Breast Cancer - Screening

Approved by the Cancer.Net Editorial Board, 02/2016

ON THIS PAGE: You will find out more about how people may be screened for this type of cancer, including risks and benefits of screening. To see other pages, use the menu on the side of your screen.

Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer before signs or symptoms appear. The overall goals of cancer screening are to:

  • Lower the number of people who develop the disease

  • Lower the number of people who die from the disease, or eliminate deaths from cancer altogether

  • Identify people with a higher risk of a specific type of cancer who may need screening more often

Learn more about the basics of cancer screening.

Screening Information for Breast Cancer

Mammography

Mammography is the best tool doctors have to screen healthy women for breast cancer, as it has been shown to lower deaths from breast cancer. Like any medical test, mammography involves risks, such as additional testing and anxiety if the test falsely shows a suspicious finding; this is called a false-positive. Up to 10% to 15% of the time, mammography will not see an existing cancer, called a false-negative result. Digital mammography may be better able to find cancers, particularly in women with dense breasts. A new type of mammogram, called tomosynthesis or 3D mammography, when combined with standard mammograms may improve the ability to find small cancers and reduce the need to repeat tests due to false-positives. Tomosynthesis is not currently a standard screening option or widely available. Research on this method is ongoing.

Other breast cancer screening methods

Other ways to examine the breasts, such as ultrasound and magnetic resonance imaging (MRI), are not regularly used to screen for breast cancer. These tests may be helpful for women with a very high risk of breast cancer, those with extremely dense breast tissue, or when a lump or mass is found during a breast examination.

According to the American Cancer Society, women with BRCA gene mutations, prior radiation therapy to the chest, or a very strong family history for breast cancer should consider alternating mammography and MRI.

Women at moderate risk of breast cancer, for example, those with precancerous changes on a biopsy, can talk with the doctor about whether MRI screening should be considered.

MRI may be better than mammography and ultrasound at finding a small mass in a woman’s breast, especially for women with very dense breast tissue. However, an MRI has a higher rate of false-positive test results, which may mean more biopsies, surgeries, and other tests. In addition, an MRI does not show tiny spots of calcium called calcifications that can be found on a mammogram. Calcifications can be a sign of in situ breast cancer (DCIS).

Ultrasound or MRI may also be used for women with a suspicious breast finding on physical examination or mammography. If a lump or mass is found during a physical examination, further testing may be needed, even if the mammogram is reported to be normal. Women are encouraged to talk with their doctor about the method of screening recommended for them and how often screening is needed.

Screening recommendations

Different organizations have looked at the evidence, risks, and benefits of mammography and have developed different screening recommendations. Decisions about screening for breast cancer are becoming increasingly individual. It’s important for each woman to talk with her doctor about how often she should receive screening and which tests are most appropriate.

  • The U.S. Preventive Services Task Force (USPSTF) recommends that women ages 50 to 74 have mammography every two years. They recommend that mammography be considered in women ages 40 to 49 after evaluating the risks and benefits of this test with a doctor.

  • ACS recommends that women age 40 to 44 have the choice to start yearly mammography. They recommend that women age 45 to 54 receive mammography every year and that women 55 and older can switch to having a mammogram every 2 years or continue yearly screening, if they choose.

The controversy about screening mammography is related to the ability of early detection to lower the number of deaths from breast cancer. Breast cancers detected by mammography are often small, with a low risk of recurrence. In contrast, rapidly growing, aggressive cancers are more commonly found in between screening mammograms, are associated with worse chance of recovery, and are more frequently found in young women.

All women should talk with their doctors about mammography and decide on an appropriate screening schedule. For women at high risk for developing breast cancer, screening is recommended at an earlier age and more often than the schedules listed above.

The USPSTF and ACS also differ on their recommendations 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 check for abnormalities or lumps. The USPSTF recommends a clinical breast examination along with mammography. The ACS does not recommend a clinical breast examination.

Finally, although breast self-examination has not been shown to lower deaths from breast cancer, it is important for women to become familiar with their breasts so that they can be aware of any changes and report these to their doctor. Cancers that are growing more quickly are often found through breast examinations between regular mammograms.

The next section in this guide is Symptoms and Signs and it explains what body changes or medical problems this disease can cause. Or, use the menu on the side of your screen to choose another section to continue reading this guide.