Breast cancer is currently the most prevalent cancer among women in China. Nowadays, the public has started to pay attention to the technological progress of breast cancer diagnosis and treatment, and “breast cancer screening” is the focus of public attention.
Female compatriots may often hear from the mass media or some doctors about breast cancer screening, such as: regular breast self-examination; some recommend regular screening at the age of 35, and some even recommend going to the hospital for special screening at the age of 20 to detect breast cancer.
At what age should breast cancer screening be performed? What items of screening are performed?
To answer these questions, it is important to first distinguish between the general population and the high-risk group. Screening for different groups of people is slightly different.
1. Screening recommendations for the general population
For the general population, the old guideline recommends: starting from age 20, go to the hospital for breast examination (clinical breast examination) once every 3 years; starting from age 40, have a mammogram + a clinical breast examination once a year.
There is controversy about how old to start screening and how often to do it.
By comparing different screening strategies, scientists have found that starting screening at age 40 reduces breast cancer mortality by 3% compared to starting screening at age 50, but consumes more health care resources and results in more false positives (cancers that are not actually breast cancer but are incorrectly suspected to be breast cancer).
Regarding the frequency of breast cancer screening, screening once every 2 years can achieve 81% of the benefits of screening once a year and can avoid many unnecessary over-screenings.
The breakdown of which is.
(1) 40-45 years old does not emphasize screening for all women, but rather, after being informed of the pros and cons, it is the woman’s choice whether to be screened or not.
(2) Above 45 years of age, it is recommended that every woman be screened and have a mammogram once a year.
(3) Over the age of 54, it is recommended that women be screened once every 2 years.
(4) As long as women are healthy and expect to live longer than 10 years, they should be screened all the time.
2.Screening recommendations for high-risk groups
There is no difference between the old and the new guidelines in that for the high-risk group, it is recommended to have an annual breast MRI.
Who are at high risk of breast cancer?
(1) Those who have been professionally risk-calculated to have a greater than 20% chance of developing breast cancer.
(2) Genetic testing reveals a mutation in the BRCA1 or BRCA2 gene.
(3) Having a parent, child, sibling with BRCA1 or BRCA2 gene mutation.
(4) Had chest radiation therapy during the age of 1030 years.
(5) Have Li-Fraumeni syndrome, multiple malformation syndrome, Bannayan-Riley-Ruvalcaba syndrome, or have a parent, child, brother, or sister with these diseases.
It should be reminded that whether a person is at high risk or not should consult a medical oncologist and undergo professional examination before determining.
3. The new guidelines of the American Cancer Society for breast cancer screening recommend
For the general population.
(1) 40-44 years old, according to personal preference, after fully understanding the pros and cons, choose or not to choose to have mammogram once a year.
(2) 45-54 years of age, 1 mammogram per woman per year.
(3) 55 years and older, 1 mammogram per woman every 2 years or continue with annual mammograms based on personal preference.
Annual screening will end when life expectancy is less than 10 years or when health does not permit.
For high-risk groups.
Annual breast MRI is recommended.