“Cancer is too scary, so I’ll just have an annual checkup”, many people simply decide to “check it out more often”. In fact, over-examination is not beneficial. Not only does frequent examination add psychological stress and financial burden, but too many mammograms may even lead to breast cancer. So, when do you need to start breast cancer screening? How often should you be screened?
First, there are two forms of breast cancer screening: opportunistic screening, in which women come forward or volunteer to go to a health care provider that offers breast screening, and group screening, in which a community or organization offers breast screening to women of age.
The need for screening and the frequency of screening are related to a woman’s age and risk of breast cancer. Learn more about this.
Women aged 20 to 39 years
Generally, breast cancer screening is not recommended for women in this age group. However, there are exceptions. If you are at high risk for breast cancer, you can start screening earlier than 20 years of age. Women aged 20 to 39 years who are at high risk should be screened once a year with the usual clinical examination, ultrasound, and mammogram.
Women in this age group can be classified as high risk for breast cancer if they meet at least 1 of the following criteria:
- A significant genetic predisposition to breast cancer, such as having at least 2 close relatives with breast cancer.
- Previous breast disease with a definite diagnosis of “moderate or severe atypical hyperplasia of the ducts or lobules of the breast” or “lobular carcinoma in situ”.
- Previous radiation therapy to the chest.
Women aged 40 to 45 years
This group can be routinely screened for breast cancer. Opportunistic screening is usually recommended starting at age 40, with one mammogram per year. The doctor will also perform a clinical examination of the breast at the time of screening, and for some women with dense breast tissue, an ultrasound is recommended at the same time.
Women aged 45 to 69 years
This is also the population that needs routine screening for breast cancer, with population-based screening and opportunistic screening. The frequency of screening can be one mammogram every 1 to 2 years, and the physician will also perform a clinical examination of the breast, and for some women with dense breast tissue, ultrasound is recommended.
Women 70 years of age and older
This group does not need to undergo population-based screening, and opportunistic screening is recommended. The frequency of screening can be reduced to 1 mammogram every 2 years, along with a clinical examination of the breast. Similarly, for some women with dense breast tissue, a concomitant B-ultrasound is recommended.
So, it is important to work with your doctor to develop a reasonable screening plan that takes into account your age and possible risk of breast cancer. The screening for breast cancer is not necessarily “diligent”.