Breast Cancer Screening

Breast cancer screening is an important aspect of women’s health. Currently, breast cancer is the second most common cancer related death in women in the US. Early detection is possible with appropriate screening.

Risk Factors for Breast Cancer

• Increasing Age
• Smoking
• Obesity
• Family History
• Exogeneous Estrogen Use

Screening Tools for Breast Cancer

• Breast Exam – most consensus guidelines recommend all women have an annual well woman exam which includes breast examination by a health care provider no later than age 21.  Individual screening may vary due to risk factors as outlined above or abnormalities identified by self-examination.
• Mammogram – guidelines for mammography screening typically support first mammogram by age 40 or sooner if clinically indicated by family history.  The American Cancer Society recommends baseline mammography between ages 35-39 which is typically covered by most insurance plans.  Talk with your provider about when mammography screening is appropriate for you for an individualized apporach to your care
• 3-D Mammography – available as a screening tool to all women
• Thermography – involves temperature readings of the skin that are increased over areas of concern for underlying cancer.  This type of screening has no evidence to support claims that it is useful at early detection of breast cancer and is therefore not recommended.

Genetic Testing for Breast Cancer

Most breast cancers occur spontaneously, or without a prior family history, however, about 7% of breast cancers are inherited. In even fewer cases, two genes known as BRCA1 and BRCA2 are responsible for the breast and/or ovarian cancers present in several generations of family members. Testing for BRCA genes and other cancer-related genes should be considered in the following individuals:

• Personal history of breast cancer prior to the age of 45
• Personal history of ovarian cancer at age age
• Known BRCA positive status in any relative
• Two or more relatives on the same side of the family (either maternal or paternal) with breast cancer prior to the age of 50 or ovarian cancer at any age
• Ashkenazi or Eastern European Jewish descent (Ashkenazi Jews comprise approximately 90% of all American Jews)