Breast Cancer Screening

In fact, the five-year relative survival rate for a woman diagnosed with early-stage breast cancer is 99%. In contrast, the survival rate for someone whose cancer is diagnosed after it has spread to distant parts of the body is 28%. About two-thirds of breast cancers are diagnosed in the early stages, thanks in large part to growing awareness around risk factors and advancements in breast cancer screening mammography.

Women at average risk for breast cancer should begin breast cancer screening with annual mammography at age 40. Screening should continue until at least age 70 or as long as a woman has a life expectancy of 10 years or longer.

While previous guidelines suggested biannual mammography was sufficient, we’ve since discovered that it’s not. In fact, annual screening provides nearly twice the protection against breast cancer mortality as biannual screening. Women at average risk for breast cancer who have a screening mammogram every two years have a 23% lower risk of dying from breast cancer, whereas women who are screened annually have a 40% lower chance.

Women at high risk for developing breast cancer should talk to their doctors about beginning breast cancer screening earlier, being screened more frequently and/or having a breast MRI along with their annual mammogram. You are considered to be at high risk if you:

• Have a BRCA1 or BRCA2 gene mutation
• Have one or more first-degree relatives (mother, sister, daughter) who have had breast cancer or any male relatives who have had breast cancer
• A personal history of breast cancer
• Radiation treatment to the chest between ages 10 and 30

When it comes to screening mammograms, you have options. Both the technology used to screen for breast cancer and the experience of the team reading the scans can greatly affect how early a cancer is detected.

3-D Mammography: This newer type of mammography, which is performed in the same manner as 2-D mammography and can be done at the same time, is even more effective at revealing early-stage tumors. 3-D mammography also means up to 40% fewer call-backs, or when patients are asked to come in for additional imaging to confirm results. Emory uses combination 2-D and 3-D mammography at each of its locations for breast cancer screening.

2-D Mammography: Traditional mammography produces two-dimensional images. It is quite effective when used and read by an experienced radiologist. While standing in front of a special X-ray machine, a technician will position one breast at a time between two plates. The plates will compress the breast tissue and then the technician will capture an image. The whole process takes about 20 minutes, and the compression only lasts a few seconds per image.

Breast MRI: Women with dense breasts and those at high risk for breast cancer can benefit from breast MRI in addition to regular screening mammography. Breast MRI uses magnets and radio waves to produce detailed images of the breasts. During the test, the woman lies face down on a table that is then slid into the MRI machine. No compression of the breast tissue is necessary, although a contrast dye is injected into a vein in the arm prior to the procedure to help on the images. The test takes about 45 minutes to complete.

Breast MRI can detect tumors that mammography alone cannot. However, it is not a replacement for mammography as mammography can detect some cancers that breast MRI cannot, and breast MRI can produce more false positives than traditional mammography. Breast MRI requires specialized equipment and therefore is only available in certain places, including Emory Breast Imaging Centers.

If you are at high risk for breast cancer, you may qualify to take part in Winship’s high-risk breast cancer clinic. Based on your individual risk, a Winship doctor will design a customized screening regimen that outlines which type of screening is best for you, when you should begin and how often you’ll need to repeat screening. The clinic will then send you reminders when it’s time for your screenings.

If you have a first-degree relative who’s been diagnosed with breast cancer, or you have a known BRCA1 or BRCA2 gene mutation, you may qualify to participate in Winship’s high-risk breast cancer clinic. To learn more, please call 404-778-7465.

In recent years, experts have begun placing greater emphasis on breast self-awareness rather than on self-examination. Because an individual’s breasts change as they age, it can be difficult to spot changes or abnormalities, if we are not already aware of how the breasts normally look and feel. That is why it is important to become familiar with what is normal when it comes to our own bodies. If you notice even small changes, you should contact your healthcare provider as soon as possible. Men should also consult a physician if they experience symptoms of breast cancer. Talk to your doctor if you notice:

• Any new lump in the breast or armpit
• Swelling in the breast
• Irritation or skin dimpling
• Red, flaky skin on the breast or nipple
• Nipple pain or inversion (turning inward)
• Abnormal nipple discharge
• Any change in the size or shape of the breast
• Breast pain

Most of the time, having these symptoms will not result in a breast cancer diagnosis. Even the majority of breast lumps are benign (noncancerous) and do not require treatment.