Breast Cancer Screening: When Should A Woman Start Getting Mammograms?
Mammograms involve risks that should be considered before proceeding. Read on to know the benefits, dangers, and limitations of mammography.
The goal of these mammograms is to detect cancer that has returned in the affected breast, known as a recurrence, or to detect new breast cancer in either of the breasts that may develop over time. But when should a woman start getting mammograms and how often they should go for it in a year? Dr Shilpy Dolas, Consultant Breast Surgeon & Breast Oncoplastic Surgeon, Motherhood Hospital, Kharadi, Pune, answers this and more here.
All women should start getting mammograms when they are 40, and they should have it once every year after that. This routine will continue until they reach the age of 75 or, for whatever reason, have a limited life expectancy. At a certain point, a careful discussion between the women and her health care team about what is best for her specific situation determines whether she should continue to get mammograms or not. For example, if an elderly woman has had breast cancer treatment, it is unclear if mammography can be safely discontinued as people age. Such women may be recommended to have a mammogram on an unaffected breast once a year as part of their follow-up care for breast cancer survivors.
If an area of concern is found on mammography, you will be advised to have further mammograms and potentially ultrasounds. These tests may establish that the observed area of concern is not likely to be cancer.
In some cases, a biopsy operation may be required to remove a sample of breast tissue for examination. A biopsy is needed in case of suspicious lump or mass. This can confirm if there is cancer present or not, which is often reassuring and does not create concern.
Some guidelines on mammograms
- If a breast cancer survivor is 75 or older and expected to live less than 5 years, mammography should be discontinued.
- Consider discontinuing mammography for breast cancer survivors 75 and older with a diagnosis of 5-to-10-years.
- Consider continuing mammography for breast cancer survivors who are aged 75 and above and are likely to live 10 years or more.
Mammograms will benefit the majority of women for many years after they have been diagnosed with breast cancer. However, some women will not benefit as much and may wish to discontinue mammograms. Stopping mammograms does not imply that women will no longer receive proper care, follow-up with their providers, or physical examinations, but it does imply that mammograms may not result in better outcomes for certain women.
Mammograms may not be beneficial in these situations
- If a woman is over the age of 50 and has other significant medical conditions, such as heart disease or stroke, especially if these conditions impair physical function and mobility. These other medical conditions frequently increase the risk of death in older patients who have previously been treated for breast cancer. As a result, it is unclear whether continuing mammography indefinitely makes sense for patients who face significant medical challenges. This is because there may be no clear benefits of mammography.
- Women being treated for low-risk breast cancer who are taking medications to help prevent the formation of new cancers. These medications, such as tamoxifen or aromatase inhibitors, reduce the risk of developing another breast cancer, sometimes to levels lower than the general population of older women who have never had breast cancer. Mammograms may also play a less important role in this situation.
Conclusion
Mammograms involve risks that should be considered before proceeding. During the testing, there may be some discomfort. There is also a potential that a mammography result will lead to a biopsy that reveals no cancer, which is known as a false positive.
Sometimes, the doctors are unable to determine which breast tumours will spread and which will remain contained within the breast. As a result, annual mammograms continue to be the best option for discovering cancer early, increasing the odds of cure, and lowering the risk of mortality from breast cancer.
Always consult your doctor if you have the risk of personal breast cancer or you recognize abnormalities or changes in your breasts. Discuss the benefits, dangers, and limitations of mammograms and determine what is best for you together. Your doctor can help you weigh the benefits of screening against the restrictions and dangers.