How are women screened for breast cancer?

Updated: Apr 10, 2019
  • Author: Erin V Newton, MD; Chief Editor: Marie Catherine Lee, MD, FACS  more...
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For women younger than 40 years at average risk for breast cancer, there have no been randomized studies done to suggest a benefit to screening. The various experts groups have not reached a consensus among them, but several recommend a clinical breast exam (CBE) every 3 years and a discussion about the benefits and limitations of breast self exam (BSE).

For women over the age of 40 years at average risk for breast cancer, many expert groups recommend CBE annually. In terms of imaging, the most widely recommended screening approach in the United States for this group has been annual mammography. [1] The age at which to discontinue mammography has been a controversial subject, with some expert groups suggesting after age 75 [2] , while the American College of Radiology recommends annual screening mammography until the life expectancy is less than 5 to 7 years, based on comorbidities. [3]

Although mammography guidelines have been in place for over 30 years, 20-30% of women still do not undergo screening as indicated. The 2 most significant factors in determining whether a woman undergoes mammography are physician recommendation and access to health insurance. Non-white women and those of lower socioeconomic status remain less likely to obtain mammography services, and these women are more likely to present with life-threatening, advanced-stage disease.

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