Breast Cancer Screening: What Every Woman Needs to Know
Key takeaways:
Breast screening is a way to check for early stages of breast cancer before there are any signs or symptoms.
Breast cancer is the second most common type of cancer in women in the U.S. If it’s caught early, it can be cured.
The mammogram is the most common screening test, but there are other tests that are used in certain situations.
Most women should start getting screened between ages 40 and 45. Women with risk factors for breast cancer may need to start earlier.
Getting screened is easy, and there are options if you don’t have health insurance or your insurance doesn’t cover it.
Breast cancer screening is one of the most important steps you can take to stay healthy and cancer free.
Table of contents
Why trust us
Our Author:
Maria Robinson, MD, MBAMaria Robinson, MD, is a board-certified dermatologist and dermatopathologist with over 10 years’ experience in treating people. She has a special interest in nutrition and how it can be used to treat disease and optimize health, and has trained in nutrition and integrative health. She also serves as a consultant for different health technology companies and is active on several non-profit boards. Maria believes that education is the foundation for good health, and enjoys helping others learn how to improve theirs. She can be found writing about skin and nutrition at DietandDerm.com.
For this guide, we reviewed national and international studies about breast cancer screening to highlight which methods are most effective. We also reviewed the guidelines from major medical organizations and experts, including the U.S. Preventive Services Task Force, to bring together an overview of the best practices for breast cancer screening.
What is breast cancer screening?
Breast cancer screening is a way to check for early stages of breast cancer before there are any signs or symptoms. This makes it easier to treat the cancer, and it increases the chance of being cured. The most common screening test is the mammogram, but others are sometimes used.
Why is screening for breast cancer important?
Breast cancer is the second most common type of cancer in women in the U.S. In 2017 (the most recent year that we have data for), there were around 250,000 newly diagnosed cases of breast cancer and more than 40,000 women died from it.
Does screening for breast cancer really work?
Studies have shown that screening tests can lower the chance of dying from breast cancer (also called mortality). In fact, over the last 30 years, breast screening has helped lower mortality by about 40%.
There are different breast screening guidelines available. Many medical organizations recommend that women get screened every 1 to 2 years starting at age 40, but there are some differences as to when the screenings should start and how often they should happen.
Breast screening is an effective tool in the fight against breast cancer. Women who get a breast screening every 1 to 2 years after age 40 lower their chance of dying from breast cancer by about 40%. Knowing about screening tests and when to get them can help you stay healthy. Here’s our guide to breast cancer screening.
Could you have breast cancer?
Breast cancer is a common type of cancer that starts in the breast. About one in eight women will develop breast cancer at some point in their life, and for every 100,000 women diagnosed with breast cancer, about 20 will die from it. Breast cancer risk increases with age — every year, over 80% of cases are diagnosed in women over age 50.
Although breast cancer is more common in women, men can get it too. In fact, about 1 in every 100 breast cancer is diagnosed in a man.
Types of breast cancer
There are different types of breast cancer depending on where it starts in the breast. The breast is made up of different tissue types: lobules (glands that produce milk), ducts (tubes that carry the milk), and connective tissue (fat and fibrous tissue which support the breast). Most cancer starts in the ducts or lobules. Some of the more common types of breast cancer include:
Invasive (or infiltrating) ductal carcinoma (IDC) starts in the ducts and is the most common type of breast cancer, representing about 80% of all breast cancers.
Invasive lobular carcinoma (ILC) starts in the lobules and is the second most common type of breast cancer, representing about 10% of cases.
Triple-negative breast cancer is harder to treat and represents up to 15% of all breast cancers. It’s called triple-negative because it doesn’t have certain receptors — estrogen, progesterone, and HER2 — that are found in other breast cancers. Without these receptors, many medications can’t treat it.
Inflammatory breast cancer is a type of invasive ductal carcinoma, but it tends to spread faster than other types of breast cancer. It’s more common in women under 40, and it makes up 1% to 5% of all breast cancers.
Ductal carcinoma in situ (DCIS) is a non-invasive (or pre-invasive) early stage of breast cancer that starts in the ducts. This means that the cancer cells have not spread outside the ducts. About 20% of women diagnosed with breast cancer will have this, and most can be cured.
Symptoms
Breast cancer can cause different symptoms in different people — or it may not cause symptoms at all.
Here are some of the symptoms that some people do get:
A new lump or bump in the breast or armpit
Thickening, redness, swelling, or dimpling of the breast
A change in breast size or shape
Nipple discharge, including blood
Red or flaky skin on the nipple or breast
Keep in mind that other conditions can cause similar symptoms. Having one or more of these breast changes does not mean that you have breast cancer, but it does mean that you need to see your healthcare provider and get checked out soon.
Many people are affected by breast cancer each year. Breast cancer screening has been proven to lower the risk of dying from breast cancer and to increase the 5-year survival rates of women who get it. Knowing about screening and when to get it can help keep you healthy and cancer-free.
Understanding your breast cancer risk
Your risk of getting breast cancer depends on several factors. The main risk factors for breast cancer are getting older and being female.
But just because you have some of these risk factors doesn’t mean that you will get breast cancer.
Other risk factors for breast cancer include:
A family history of breast or ovarian cancer
Having certain inherited genetic mutations (like BRCA1, BRCA2, or PALB2), or having a family member with one
Not being physically active
Being overweight or obese after menopause
Drinking alcohol
Radiation treatment to the chest area in the past
Additionally, taking some forms of hormones (like estrogen in birth control pills) may be linked to a very small increased risk of breast cancer. The risk may increase the longer the hormone is taken, and it seems to go away if the hormones are used for a shorter period of time, like less than 5 years.
How can I lower my risk for breast cancer?
There are steps you can take to lower your risk of getting breast cancer and to increase the chance of survival if you do get it.
Get screened
Getting screened for breast cancer is one of the most important things you can do to catch breast cancer early before it becomes a problem. Mammograms have been shown to lower the chance of dying from breast cancer by about 30%. Talk to your provider about when it’s right for you to get screened.
Keep a healthy weight
Weight gain and being overweight is a risk factor for getting breast cancer after menopause. Keeping a healthy weight — or losing weight if you’re overweight — can help lower your risk of breast cancer.
Be active
Studies have shown that exercise and being active is linked with a lower risk of breast cancer. The American Cancer Society recommends that every week adults get at least 150 minutes of moderate exercise (like a brisk walk) or 75 minutes of intense exercise (which increases the heart rate).
Avoid or limit alcohol
Drinking alcohol has been linked to an increased risk of developing breast cancer. For women who drink, it should be no more than one alcoholic drink a day.
Know your family history
If you have a family history of breast cancer, you may be at higher risk of getting it yourself. Talk to your provider about when, and how often, you should get screened.
Know possible risks associated with hormones
Some types of hormones — like estrogen in birth control pills — may be associated with a slightly higher risk of breast cancer if taken for a longer period of time. Ask your provider about these risks and find out what is right for you.
Breastfeed if possible
Women who have breastfed at least once may decrease their risk of getting certain types of breast cancer.
What are the types of breast cancer screening tests?
The best breast cancer screening test for you depends on your age, your medical history, and your family history.
The different tests that exist for screening for breast cancer are:
Self-screening (breast self-exam)
The clinical breast exam
The mammogram
The MRI
There are different recommendations as to when women should be screened and how. Talk to your provider about your specific situation to find out the best screening program for you.
Breast exam
The breast exam looks for any changes or abnormalities in the look or feel of the breast. This can be done by an individual (a self-exam) or by a healthcare provider (a clinical breast exam).
Not all medical groups recommend a breast exam as part of regular breast cancer screening. Some groups, like the American Cancer Society, don’t recommend breast exams (either self-exams or clinical exams) as part of routine breast screening. Other groups, like the American College of Obstetrics and Gynecology, recommend a clinical breast exam yearly for women over 40. Why? Because some studies have not shown a clear benefit of doing regular breast exams in addition to a mammogram. However, some other studies showed that a breast self-exam and a clinical breast exam have helped find breast cancer in some women.
Talk to your healthcare provider to see what is best for your situation.
How do I do a breast cancer self-exam?
In a self-exam, start first by visually examining your breasts in front of a mirror with your arms down at your sides. Look for any changes in size, shape, or symmetry, and for any dimpling of the skin or new bumps. Make sure your nipples aren’t red, scaly, or turned in (inverted). Do the same exam with your arms in different positions: raised above your head with your palms touching and then with your hands pressed on your hips. Finally, lift your breasts to see if the bottoms are symmetric.
To examine your breasts with your hands, you can either lie down or stand in the shower using soap to make it easier. Use the pads of your fingers to feel the whole breast, first with light pressure and then with firmer pressure. Doing this in a pattern around your breast can make it easier to feel all the areas. Feel for any bumps, knots, or skin changes. Finally, squeeze the nipple and look for any discharge.
Remember that just because something is found on a breast exam doesn’t mean that it’s cancer. Changes in the breast are common at different times during your menstrual cycle, and most things found on a self-exam don’t turn out to be cancer.
Get into the habit of doing a self-exam regularly at the same time every month. The more you get to know your breasts and what is normal for you, the more likely you are to pick up on small changes and abnormalities early on.
The clinical breast exam
This is an examination of your breasts and armpits by a trained clinician. More on this and what to expect below.
Mammogram
A mammogram is a low-dose X-ray of the breast. It can often find breast cancer early, when it’s small and easier to treat. Mammograms are the main type of screening test used to screen for breast cancer.
They have been shown to lower the chance of dying from breast cancer. But they can also find things that don’t turn out to be cancer. When this happens, it’s called a false-positive test. False positives can lead to more testing and to a lot of stress and anxiety. Because of this, there has been some discussion about how effective mammograms really are as a general screening tool.
However, most experts and medical organizations agree that mammograms are a safe and effective tool to help fight breast cancer, and that they should be used to screen women.
Breast magnetic resonance imaging (MRI)
A breast MRI uses magnets and radio waves to take computerized pictures of the breast. It can be used together with a mammogram to screen women at higher risk of breast cancer. MRIs are able to find some cancers that aren’t seen on a mammogram, but they are more likely to find things that don’t turn out to be cancer (a false-positive test). Because of this, MRIs aren’t recommended for women who aren’t at higher risk.
What happens during a breast cancer screening test?
Clinical breast exam
The clinical breast exam is similar to a self-exam, except that it is done by a trained healthcare provider. It is often done during a regular checkup. In addition to visually checking your breasts, the provider will feel your breasts for any knots or bumps while you are lying down. They will usually also feel in your armpits for bumps.
Mammogram
During a mammogram, each breast is evaluated separately. Two plates are used to flatten (compress) the breast, which helps spread the tissue apart before the X-ray is taken. The radiology technician may ask you to move into different positions for a better angle of different parts of the breast.
Radiologists, who are doctors with specialized training in X-rays and other scans, review the mammogram for abnormal areas. If you’ve had a mammogram before, they will compare it to your previous test to see if there are any changes. Having an abnormal area doesn’t mean you have cancer — the radiologist and your provider will determine what more testing you need.
Mammograms are used in two main ways:
Screening mammograms are used in women who don’t have any history of breast symptoms or problems. Usually, X-rays from two different angles are taken from each breast.
Diagnostic mammograms are used if there are breast symptoms or if there was a change seen on a screening mammogram. A diagnostic mammogram is done in the same way as a screening mammogram, but it may look at parts of the breast that weren’t seen before or it may focus more in one area.
A three-dimensional (3D) mammogram (also called breast tomosynthesis or digital breast tomosynthesis (DBT)) is a newer type of mammogram. It uses many breast X-ray pictures to form a 3D image of the breast in addition to the regular 2D pictures. Some studies have shown that using this may be better in women with dense breasts and may decrease the chance of needing additional X-rays.
Dense breasts have more glands and fibrous tissue and less fat than breasts that are less dense. This can sometimes make it harder to see things — like early breast cancer — on a mammogram. You’re more likely to have dense breasts if you’re:
Younger
Are pregnant or breastfeeding
Taking hormone-replacement therapy
Have a lower body weight
The 3D mammogram isn’t available everywhere, and more studies are needed to see how it compares to regular mammograms for preventing breast cancer deaths.
Breast MRI
Breast MRIs are usually done in an outpatient building, which might be associated with a hospital. A special type of MRI machine is used that’s designed to evaluate breast tissue. Depending on your situation, your provider may order an MRI test with a special contrast material called gadolinium that’s given by IV. This can sometimes make seeing the breast tissue easier.
Like with other MRIs, you will need to lie in a long narrow tube while the test is being done. If it’s hard for you to be in small, enclosed spaces, let your provider know ahead of time. You may need to take some prescription medication before the test to help you relax.
Getting a breast MRI will usually take between 45 and 60 minutes. Before getting the MRI, you’ll have to remove any metal objects (like earrings or hair clips). If you have any metal in your body, like a pacemaker, you need to let your provider or the MRI technician know ahead of time.
During the test, you’ll lie face down on a long table. Your breasts will hang down through an opening in the table. Once you’re in position, the table slides feet first into a long tube. Once in the tube, you should stay as still as possible while the MRI is taking pictures. You won’t feel anything, but you may hear thumping, clicking, and whirring noises while you’re in the tube.
When you’re done, you may need to wait a little bit to make sure more pictures don’t need to be taken.
What are the risks and benefits of breast cancer screening?
Breast exams
Risks
Some studies have not shown a clear benefit of regularly getting a mammogram to lower the risk of breast cancer. Breast exams on their own also haven’t been shown to be effective in catching breast cancer consistently.
A clinical breast exam by a healthcare provider may also make some people uncomfortable.
Many findings on a breast-exam may also not turn out to be cancer. This can cause a lot of anxiety and even possibly extra testing.
How effective a clinical breast exam is can also depend a lot on how trained the person doing it is.
Benefits
Breast exams — both self-exams and by a healthcare provider — are easy to do and don’t cost a lot.
They have also been shown to catch some breast cancers that mammograms miss.
Having a clinical breast exam also provides a chance for women to learn about breast health, the risks of breast cancer, and the importance of screening
Mammograms
Risks
Overall, mammograms are very safe and can help find breast cancer in early stages. Like with any test, there are some associated risks. It’s important to understand these risks and to discuss them with your provider before getting tested. Some of these risks include:
Radiation exposure: Mammograms do use radiation, but it is a very low dose. The dose of radiation in a screening mammogram is about the same as the amount of radiation a woman gets from her natural surroundings over a period of about 7 weeks.
Mammograms aren’t 100% accurate: Mammograms don’t catch all cancers — in general, they don’t find about one in five breast cancers. When this happens it’s called a false-negative result, and it’s more likely to happen in women with dense breasts.
Mammograms can lead to more testing: Mammograms can be abnormal even though there isn’t cancer — this is called a false-positive result. Over a 10-year period, about half the women getting mammograms will have a false-positive result at some point. This is more likely to happen if a woman is younger, if it’s her first mammogram, if she’s had previous breast biopsies, or if she has dense breasts. False positives can lead to anxiety and more testing that isn’t necessary.
Overdiagnosis and overtreatment: A mammogram may find some cancers and precancers that are not life threatening and that would never have grown or spread (called overdiagnosis). Because they are technically cancer (or precancer), they are treated even though they didn’t need to be (overtreatment). The problem is that it’s not possible to tell these cancers from those that will spread, so treatment is usually done. Some studies have shown that this can happen up to 10% of the time.
Benefits
Mammograms can help catch breast cancer early, when it is small and can be treated more easily. Studies have also shown that mammograms can lower the chance of dying from breast cancer.
Mammograms are also pretty easy to do and don’t take much time, and are widely available in many different locations.
Breast MRIs
Risks
Breast MRIs are associated with some risks:
They can find things that don’t turn out to be cancer (a false-positive). This can lead to a lot of anxiety and more tests — and even biopsies — that aren’t needed.
Getting an MRI can be hard for a lot of people. Being in a small, enclosed space can cause stress and anxiety.
Breast MRIs are expensive and not available in many locations.
Benefits
Used with a mammogram, they can be a good screening tool for certain women who are at higher risk of breast cancer.
They can help measure the size of the cancer in women who have already been diagnosed with breast cancer. This can help decide prognosis and treatment.
Who should get breast screening and when?
The type of breast screening you should get and when you should get it depend on your age and your risk for developing breast cancer.
Women are categorized as being average risk or high risk for the purposes of breast cancer screening. Most women have an average risk, which means you don’t have:
A personal history of breast cancer
A strong family history of breast cancer
A genetic mutation that can increase your risk (like BRCA1, BRCA2, or PALB2 gene)
A history of chest radiation therapy to your chest before the age of 30
You are considered high risk if:
Your risk of getting breast cancer is 20% to 25% increased. This is based mainly on your family history, and there are some risk questionnaires that can help you figure that out, like from the National Institutes of Health. Talk to your provider to learn more about your specific risk.
You inherit one of the known mutations in the breast cancer gene, BRCA1 or BRCA2.
You inherit the PALB2 genetic mutation, a newer mutation that researchers discovered increases breast cancer risk.
You have a first-degree relative (parent, sibling, or child) who is known to have one of the genetic mutations above, but you have not had genetic testing yourself.
You had radiation therapy to your chest between ages 10 and 30.
You have Li–Fraumeni syndrome, Cowden syndrome, or Bannayan–Riley–Ruvalcaba syndrome, or a first-degree relative with one of the syndromes.
In general, experts agree that mammograms are very important screening tests. But there isn’t complete agreement on when women should start getting mammograms or how often they should get them.
There is no routine screening program for breast cancer in men, unless they are considered high risk, which includes things like a strong family history of the disease or carrying the BRCA1 and BRCA2 mutations. People in this group should consider breast self-exams and screening mammography starting at age 40.
Experts and different medical organizations have slightly different recommendations on screening guidelines for different women, so it’s important to talk to your provider about your unique situation to see what’s best for you.
Here are some general guidelines based on different recommendations from some of the major health organizations.
At what age should I start getting screened for breast cancer?
For women at average risk, experts recommend regular screening starting at the age of 40.
For women with a higher risk of getting breast cancer, the guidance recommends breast MRI and mammograms before the age of 30.
How often should I do breast cancer screening tests?
For women at average risk:
Between 40 and 49 years old, starting at age 40, women can consider getting a mammogram every year. Some organizations recommend getting them every two years.
Between 40 and 74 years old, women should be screened every 1 to 2 years.
For women at high risk:
Starting by age 30 (and not before age 25), women should get an annual mammogram and MRI. If an MRI is not an option, an ultrasound can be considered.
For women with a history of chest radiation, an annual mammogram and MRI are recommended starting 8 years after radiation treatment (but not before age 25).
Women at high risk of getting breast cancer should be screened regularly from a young age, and consider having a breast MRI in addition to a yearly mammogram — especially before menopause. The guidelines aren’t as clear as to when screening should stop. Some organizations recommend that screening should continue until a woman is expected to only live for 5 to 7 more years based on her health or age, or until a woman would no longer want treatment even if she had an abnormal screening test.
How much does breast cancer screening cost?
Most insurance companies — including Medicare and Medicaid — cover the cost of screening mammograms. The Affordable Care Act also requires new health insurance plans to cover screening mammograms every 1 to 2 years for women 40 years and older. Check with your insurance company to see what is covered and if you’ll have any out-of-pocket costs.
If you don’t have insurance or your plan doesn’t cover mammograms, here are some options for low-cost or free mammograms:
National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is a program offered by the Centers for Disease Control and Prevention that provides low-income, uninsured, and underserved women access to breast and cervical cancer screening. Visit here to see if you’re eligible and find where you can get screened.
Planned Parenthood offers breast exams and referrals for mammograms. They also offer some follow-up tests if needed, like breast ultrasounds.
The Komen Breast Care Helpline from the Susan G. Komen Foundation can help you find low-cost breast cancer screening in your area.
October is Breast Cancer Awareness Month, and some centers may offer mammograms at reduced cost. The FDA website can help you find centers near you.
Where can I get breast cancer screening?
Mammograms and MRIs are usually done at a diagnostic imaging center, which is a building where X-rays and other medical scans are done. Some centers will focus just on women’s health issues. To find the best center for you, contact your insurance company to see which location near you is in your network and will be covered by insurance.
If you don’t have insurance or it doesn’t cover breast cancer screening, you can use the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to find a free or low-cost option near you.
Your mammogram report
Waiting for your mammogram results can be very stressful. When you finally get your report, you may be confused by what it’s actually saying. Here’s some help with understanding your results and any next steps that you may need to take.
Radiology doctors use a grading system when they give mammogram reports. This system is called the Breast Imaging Reporting and Data System (BI-RADS), which has different categories from 0 to 6. This makes talking about the results and follow-up tests easier. Here we discuss what the different categories mean.
Category 0: Incomplete, additional imaging and/or comparison to previous mammogram is needed
There may be an abnormality, but it’s not clear. Another mammogram with different views may be helpful. Sometimes an ultrasound is recommended to help evaluate what was found. Comparing the results to any previous mammograms may be helpful to see if there are any changes.
Category 1: Negative (normal)
No signs of cancer were found on your mammogram. You should continue to have regular screening.
Category 2: Benign (non-cancerous) finding
No signs of cancer were found on your mammogram, but there were other, non-cancerous, findings, like a cyst or calcification. These are reported so that in the future they aren’t mistaken for signs of cancer.
Category 3: Probably benign (non-cancerous) finding, follow-up in a short time frame
There is a high chance (greater than 98%) that the finding is not cancerous. In order to make sure, you may need to have a follow-up test in 6 months to make sure the spot doesn’t change. If you or your family has a history of breast cancer, you may do more tests now rather than wait.
Category 4: Suspicious finding, biopsy should be considered
The findings could be cancer, but it’s not definite and a biopsy may be needed for further evaluation. The results in this category may be broken down even further: 1) 4A — low chance of being cancer (less than 10%); 2) 4B — moderate chance of being cancer (between 10 and 50%); and 3) 4C — higher chance of being cancer (between 50 and 95%).
Category 5: Highly suggestive of malignancy
The findings are highly suspicious, with a 95% chance of being breast cancer. A biopsy will be needed.
Category 6: Known biopsy-proven cancer
This means that you have already been diagnosed with breast cancer. These mammograms may be used to see how well the cancer is responding to treatment.
The BI-RADS report will also give a result for how dense your breast tissue is. If you have dense breasts, it may be harder to see abnormal changes on the mammogram and you may have a higher risk of getting breast cancer. Talk to your healthcare provider about what your mammogram report means for you.
What happens if my mammogram is abnormal?
If you have an abnormal mammogram, you are not alone. Getting called back after an abnormal screening mammogram is pretty common, and fortunately less than 10% of women called back for more tests end up having cancer.
You’re more likely to need additional testing if it’s your first mammogram or if there isn’t a previous mammogram to compare it to. More testing usually means getting another mammogram or possibly an ultrasound to get a better look at a specific area in your breast.
Here we review some of the additional tests you may need after an abnormal mammogram.
Follow-up mammogram (diagnostic mammogram): A diagnostic mammogram is just like a screening mammogram, except more pictures are taken to get a closer look at a specific area.
Ultrasound: An ultrasound uses sound waves to create a picture of the inside of the breast. It is sometimes used to look at abnormal spots found on a mammogram. Ultrasounds can tell the difference between cysts (common, non-cancerous growths) and tumors, which may need more testing. Ultrasounds may also be used to help guide a needle biopsy.
Breast MRI: Some women may get a breast MRI to evaluate an abnormal spot on a mammogram.
Breast biopsy
Your mammogram or follow-up tests may show a spot that could be breast cancer. In this situation, you may need to have a breast biopsy, which means a piece of tissue is removed and looked at under the microscope.
Getting a biopsy can cause a lot of anxiety, but it’s important to know that just because you need a biopsy doesn’t mean you have cancer. Most breast biopsies don’t turn out to be cancer.
There are different types of breast biopsies — some use a hollow needle and others require the skin to be cut in a small surgical procedure. The type of biopsy you’ll need depends on many factors, including how big the spot is, where it is, and how likely it’s cancer. Here we review some types of breast biopsy.
Fine needle aspiration (FNA) biopsy
An FNA uses a thin, hollow needle to remove cells from the suspicious spot. Sometimes an ultrasound is used to help guide the needle. This test can be done in an office and a numbing medicine may be used during the procedure.
Core needle biopsy (CNB)
This test uses a larger needle and removes more tissue than an FNA. This test may be used if breast cancer is suspected. A CNB can also be done in the office, and a local numbing medicine is used because of the needle’s size. An ultrasound, or other imaging test, is usually used to help find the spot.
Surgical (open) biopsy
This type of biopsy gets more tissue, and it may be needed if the results of an FNA or CNB aren’t clear. It can remove part (incisional) or all (excisional) of the abnormal area. This type of procedure is usually done in the outpatient part of a hospital. You are usually given local numbing medicine and sedation, but sometimes it can be done under general anesthesia. Because your skin is cut during a biopsy, you will need stitches after this procedure.
Keep in mind
Some people have a higher risk of getting breast cancer, and the screening recommendations for them will be different. Most likely, they will start screening earlier, have it more often, and will probably have other screening tests in addition to regular mammograms.
The commonest reason why someone has a higher risk of getting breast cancer is because they have inherited mutations in their DNA (BRCA1, BRCA2, or PALB2). These are genes that form proteins which help fix damaged DNA in cells. When they are mutated (or faulty), they don’t do their job correctly, and cancerous cells are allowed to grow unchecked.
You have two copies of each of these genes — one from each of your parents. If you inherit a bad copy of one of the genes (a mutation), you have an increased risk of getting certain types of cancer — especially breast and ovarian cancer. You are also more likely to get those cancers at a younger age.
Knowing that you have a genetic mutation, or that you have a family member with it, is important because it changes how you should get your breast cancer screening. If you have one of these mutations, or if you have a first-degree relative with it (even if you haven’t been tested), you may need to start screening at age 30. And you may also need a breast MRI. Talk to your provider to find the most appropriate screening plan for your situation.
More information and resources
Why trust our experts?
References
Best study we found
Tirona, M. R. (2013). Breast cancer screening update. American Family Physician, 87(4), 274-278.
American Cancer Society. (2021). Breast cancer. Retrieved from https://www.cancer.org/cancer/breast-cancer/
American Cancer Society. (2021). Breast cancer early detection and diagnosis. Retrieved from https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/
American College of Obstetricians and Gynecologists. (2019). Mammography and other screening tests for breast problems — FAQs. Retrieved from https://www.acog.org/womens-health/faqs/mammography-and-other-screening-tests-for-breast-problems
Barton, M. B., Elmore, J. G., & Fletcher, S. W. (1999). Breast symptoms among women enrolled in a health maintenance organization: frequency, evaluation, and outcome. Annals of Internal Medicine, 130(8), 651-657.
Bernstein, L., Henderson, B. E., Hanisch, R., et al. (1994). Physical exercise and reduced risk of breast cancer in young women. Journal of the National Cancer Institute, 86(18), 1403-1408.
Block, W. D., & Muradali, D. (2013). Breast cancer in men. Canadian Medical Association Journal, 185(14), 1247.
Breastcancer.org. (2019). Breast self-exam. Retrieved from https://www.breastcancer.org/symptoms/testing/types/self_exam
Breastcancer.org. (2020). U.S. breast cancer statistics. Retrieved from https://www.breastcancer.org/symptoms/understand_bc/statistics
Centers for Disease Control and Prevention. (2017). United States cancer statistics: Data visualizations. Retrieved from https://gis.cdc.gov/Cancer/USCS/DataViz.html
Centers for Disease Control and Prevention. (2020). Breast cancer. Retrieved from https://www.cdc.gov/cancer/breast/index.htm
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (2020). Cost-effectiveness of breast cancer interventions. Retrieved from https://www.cdc.gov/chronicdisease/programs-impact/pop/breast-cancer.htm
Centers for Disease Control and Prevention, National Breast and Cervical Cancer Early Detection Program (NBCCEDP). (2020). About the program. Retrieved from https://www.cdc.gov/cancer/nbccedp/about.htm
Elmore, J. G., Armstrong, K., Lehman, C. D., & Fletcher, S. W. (2005). Screening for breast cancer. Journal of the American Medical Association, 293(10), 1245-1256.
Gotzsche, P. C., Jorgensen, K. J., & Cochrane Breast Cancer Group. (2013). Screening for breast cancer with mammography. Cochrane Database Systems Reviews, 2013(6), CD001877.
HealthCare.gov. (n.d.). Preventive care benefits for women. Retrieved from https://www.healthcare.gov/preventive-care-women/
Islami, F., Liu, Y., Jemal, A., et al. (2015). Breastfeeding and breast cancer risk by receptor status – a systematic review and meta-analysis. Annals of Oncology, 26(12), 2398-2407.
Lee, C. H., Dershaw, D. D., Kopans, D., et al. (2010). Breast cancer screening with imaging: recommendations from the society of breast imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. Journal of the American College of Radiology, 7(1), 18-27.
Liu, Y., Nguyen, N., & Colditz, G. A. (2015). Links between alcohol consumption and breast cancer: A look at the evidence. Women’s Health, 11(1), 65-77.
Mandelblatt, J. S., Stout, N. K., Schechter, C. B., et al. (2016). Collaborative modeling of the benefits and harms associated with different U.S. breast cancer screening strategies. Annals of Internal Medicine, 164(4), 215-225.
Morch, L. S., Skovlund, C. W., Hannaford, P. C., et al. (2017). Contemporary hormonal contraception and the risk of breast cancer. New England Journal of Medicine, 377, 2228-2239.
National Human Genome Research Institute. (2019). Families sharing health assessment and risk evaluation (SHARE). Retrieved from https://www.genome.gov/research-at-nhgri/Projects/Families-SHARE
National Institutes of Health, National Cancer Institute. (2020). BRCA gene mutations: Cancer risk and genetic testing. Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet
National Institutes of Health, National Cancer Institute. (2020). Breast cancer screening (PDQ) — patient version. Retrieved from https://www.cancer.gov/types/breast/patient/breast-screening-pdq
O’Malley, M. S., & Fletcher, S. W. (1987). U.S. Preventive Services Task Force. Screening for breast cancer with breast self-examination. A critical review. Journal of the American Medical Association, 257(16), 2196-2203
Phi, X., Tagliafico, A., Houssami, N., et al. (2018). Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts — a systematic review and meta-analysis. BMC Cancer, 18, 380.
Planned Parenthood. (n.d.). Women’s services. Retrieved from https://www.plannedparenthood.org/get-care/our-services/womens-services
Provencher, L., Hogue, J. C., Desbiens, C., et al. (2016). Is clinical breast examination important for breast cancer detection?. Current Oncology, 23(4), e332-e339.
Seely, J. M. & Alhassan, T. (2018). Screening for breast cancer in 2018 – what should we be doing today?. Current Oncology, 25(Suppl 1), S115-124.
Susan G. Komen. (n.d.). Mammography. Retrieved from https://www.komen.org/breast-cancer/screening/mammography/
Tirona, M. R. (2013). Breast cancer screening update. American Family Physician, 87(4), 274-278.
U.S. Food & Drug Administration. (2020). Search for a certified facility. Retrieved from https://www.fda.gov/radiation-emitting-products/consumer-information-mqsa/search-certified-facility
U.S. Preventive Services Task Force. (2009). Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 151(10), 716-26.
