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What To Expect With Breast Cancer Screening

by Breast.com
​According to most medical experts today, a self-performed breast exam is not recommended as an adequate screening tool for breast cancer. This means mammography is the most effective breast cancer screening tool available at the present time, however its benefits can vary according to the age of the woman being screened. It is also important to note that women in higher risk categories for cancer may need to get screened earlier and more frequently than average recommendations currently indicate.

Although mammography does save lives, it is not perfect and understanding your chances of having a false positive result may reduce the anxiety over an abnormal finding on any single mammogram. Over a period of ten years, about 5 women out of 1,000 will have their lives saved by mammography; and a third to a half of them will have at least one false positive result on a mammogram. Of those with false results, about one fifth will go on to have a biopsy performed, but only a few of them will be found to actually have breast cancer.
 
However, the life-saving benefits of mammography are quite clear for women between the ages of 50 to 69, and based on evidence from controlled trials done in the United States, Canada and Europe, all women in that age group should have regular mammograms every year. An analysis of several controlled trials found that women aged 50 and older who got regular mammography had a 23 percent lower risk of dying from breast cancer than women who did not. Although screening mammography rates among U.S. women ages 50 to 64 declined from 78.7 to 74.2 percent between 2000 and 2008, a 2010 study of women aged 50 and older who got regular mammography screening showed that group had a 10 percent lower risk of dying from breast cancer than women who did not get regular mammograms. The specific reasons for the decline in screening are not known, but there is concern that the lower screening rates could lead to an increase in breast cancer mortality in the future.
 
Mammography for women aged 40 to 49 probably saves a lot of lives too, but the benefits for younger women are less dramatic than for older women. Analysis of randomized controlled trials found that women aged 40 to 49 who got regular mammograms had at least a 15 percent lower risk of dying from breast cancer. That result was supported by another study that found women aged 40 to 49 who attended regular mammography screening had as much as a 29 percent lower risk of dying from breast cancer than women who did not. Other studies of the same age group that found less benefits from mammography were probably due to the fact younger women tend to have denser breast tissue which makes abnormal findings harder to detect with current mammography screening practices. Because breast cancers in younger women tend to grow faster than breast cancers in older women, regular mammograms every one or two years in younger women may not be able to catch as many cancers in their early stages when they are the most treatable.
 
However, since women aged 40 to 49 have a lower risk of breast cancer, it means there will be fewer benefits of screening and that there will also be some drawbacks, including a higher rate of false positive results. The false positive results are more likely in younger women because they tend to have fewer breast cancers overall. Younger women also undergo more unnecessary procedures and follow-up tests like ultrasounds and biopsies, only to find out later that they do not have breast cancer at all. Most major health organizations recommend regular mammograms and feel the benefits of mammography for women aged 40 to 49 outweigh any risks from false positive results. Although the U.S. Preventive Services Task Force recommends that routine mammography screening should start at age 50, the American College of Physicians recommends that women aged 40 to 49 and their doctors should make their own decisions on mammography based on each woman's individual breast cancer risk profile.
 
There have not been many studies conducted on the benefits of mammography for women aged 70 and older, and the U.S. Preventive Task Force does not recommend routine mammography screening in women aged 75 and older. However, most major health organizations recommend women aged 70 and older continue to get regular mammograms since the risk of breast cancer increases with age. The general consensus is that women over 70 who are in good health should probably continue to get regular mammograms.


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