Breast cancer is the second most commonly diagnosed cancer in women (after skin cancer). Breast self-exam alone has not been shown to reduce deaths from breast cancer.
Clinical breast exam by a health care professional, breast self-exam, and mammography are currently recommended for early detection. Routine breast cancer screening has the potential to reduce deaths from breast cancer in women.
Women with a strong family history of breast cancer should start routine screening at least 10 years before the age of onset of breast cancer in their relatives.
Breast cancer risk can be inherited from both paternal and maternal sides of the family.
- All women over 20 years of age are encouraged to perform monthly breast self-exams. Ask your health care provider about doing the self-exam.
- Women age 40 - 49 are advised to have a mammogram every 1 – 2 years based on risk factors.
- Women over 50 years are advised to have a mammogram every year.
- Women over 75 years should discuss the frequency of mammograms with their health care provider.
Marshfield Clinic will continue to follow the American Cancer Society’s guidelines
Marshfield Clinic does not anticipate changing its recommendations for breast cancer screenings, even though a federal panel has called for major changes.
The U.S. Preventive Services Task Force on November 16, 2009 issued guidelines calling for screening mammograms to be performed every two years beginning at age 50 for women at average risk of breast cancer. The task force also recommended that physicians no longer instruct women in how to perform their own breast self-exams.
Marshfield Clinic has long followed the American Cancer Society’s guidelines and other professional society guidelines recommending mammograms starting at age 40. The Clinic also follows the ACS guidelines encouraging women to perform breast self-exams and to have a clinical breast exam annually. Women are encouraged to talk to their providers about any concerns.
“I would anticipate that Marshfield Clinic will continue to support mammography screening for women in their 40s,” said Douglas Reding, M.D., a hematologist/oncologist . “Marshfield Clinic specialists from various departments involved in cancer treatment will continue to follow American Cancer Society guidelines and will carefully examine any recommendations to modify this.”
He added that the Clinic clearly recommends that women who have detected a possible lump, or whose physician has found any abnormality in a clinical breast exam, should have a mammogram, regardless of age.
“Our perspective is that detecting cancer early is beneficial, regardless of whether the patient ultimately lives or dies, because it is much easier to treat early stage breast cancer,” Dr. Reding said. “Such patients are more likely to have a better quality of life. The U.S. Preventive Services Task Force focused only on whether or not the screening tests result in decreased mortality and the possibility of additional unnecessary tests for false positive mammogram results.”
The task force, which has already taken a conservative view on screening tests for other forms of cancer, addressed the mammography issue as a comparative effectiveness question. In other words, the panel’s goal is to determine whether spending money on screenings that do not help many people live longer is an effective use of health care dollars. Mammograms in women in their 40s also produce a large number of false positive results, which lead to unneeded breast biopsies, anxiety and distress, the task force said.
Dr. Reding noted that most people know a young woman who has had breast cancer. If that woman had a mammogram that detected a tumor, it probably saved her life. That’s why Marshfield Clinic believes that the lifesaving benefits of screening women for breast cancer in their 40s outweigh any potential negatives from false positives. Any woman who is in doubt about the value of mammography is urged to consult her health provider.