Breast cancer is the second most common cancer in women and the leading cause of cancer death in women in the U.S. Those are scary statistics. But you can do something about it. Breast cancer can be caught early and early detection gives you the best opportunity to have treatment that is less invasive and more effective.
Screening for breast cancer is important and you may have heard some mixed messages about it recently. It can get pretty confusing when there are differing opinions.
What we all agree on:
Mammograms save lives. A mammogram is an X-ray of your breasts and is the best way to detect breast cancer in the early stages, when it is easily treatable. These can often be found before you can feel a lump or have any other symptoms.
Getting my boobs squished sucks. Yep, no argument there. If it is severely painful, some women may benefit from topical lidocaine prior to the procedure to make it more tolerable.
Mammograms sometimes detect false positives. Sometimes, in our concern to avoid missing any potential cancerous lesion, we (meaning the computer programs and radiologist) will look at the mammogram and see an area that will look concerning on the first pass. This will result in you returning for further mammogram or ultrasound images and possibly even a biopsy to see if the area is cancerous in nature. Fortunately, often these will be totally normal tests. Unfortunately, these will result in more tests and extra worry on your part until the results come in.
What we still can’t agree on:
When to start mammograms and how often to complete them. Depending on which governing body you ask (USPSTF, NCI, ACOG, AMA, AAFP, ACS, ACR, etc), it can get overwhelmingly confusing to try to figure out when you are supposed to get a mammogram! Some say you should start at age 40, some say age 50, some say stop at age 70, some say age 75. Then they all differ on how often you should get that stressful mashing of the breasts – every year, every 2, every 3 years – what’s a woman to do!
Please talk to your doctor. He may have updated information, will be able to review your personal health risks (see some of them below), and will review the risks and benefits of completing mammography in the different time frames. You don’t have to make the decision alone.
There are some factors that increase your risk for breast cancer. A first degree relative with breast cancer and the age at which that relative was diagnosed can increase your risk, particularly if that relative had a gene that you could have inherited as well (BRCA). While only 5-6% of breast cancers are associated with this genetic mutation, BRCA testing is available if you have a relative who tested positive for this mutation. Even if your relative didn’t have a BRCA gene, it is important to let your doctor know who in your family had breast cancer and at what age.
You may also have a small increased risk of breast cancer through exposure to estrogen. This can be from birth control pills, never having been pregnant, or having your first child after age 30.
Breast thermal imaging maps the surface heat of the breast using a heat sensitive camera. Unfortunately, breast thermography has not been shown to be an effective screening tool for breast cancer and should not replace mammography. Thermal imaging was first suggested as an alternative based on the observations that breast cancer patients had elevated skin temperatures over their cancers. In the original investigations, thermography was found to have a false negative rate of greater than 60% and a 2012 review showed that it missed 75% of the cancers seen on mammogram. Although the U.S. FDA did approve infrared imaging technology (based on safety data, not efficacy), it did issue a safety communication stating “the FDS is unaware of any valid scientific evidence showing that thermography, when used alone, is effective in screening for breast cancer.” The American Cancer Society recommends “thermography should not be used as a substitute for mammograms.”
Breast cancer is detectable early and treatable early. Please contact your doctor and arrange for a mammogram!