Breast cancer screening

As part of Breast Cancer Awareness Month in October, experts at The University of Texas M. D. Anderson Cancer Center encourage women to learn about recommended screening guidelines to improve their chances for early detection of breast cancer.

When breast cancer is caught early, the chance for successful treatment is greatest.

According to the American Cancer Society, breast cancer is the most commonly diagnosed cancer in women with more than 178,000 new cases expected this year. It's the second leading cause of cancer death with more than 40,000 expected before year-end.

The good news is that breast cancer death rates have steadily decreased since 1990. This recent decline can be attributed in part to the increase of early detection through breast cancer screening.

Breast Cancer Screening

M. D. Anderson also recommends women have:

• clinical breast exams every one to three years beginning at age 20
• yearly mammograms and clinical breast exams beginning at age 40

M. D. Anderson does not recommend that women conduct a “formal” breast self-examination anymore, but instead recommends that women be familiar with their breasts.

“All women should be familiar with their breasts so that they will notice any changes and report them to their doctor without delay,” says Banu Arun, M.D., associate professor in M. D. Anderson's Department of Breast Medical Oncology and director of the Clinical Cancer Genetics program.

MRI for Women at High Risk

In a recent study, results showed that when certain women at high risk for breast cancer have both a mammogram and magnetic resonance imaging (MRI), there is a better chance for breast cancer to be detected early when it is easiest to treat.

The American Cancer Society recently updated its breast cancer screening guidelines to include MRI scans, in addition to mammography, for certain women at high risk of developing breast cancer. They recommend an MRI and mammogram for women who have one of the following:

• genetic test results showing a gene mutation: BRCA 1 or 2, Li-Fraumeni syndrome, Cowden syndrome or Bannayan-Riley-Ruvalcaba syndrome
• first-degree relative (parent, child, sibling) with one of the above mutations (if the woman has not yet been tested)
• lifetime breast cancer risk of 20 to 25 percent or greater on an accepted risk assessment tool predominantly based on family history
• history of radiation therapy to the chest (between the ages of 10 and 30)

“M. D. Anderson has been following these guidelines for the past three years among women at high risk in our Clinical Cancer Genetics program,” says Arun.

At this time, it is unknown whether an MRI is beneficial for women at high risk who do not meet any of the above criteria. For most women, MRI scans have not yet been shown to be beneficial for breast cancer screening.

Women should speak with their health care provider to determine if they are at high risk of developing breast cancer and if an MRI scan would be appropriate. A woman's health care provider can help her determine what screening tests are appropriate. Women also should check with their health insurance company to see if the cost of a screening MRI is covered.