Screening for Breast Cancer

About Breast Cancer Screening

Breast cancer is a serious disease that occurs when the cells in the breast become abnormal and start dividing uncontrollably, forming a tumor. It is one of the most common types of cancer in women.

Detecting breast cancer early is extremely important for several reasons:

Improved outcomes: Early detection significantly improves the chances of successful treatment and better outcomes. It allows doctors to start treatment earlier, which can help prevent the cancer from spreading to other parts of the body.
Less aggressive treatment: Detecting breast cancer early may mean that less aggressive treatments, such as surgery or radiation therapy, can be used instead of more invasive procedures like chemotherapy.
Increased survival rate: The earlier breast cancer is detected and treated, the higher the chances of survival. Early detection gives individuals a better chance of living a longer and healthier life.
Reduced emotional and financial burden: Detecting breast cancer early can help reduce the emotional stress and financial burden associated with more advanced stages of the disease. Early detection may lead to less extensive treatments and fewer complications, which can positively impact a person's quality of life.

How Breast Cancer Screening is Done

Breast cancer screening looks for signs of cancer before a person has symptoms. Finding breast cancer early can make treatment more effective. The right screening plan depends on your age, personal risk factors, breast density, and health history. Your healthcare provider can help you decide when to start and how often to be screened.

Mammogram: A mammogram is a low-dose X-ray of the breast and is the main test used for routine breast cancer screening. It can find some cancers before they can be felt. Many guidelines recommend starting regular mammograms at age 40. For people at average risk, the U.S. Preventive Services Task Force recommends a mammogram every 2 years from ages 40 to 74. Some organizations recommend yearly screening for certain age groups, so it is important to talk with your healthcare provider about the schedule that is right for you.
3D mammogram, or breast tomosynthesis: This is a type of mammogram that takes images of the breast from several angles. It may be used as part of routine screening and can be especially helpful for some people with dense breasts.
Clinical breast exam: During this exam, a healthcare professional checks the breasts and underarm area by sight and touch. A clinical breast exam may be part of a visit, but it is not a replacement for a mammogram. Some guidelines do not recommend it as a routine screening test for people at average risk.
Breast ultrasound: Ultrasound uses sound waves to make pictures of the inside of the breast. It is often used to look more closely at an area seen on a mammogram or to evaluate a lump. It is not usually used alone as a routine screening test for people at average risk.
Breast MRI: MRI uses magnets and radio waves to create detailed breast images. It is usually used along with mammography for people at high risk, such as those with certain inherited gene changes, a very strong family history, or prior chest radiation at a young age. It is not routinely used for people at average risk.
Genetic counseling and testing: Testing for inherited gene changes, such as BRCA1 or BRCA2, does not diagnose breast cancer and is not a screening test by itself. It can help identify people who may need earlier or more intensive screening.
Tests that are not substitutes for mammograms: Thermography has not been shown to be an effective replacement for mammography. If you are considering any alternative or supplemental test, talk with your healthcare provider first.

Before screening, let your healthcare provider know if you have breast symptoms, are pregnant or breastfeeding, have breast implants, have had breast surgery, or have a personal or family history of breast cancer. If you notice a lump, nipple discharge, skin changes, or any other new breast change, contact your healthcare provider even if your next screening test is not due.

Screening has benefits, but it can also lead to follow-up tests for findings that are not cancer. Your healthcare provider can help you understand the benefits and possible downsides and choose a screening plan that fits your risk and preferences.

Who Should Follow Mammogram Guidelines?

Mammogram guidelines are mainly written for people at average risk for breast cancer. In general, this includes women and other people assigned female at birth who have breast tissue and do not have certain high-risk factors. Many guidelines now recommend starting regular mammograms at age 40, but the best schedule can depend on your personal risk and preferences.

People at average risk: Average risk usually means you do not have a personal history of breast cancer, a known inherited gene change that increases breast cancer risk, a strong family history of breast cancer, or a history of radiation treatment to the chest at a young age. For many people at average risk, regular mammograms are recommended from ages 40 to 74. Some guidelines recommend every 2 years, while others recommend yearly screening for certain age groups.
People ages 75 and older: There is not enough evidence to give one screening recommendation for everyone in this age group. Decisions about whether to continue mammograms should be based on overall health, life expectancy, personal values, and discussion with a healthcare provider.
People at higher risk: Some people may need to start screening earlier, have screening more often, or have additional tests such as breast MRI. This may include people with a known BRCA1 or BRCA2 gene change, a strong family history of breast cancer, prior radiation treatment to the chest before age 30, certain inherited cancer syndromes, a personal history of breast cancer, or a prior biopsy showing high-risk breast changes.
People with dense breasts: Dense breast tissue can make mammograms harder to read and may be linked with a higher risk of breast cancer. A mammogram is still recommended, but your healthcare provider can discuss whether any additional screening may be appropriate for you.
Transgender and nonbinary people: Screening needs can depend on the breast tissue you have, your medical history, and any gender-affirming care you have received. Talk with a healthcare provider about the screening plan that fits your situation.

If you are not sure which group applies to you, ask your healthcare provider to review your personal and family history. Together, you can decide when to start screening, how often to be screened, and whether you need any tests in addition to a mammogram.