A recent report from the American Cancer Society has pushed back the recommended age for women to begin annual mammograms from 40 to 45 years of age. This has stirred up controversy in the medical community, with many physicians pushing back against this change in their recommendations.
Here in Canada, the Canadian Cancer Society recommends discussing your breast cancer risk with your doctor starting at age 40, and working with them to determine how often you should have a mammogram. Their recommendation for women between the ages of 50 and 69 is to receive a mammogram bi-annually.
The conflicting messages and lack of a definitive answer as to how often a woman should have a mammogram relates to the nature of the test itself. Mammography involves the use of x-ray technology, which can only detect cancer in the breast tissue once a lump has formed. This could mean that the lump had been developing over months and years before it is detected. There are many medical experts that believe this is all the more reason to keep up with regular mammograms.
Research has shown that women who have mammograms regularly are less likely to have a false positive (when the test results suggest cancer when none is present). There is also consensus that regular mammograms increase the odds of detecting cancer if it is present. Survival rates for any type of cancer are improved when detection is early; there is evidence to suggest that women over the age of 40 who receive annual mammograms increase their survival rate by 15 per cent.
Making breast health a priority.
It is important to take responsibility for your breast health and engage with your family physician on a plan of action. Should you have a family history of breast cancer, your doctor may recommend being tested for the BCRA1 and BCRA2 genetic mutations. Women who present either of these gene mutations are 80 per cent more likely to develop breast cancer in their lifetime. Undergoing these tests can help you to ascertain your risk factor and take action accordingly.
In addition to working closely with your physician, keeping an eye out for changes in your breasts at home is crucial to early detection. In the past, women were encouraged to follow a specific method to examine their breasts; however, research has shown this isn’t necessary. Becoming familiar with your breasts and checking them regularly for changes in whatever way you are most comfortable is all that is required. You will want to examine the entire breast up to and including the collarbone and armpit.
The Canadian Cancer Society suggests discussing the following changes with your doctor:
- A lump or swelling
- Changes in the size or shape of the breasts–especially asymmetrical changes
- Dimpling, puckering and thickening of the skin
- Redness, swelling and increasing warmth in the breast
- A nipple becoming inverted
- Discharge from the nipple
- Crusting scaling and ulcers on the nipple
- Itching of the breast and/or the nipple
- Unusual breast tenderness or pain
The key to maintaining breast health is based on awareness and action. Doing your part at home and initiating the appropriate tests and regular mammograms under the guidance of your healthcare provider will set you on the correct course towards early detection and improved survival rates should breast cancer develop.