Breast Cancer Screenings

What are breast cancer screenings?

Breast cancer screenings are tests that help detect breast cancer. These screenings can often spot signs of cancer before you have any symptoms. Some examples of screening tools include mammograms, breast MRIs and clinical breast exams.

Women at average risk for breast cancer should have their first screening at age 40. Talk to a healthcare provider about when to start breast cancer screenings and how often you need them.

Screenings alone don’t diagnose breast cancer. It takes a combination of tests and procedures to make a breast cancer diagnosis. But breast cancer screenings tell your provider when they need to look closer.

Breast cancer screening methods

Healthcare providers use several types of imaging tests to examine your breast tissue and check for signs of breast cancer. They may use two or three tests to help lead them to a breast cancer diagnosis.

Mammogram

Mammograms are the gold standard for detecting breast cancer. It’s the most common screening. It uses a special X-ray machine to produce a picture of the tissue inside your breast. It involves placing your breast inside a flat plate or paddle. The plates compress your breast so it’s flat.

Breast ultrasound

Ultrasound is another tool providers use to see the inside of your breast. Your provider may suggest getting one if they see something irregular on a mammogram or breast exam. Your provider either moves a small, handheld device around your breast or uses a larger ultrasound device to scan your entire breast. This device releases sound waves through your breast tissue and converts the sound waves to images your provider can see on a screen.

Breast MRI

Breast MRI is another test that creates clear pictures of the inside of your breasts using a magnet, IV contrast and radio waves. Your provider uses it along with other screening tools to detect cancer, especially if you’re at a higher risk or if you’ve had an abnormal mammogram result.

Molecular breast imaging (MBI)

MBI is a test that uses radioactive tracer and a special camera to highlight cancerous cells in your breast tissue. It works by “lighting up” areas where cells appear irregular or out of control.

Contrast-enhanced mammography (CEM)

This test uses IV contrast in combination with mammography to find areas that may be cancer.

Clinical breast exams

This is when your provider feels around your breast for lumps or changes with their fingers. It can miss small or early-stage cancers that imaging tests can usually detect. It doesn’t replace getting a mammogram.

Breast self-awareness

A breast self-exam is when you feel your own breasts for lumps or changes with your fingers. Being aware of how your breasts look and feel is another good way to detect changes in your breast health. You should report changes to your healthcare provider right away.

What are the breast cancer screening guidelines?

The exact recommendation varies. Every organization has a slightly different opinion. But they all agree:

• Screening should start at age 40 for women at average risk for breast cancer. They should continue every one to two years.
• Women at higher risk for breast cancer may need screenings before age 40. They should repeat every year.
• Mammography is the best first screening option for most women.

How often you get screenings depends on your personal risk. Your healthcare provider will use a breast cancer risk assessment. This tool predicts your chances of getting breast cancer based on factors like:

• Having the BRCA gene mutation
• Having a parent, sibling or child with a history of breast cancer
• Age
• Having radiation therapy to your chest
• Genetic syndromes associated with early-onset cancers
• Breast density

Once your provider determines your overall risk, they’ll recommend when and how often you should have a breast cancer screening.

What are the risks and benefits of breast cancer screenings?

The benefit of screening for breast cancer is that it allows healthcare providers to catch cancer in the earliest stages. This is when it’s easiest to treat.

The benefits of regular screening far outweigh the harm of cancer going undetected. Possible risks include:

• Exposure to small but safe levels of radiation.
• False-positive results, which is when a screening suggests cancer when there is none. This can lead to additional testing and cause unnecessary anxiety or fear.
• False-negative results, which is when a screening misses cancer. This is why it’s important to get regular screenings and discuss your risk with your healthcare provider.

What type of results do you get from a breast cancer screening?

Healthcare providers use a tool called BI-RADS to report most breast cancer screening results. It’s a standardized way to describe the results of breast imaging in a way you can understand. There are six categories, and each category has a definition. If your results don’t make sense to you, reach out to your healthcare provider so they can explain them.

Most screening results are available within a few business days. But this can depend on several factors. Your healthcare provider can tell you more about when to expect your results.

What do I do if my results are abnormal?

Having an abnormal result on one screening test doesn’t mean you have breast cancer. It means more tests are necessary. A breast biopsy can diagnose breast cancer definitively.

When should I call my healthcare provider?

Contact your healthcare provider if you:

• Have questions about when you should get your first or next mammogram
• Notice any new and unusual symptoms, like nipple discharge, inverted nipple, breast skin changes or breast lumps
• Have questions about your screening results
• Want more information on the types of breast cancer screenings available

Don’t wait for your next screening if you notice changes to your breasts.