American Cancer Society Recommendations for the Early Detection of Breast Cancer
Breast cancer is by far the most common cancer in women worldwide, both in developed and developing countries.
Finding breast cancer early and getting state-of-the-art cancer treatment are the most important strategies to prevent deaths from breast cancer. Breast cancer that’s found early, when it’s small and has not spread, is easier to treat successfully. Getting regular screening tests is the most reliable way to find breast cancer early.
The American Cancer Society has screening guidelines for women at average risk of breast cancer, and for those at high risk for breast cancer.
Recommendations for women at average breast cancer risk
These guidelines are for women at average risk for breast cancer. For screening purposes, a woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation known to increase the risk of breast cancer (such as in a BRCA gene), and has not had chest radiation therapy before the age of 30.
What Is BRCA gene?
The name BRCA is an abbreviation for “BReast CAncer gene.” BRCA1 and BRCA2 are two different genes that have been found to impact a person’s chances of developing breast cancer.
Every human has both the BRCA1 and BRCA2 genes. Despite what their names might suggest, BRCA genes do not cause breast cancer. In fact, these genes normally play a big role in preventing breast cancer. They help repair DNA breaks that can lead to cancer and the uncontrolled growth of tumors. Because of this, the BRCA genes are known as tumor suppressor genes.
However, in some people, these tumor suppression genes do not work properly. When a gene becomes altered or broken, it doesn’t function correctly. This is called a gene mutation.
Guide for women at high risk
Women between 40 and 44 have the option to start screening with a mammogram every year.
Women 45 to 54 should get mammograms every year.
Women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.
All women should understand what to expect when getting a mammogram for breast cancer screening – what the test can and cannot do. Clinical breast exams are not recommended for breast cancer screening among average-risk women at any age.
Mammograms are low-dose x-rays of the breast. Regular mammograms can help find breast cancer at an early stage when treatment is most successful. A mammogram can often find breast changes that could be cancer years before physical symptoms develop. However, mammograms are not perfect. They miss some cancers. And sometimes a woman will need more tests to find out if something found on a mammogram is or is not cancer.
In recent years, a newer type of mammogram called digital breast tomosynthesis (commonly known as three-dimensional [3D] mammography) has become much more common. Many studies have found that 3D mammography appears to lower the chance of being called back for follow-up testing. It also appears to find more breast cancers, and several studies have shown it can be helpful in women with more dense breasts.
American Cancer Society screening recommendations for women at high risk
Women who are at high risk for breast cancer based on certain factors should get a breast MRI and a mammogram every year, typically starting at age 30. This includes women who:
Have a lifetime risk of breast cancer of about 20% to 25% or greater, according to risk assessment tools that are based mainly on family history (see below)
Have a known BRCA1 or BRCA2 gene mutation (based on having had genetic testing)
Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
Had radiation therapy to the chest when they were between the ages of 10 and 30 years
Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have first-degree relatives with one of these syndromes.