Screening Recommendations, Risk Factors and Breast Density
Do you know the guidelines for getting screened for breast cancer? The American Cancer Society updated its recommendations last year:
Ages 40 to 44: Begin mammograms if you wish; discuss screening with your provider by age 40.
Ages 45 to 54: Get annual mammograms if you have average risk of breast cancer.
Ages 55 and older: Get mammograms once every 2 years or seek annual exams, depending on your risk.
Note: Women with a relative (parent, sibling or child) who had breast cancer may consider starting screening from ages 40 to 49.
Be sure to review your medical history and any other breast cancer risk factors with your health care provider. If you’re in a high-risk group — based on gene mutations, a strong family history or other factors — ask your provider if more screening tests might be useful.
Factors that may RAISE RISK for breast cancer:
✒ Age — the older a woman, or man, the higher the risk.
✒ Age at menopause — after age 55, risk is about 30% higher than having menopause before age 45.
✒ Alcohol use — women consuming 2 to 3 alcoholic drinks per day have a 20% higher risk than nondrinkers.
✒ Blood estrogen — having higher levels after menopause.
✒ Family history — having a first-degree relative who had breast, ovarian or prostate cancer.
✒ Genetic mutations — including BRCA1 and BRCA2 genes.
Other factors that may slightly increase risk include: higher bone density after menopause; birth control pill use; estrogen-plus-progestin use; being overweight; and being Caucasian.
Factors that may LOWER RISK for breast cancer include: being physically active throughout life; maintaining a healthy weight; breastfeeding; consuming vegetables and fruits; and giving birth before age 35. Generally, the more children a woman has given birth to, the lower her risk tends to be.
Good to know: If possible, choose a testing facility that uses digital mammography with potentially better detection. If you’re going to a new facility, bring your prior mammogram images. Schedule your test for a time when you have minimal breast tenderness, such as a week after your menstrual period. The day of your exam, don’t use deodorants, antiperspirants, powders, lotions, creams or perfumes under your arms or on your breasts.
What about breast density?
When you had your previous mammogram, your report may have noted the density of your breast tissue. Everybody has a different level of density, which is determined by a radiologist who examines your mammogram.
Breast density compares the area of breast and connective tissue to the area of fat — the differences show up on your mammogram.
✒ High breast density means more breast and connective tissue compared to fat.
✒ Low breast density means more fat compared to breast and connective tissue.
High-density tissue can make it harder to detect cancer on a mammogram and might increase your risk of developing breast cancer.
So, if you have dense breasts, are mammograms necessary? Yes. Mammogram screening remains essential because it’s the best way to find breast cancer early, even in women who have dense breast tissue. If you don’t know what your breast density level is, ask your health care provider to check your previous mammogram report and advise you.
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