Breast cancer screening: Why it matters and when to start

The American Cancer Society estimates that more than 320,000 women in the U.S. will be diagnosed with invasive breast cancer in 2026.

Halley Vora, MD, surgical oncologist and director of breast health services at Loma Linda University Health explains that screening can detect the disease before symptoms appear, giving patients a better chance at survival.

When should women begin screening?

The National Comprehensive Cancer Network (NCCN) recommends that women begin annual mammogram screening at age 40. This is the general recommendation for average-risk individuals, so Vora encourages talking with your primary care provider about your personal risk to determine when you should start.

"Some patients who have genetic mutations, like a BRCA gene, may be recommended to start screening as early as age 25," says Vora.

Breast cancer is not caused by individual behavior alone, but the American Cancer Society outlines risk factors that may increase a person's chance of developing the disease. These include:

• Family history

• Age

• Lifestyle habits, such as physical activity, diet, and body weight

Having risk factors does not mean you will develop breast cancer, but they can help guide a conversation with your physician about screening.

"If you're worried about your personal risk factors or have a concerning family history, discuss it with your physician," Vora says.

From there, your provider can determine whether you would benefit from further risk assessment, such as genetic testing.

Breast cancer is far less common in men, but it can occur. Routine screening is not recommended for men at average risk, but men with a family history of breast cancer or a known genetic mutation, such as BRCA, should talk with their physician about their risk.

Benefits of screening

Screening can detect breast cancer in its early stages, when the tumor is small and confined to the breast. Treatment is more likely to be successful at this point.

"Mammograms save lives," says Vora. "Early detection is what makes the majority of breast cancer curable."

According to the American Cancer Society, the five-year relative survival rate for women diagnosed with localized breast cancer, meaning there is no sign the cancer has spread outside the breast, is greater than 99%. That rate drops sharply to 32% when the cancer is diagnosed at a distant stage, after it has spread to distant parts of the body such as the lungs, liver, or bones.

Types of screening

Mammograms

Screening typically begins with a mammogram, which is an X-ray of the breast taken while the breast is compressed between two plates to spread the tissue for clearer images. Radiologists then review the images for abnormalities and early signs of cancer.

MRI (magnetic resonance imaging)

A breast MRI uses magnets and radio waves to create detailed images. Vora explains that mammograms are the "gold standard," but MRIs may be used in addition to mammograms for women at higher risk of developing the disease.

Other screening

Other forms of screening include:

• Breast ultrasound, which uses sound waves to create images of breast tissue

• Clinical breast exam, in which a physician checks the breasts for lumps

This Breast Cancer Awareness Month, schedule your mammogram or a breast health consultation at Loma Linda University Cancer Center.