Breast cancer screening

HOUSTON The importance of early detection of breast cancer is key in combating breast cancer. The size of the breast cancer is the single most important factor that determines prognosis or survival; women with smaller tumors have a significantly better survival rate, particularly when the cancer is not easily detected. Numerous large mammography screening trials have clearly demonstrated that diagnosing breast cancer in the earliest stage reduces the death rate significantly and is best achieved by timely and appropriate screenings. The goal of screening, then, is to save lives by detecting cancer while it is small and preferably before it can even be felt as a breast lump.

Methods of early detection:

Currently, mammography is the only method recommended for the screening of breast cancer. The American Cancer Society recommends annual screening for women 40 years and older. Women with a family history of breast cancer should take a more conservative approach and begin screening five to ten years earlier. Screening with breast ultrasound has also been shown to be effective, but has not yet been tested in large trials and isn't typically recommended for breast cancer screening. Breast ultrasound is often used as a secondary tool for certain women such as those with a dense tissue pattern on a mammogram or who are at a higher risk for breast cancer. Breast Magnetic Resonance Imaging (MRI) is another screening tool, but is typically reserved for a specific set of women with a high risk of breast cancer.

What can you expect when you undergo screening mammography?

About one in 10 women undergoing a screening mammography are asked to come back for additional testing, typically to clarify a finding on the initial examination. Whenever possible, records of previous mammograms can aid your physician in interpreting current and future mammograms and reduce the need to return to undergo additional evaluation. About 10 percent of women called back following screenings are advised to undergo a biopsy for a possible cancer with 25-30 percent of women of those biopsied ending up with a diagnosis of breast cancer.

Does mammography miss identifying breast cancer?

Unfortunately, about 15 percent of cancers may be missed entirely during a mammography. This usually occurs with women who have dense breasts where cancer can be obscured. Please consult you physician if you have any concerns. Remember, the majority of cancers are diagnosed with mammography, which is currently the best method available for the early detection of breast cancer.

Regular mammography screenings reduces the risk of advanced breast cancer cases, allowing for earlier detection. Mammography does, indeed, save lives.

Dr. Mahesh Shetty is the Chief of Mammography at The Woman's Hospital of Texas. Recently elected as a Fellow of the Society of Breast Imaging and invited to be an examiner in mammography by the American Board to Radiology, Dr. Shetty has also authored numerous publications on women's imaging and mammography. He also serves as the president/founder of The Woman's Cancer Foundation, a nonprofit established to assist in screening for breast and cervical cancer in low resource countries.


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