An NCI-designated Comprehensive Cancer Center
By City of Hope | August 11, 2017

Breast cancer is the most common cancer in women in the United States, after skin cancer. It’s also the second-leading cause of cancer death in American women.

Because it’s so common, women hear a lot about breast exams, mammograms and other screening tools. Routine screenings can help detect breast cancer at earlier stages, when it may be more treatable. But it can be hard to make sense of the screening recommendations.

What should you know about breast cancer screening? Monique White-Dominguez, D.O., an assistant clinical professor in the Department of Medicine, Division of Hospital Medicine at City of Hope, discussed the current options and recommendations.

Self-exams and clinical exams

Breast cancer screening should start at home. White-Dominguez recommends women get in the habit of doing monthly breast self-exams, right after their periods. It can take practice, she said, but if women examine their breasts regularly, they’ll learn to recognize what feels normal. “It's getting yourself comfortable with feeling your breast to be able to see if you have a lump or if there is anything abnormal.”

It’s also important to have your doctor do a physical breast exam once a year, White-Dominguez said, such as during a Pap smear or annual physical.

Understanding mammograms

While physical exams are helpful, mammograms are still the mainstay of breast cancer screening. Mammograms are X-rays of the breast that can check for signs or symptoms of disease.

Traditionally, mammograms provided a two-dimensional view of the breast. In the last few years, 3-D mammograms, also known as breast tomosynthesis, have become popular. These mammograms can provide more detailed 3-D images of the breast tissue, White-Dominguez explained.

When should you schedule a mammogram? For women with an average risk of breast cancer, the American Cancer Society screening recommends:

  • Women age 40 to 44 should consider annual mammograms

  • Women age 45 to 54 should get annual mammograms

  • Women age 55 and older should switch to mammograms every two years, or have the choice to continue annual screening

Women with high breast cancer risk should discuss beginning screening earlier. For these women, the American Cancer Society recommends beginning annual screening mammograms at age 30.

Other screening methods

Health care providers have other tools to help screen for breast cancer, White-Dominguez said. For women at high risk, doctors might choose to use ultrasound or MRI in addition to mammograms to look for signs of cancer.

Women with a strong family history of breast cancer might also wish to consider genetic testing. With a simple blood test, genetic testing can determine whether a person carries genetic changes, or mutations, that can increase the risk of breast and other cancers.

Whatever your risk level, White-Dominguez added, it’s important to know your screening options so you can spot abnormalities early and treat them properly. “I believe screening is helpful for everyone – low risk, average risk and high risk – and I urge women to have this discussion with their licensed health care provider [about] what's going to be best for them,” she said. “Sit down with your doctor and see what's right for you.”

At City of Hope, your care team will utilize the most state-of-the-art breast imaging technologies and laboratory techniques to guide your personalized treatment.

Learn more about breast cancer and prevention at City of Hope.


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