My breasts, my tests: Get the facts on screening options

Breast cancer screening is vital to early breast cancer diagnosis and better patient outcomes. However, do you know which type of screening is right for you? Are you aware of what the procedures are, why they are done or what your risks might be? Take control of your health so you can make the informed decision that is best for you.

Mammography

Mammography is recommended every two years from the ages of 50 to 69 in the average-risk woman. Some provinces, however, recommend continuing the screening procedure until the age of 74. If you are between the ages of 40 and 50 or older than 74, then mammography might still be an option, depending on your concerns and personal choice. Between the ages of 40 and 50, mammography is still effective at detecting early breast cancers, but breast cancer itself is much less common, increasing the percentage of “false alarms” and unnecessary invasive testing. Women who are at intermediate risk (meaning they have one first-degree relative over the age of 50 or a couple of second-degree relatives with breast cancer) can consider this option. Mammography is generally not recommended for the average-risk woman before the age of 40 because of accuracy issues, as the breasts are usually not dense enough.

Side effects

The side effects of mammography are related to the procedure itself, as some women find it uncomfortable or painful. The risk of mammography is that it is not 100 per cent specific. This means a biopsy might be recommended, putting a woman through unneeded stress, pain and sometimes even surgery, for a benign disease. That said, it is the most accurate screening test we have, and it saves lives daily by diagnosing early cancer that would not have been found until later otherwise.

If you have a family history of breast cancer or ovarian cancer —  especially in first-degree relatives — have had chest radiation or have a family member with a known BRCA1 or BRCA2 mutation, then you might be eligible for screening mammography before the age of 40 and every year after. Make sure to speak with your physician about when screening should start for you.

MRI

Magnetic resonance imaging, or MRI, is becoming more common in breast cancer screening and evaluation. If you are considered high risk for breast cancer, MRI is often done yearly along with mammography after the age of 30. Also, if an abnormal spot is seen on a mammogram, then MRI might be recommended to further assess. MRIs are loud and tight, so women who suffer from claustrophobia might need sedation prior to the test. MRIs are contraindicated in anyone with metallic foreign bodies near the area being tested. Your physician should ask you multiple questions to assure it is safe prior to undergoing the test.

Ultrasound

Ultrasound is generally not a good screening test for breast cancer. However, it is often performed alongside mammography in women with abnormal findings or dense breasts. An ultrasound may also be suggested as an initial test in average-risk women younger than 40 with a breast concern. It should not, however, be the sole decision-maker as to whether a lump is dangerous, though ultrasound can aid in clinical judgment.

Genetic testing

Genetic testing might be offered if you are high risk for breast cancer and have not previously been tested. High-risk populations include (but are not limited to) those who have one or more first-degree relatives with breast cancer or ovarian cancer, have a relative with a known BRCA1 or BRCA2 mutation, have had breast cancer themselves at a young age, have had bilateral breast cancer or ovarian and breast cancer or who have an extensive family history of breast cancer or ovarian cancer, especially at young ages. If you are unsure about your risk, then speak with your physician to determine where you fit.

Breast cancer screening has been proven to detect early disease, thereby saving lives. In fact, the majority of breast cancers are now diagnosed through the screening program. For more information on screening and risks, you can always visit the Canadian Breast Cancer Foundation.

More on cancer prevention

Colorectal Cancer Awareness Month: What you need to know
Ovarian cancer: Being aware
Your guide to the prevention and detection of skin cancer

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