When caught early and localized, breast cancer is highly treatable, so detection should be a top priority.
“I often tell my newly diagnosed patients that treatment is not just treatment, it’s curative,” said Endeavor Health breast surgical oncologist Thomas (T.J.) Smith, MD. “We’re finding breast cancer so early now and that’s because we have great screening.”
Mammograms detect tumors that are not palpable or found in clinical exams. Tumors approaching two centimeters can be found in a clinical exam, but mammograms can sometimes discover a tumor that is just millimeters in size, said Dr. Smith.
Endeavor Health uses the latest 3D tomosynthesis at all its mammography locations. This advanced imaging combines multiple breast X-rays to create a three-dimensional picture of the breast, producing more precise and detailed images that help detect cancer earlier.
“It’s very impressive what we can find on mammograms,” said Dr. Smith, who encourages women to ask what type of mammography equipment will be used when they are scheduling a screening as not every health system has 3D tomosynthesis machines.
Most breast cancers are slow growing and the incidence of breast cancer increases with age. The median age for breast cancer diagnosis is 62, but that means more than 50% of breast cancer cases are diagnosed before the age of 62. “That points out the importance of following the screening recommendations,” urged Dr. Smith. “We’ve seen patients as young as 29.”
Dr. Smith and colleagues recommend that women begin annual screening mammograms at age 40. But learning about your personal risk factors is also important and women should talk to their primary care physicians about their family history to determine if genetic testing and earlier screening is warranted.
For women who carry the BRCA1 or BRCA2 genetic mutation, screening recommendations may start as early as 25 or 30 and will also include annual breast MRIs.
MRIs, or magnetic resonance imaging, are more sensitive and can pick up smaller spots, but also have a higher chance of detecting benign lumps.
“The best test and the most proven test to decrease mortality from breast cancer is the mammogram,” said Dr. Smith. Annual mammograms help physicians compare results to previous year’s screening. “Bad things don’t stay the same, bad things grow,” said Dr. Smith, emphasizing the need for a baseline mammogram at age 40.
For women with dense breast tissue additional screening may be recommended including ABUS* (automated screening breast ultrasound exams) or breast MRI. ABUS screenings can be a more effective screening for dense breasts, sometimes picking up small things not seen in mammograms.
In addition to mammograms, annual breast exams by a physician are also important.
Dr. Smith urges all women to be self-aware. “If you feel something, if something feels different let your physician know,” he said. “Don’t let anyone dismiss you, especially for women under 40. Be your own best advocate.”
*Medicare patients should check their individual coverage regarding ABUS screening.
