Breast cancer screening: Choosing the option best for you
10/7/2019 by Dr. Elizabeth Gilman
Breast cancer is the most common cancer in women, regardless of race or ethnicity. One in eight women will develop breast cancer over the course of their lifetime (by about age 80), according to the Centers for Disease Control.
What are the screening options for breast cancer?
Mammograms are basically x-rays of the breast, with or without tomosynthesis (3D imaging), and remain the mainstay of breast cancer screening. The purpose of mammography is to detect whether there are abnormal collections of calcium that could indicate breast cancer before a lump can be felt. Mammograms also reveal breast density. Increased density, typically density C and D, is associated with increased risk of breast cancer.
In general, recommendations say average-risk women should begin having mammograms at age 40. If you're an Employee and Community Health patient, you can schedule your mammogram on Patient Online Services.
There's more than one kind of breast-screening examination, so it's important to talk with your provider about the options for screening and whether you're at average or increased risk. Together, you can make a choice that suits your situation best. Keep in mind that these options don't replace regular screening mammograms:
- Molecular Breast Imaging (MBI), a supplemental breast cancer screening test, doesn't replace mammograms, but an injected dye "sees" through dense breasts. MBI can also be used when there is a breast problem that needs further evaluation or if the patient is at high risk of breast cancer and needs specialized screening.
- Breast magnetic resonance imaging (MRI) is used in addition to a mammogram for women at a high risk of breast cancer, including greater than 20% lifetime risk, having a strong family history, certain genetic mutations or being treated with chest radiation for Hodgkin's lymphoma before the age of 30.
- Automated whole-breast ultrasound (ABUS) is another tool for screening women with dense breasts. It uses sound waves to see through the breast. This test has a high false-positive rate and isn't currently offered at Mayo Clinic.
- Thermography uses infrared technology to record different temperatures on the surface of the skin. Thermography is NOT approved by the U.S. Food and Drug Administration (FDA) for breast cancer screening because it detects only about half of breast cancers.
Can I do anything to decrease my risk of breast cancer?
The good news is the answer to that question is "yes"! There are things that you can do to decrease the risk of breast cancer.
- We know that, especially for women who have gone through menopause, being at a healthy body weight decreases the risk of breast cancer.
- Regular aerobic exercise, 30 minutes at least five days per week, can lower the risk of breast cancer by 10-20%.
- Alcohol is also known to increase the risk of cancer, and women who have two to three beverages per day have a 20% higher risk than women who don't drink alcohol.
- Studies have NOT shown increased risk of breast cancer by wearing bras, drinking caffeine, or using cellphones or deodorant/antiperspirant.
Dr. Liz Gilman is an Internal Medicine physician in the Division of General Internal Medicine. She spends a majority of her time in the Breast Clinic and has a special interest in breast cancer prevention and women at a high risk of breast cancer.