Screening recommendations
Different organizations have observed the evidence, risks, and benefits of mammography and have developed several screening recommendations. Decisions about screening for breast cancer are becoming increasingly individual. It is important for each woman to speak with their doctor about how often they should receive screening and which tests are most appropriate.
The U.S. Preventive Services Task Force (USPSTF) suggests that women from ages 50 to 74 have mammography every 2 years. They recommend that mammography be done by women from age 40 to 49 after determining the risks and benefits of this test with a doctor.
ACS recommends that women from ages 40 to 44 can start yearly mammography. They recommend that women from ages 45 to 54 receive mammography yearly and that women 55 and older can switch to having a mammogram every 2 years or continue yearly screening if they choose.
Other groups also offer recommendations regarding screening, even the American College of Radiology and the Society of Breast Imaging. They suggest annual mammography starting at age 40. Some international groups do not allow routine population-based screening for any age but instead recommend an individualized approach.
The controversy about screening mammography is linked to the ability of early detection to reduce the number of deaths from breast cancer. Breast cancers detected by mammography are often small. In contrast, rapidly growing, aggressive cancers are more commonly seen in screening mammograms [6]. They are called interval cancers. Interval cancers are more aggressive than screen-detected cancers and cause more deaths compared to screen-detected cancers. They are also more frequently found in young women.
For women more susceptible to developing breast cancer, screening may be done at an earlier age and more often than the schedules listed above. Some older women may stop screening at some point, especially if they have serious health conditions that reduce their life span or the strength to involve in physical activities. All women should talk with their doctors about breast screening and decide on an appropriate screening schedule.
The USPSTF and ACS also have different suggestions for clinical breast examinations. A clinical breast examination is when a doctor or other health care professional performs a physical examination of your breasts to see if there are abnormalities or lumps. The USPSTF recommends a clinical breast examination along with mammography. The ACS does not recommend a clinical breast examination for women with an average risk of developing breast cancer.
Conclusion
While studies have not confirmed the relevance of breast self-examination in reducing deaths from breast cancer, it is important for women to get familiar with their breasts so that they can easily notice any changes and report these to their doctor. Cancers that are developing more quickly are often observed through breast examinations in between regular mammograms.
References
[1] http://www.nature.com/scitable/topicpage/genetic-mutation-1127
[2] https://www.medicinenet.com/cancer_detection/article.htm
[3] https://www.radiologyinfo.org/en/info/tomosynthesis?google=amp
[4] https://www.medicalnewstoday.com/articles/37136
[5] https://amp.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/breast-density-and-your-mammogram-report.html
[6] https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm