of screening such as an ultrasound or MRI.
Ultrasound
Breast ultrasound can tell the difference between fluid-filled masses like cysts and solid masses. Solid masses require further testing, such as biopsy, to determine whether they’re cancer.
In an ultrasound, a technologist applies gel to the skin or a handheld, wand-like instrument called a transducer. The technologist moves the transducer around the skin. This sends out sound waves and picks up the echoes as they bounce off body tissues deeper in the skin. People may feel a little pressure from the transducer, but otherwise they should experience no pain.
MRI
A doctor may recommend an MRI if a woman is at high risk for breast cancer. In addition, if doctors have a concern about a mammogram or ultrasound finding, an MRI can help give a clearer picture of the exact location and size of potential cancer.
MRIs use strong magnets to make detailed, cross-sectional pictures of the body, providing a view from multiple angles. MRIs are not painful but do require people to lie in the same position for a period of time.
MRIs carry with them the risk of false-positive results at a rate of 52 out of 1,000 cases, according to the Radiological Society of North America. False positives can lead to unnecessary invasive procedures, such as biopsy, as well as causing distress.
Navigating the Options
Dr. Zeug says women should discuss their history and potential risk factors with their primary care provider. A physician or advanced practice provider can provide guidance on the need for additional testing. However, nearly every woman should begin with a mammogram as an initial test.
“Your doctor also may refer you to a high-risk breast clinic to help with navigating the need for additional tests,” Dr. Zeug says. “We know decision-making can feel overwhelming, but we want women to know support is here for them.”
Use MyThedaCare to schedule a mammogram or an appointment with your primary care provider.
