Breast Cancer Prevention (cont.)

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What is the risk of radiation with repeated mammography screening over the years?

With modern mammography equipment, the amount of radiation exposure is extremely small. Although there is no level of radiation without some theoretical risk, there is no evidence of increased breast cancer risks from mammography performed in the recommended manner. Furthermore, the benefits of early detection far outweigh these theoretical concerns.

Are there any controversies in the area of breast cancer screening?

The screening guidelines described above from the ACS and the USPSTF differ in their recommendations for when screening mammograms should begin. The ACS recommends yearly mammograms starting at age 40, while the USPSTF recommends mammograms every two years beginning at age 50.

There is further debate over the issue of mammography screening in young women, as discussed previously. There is also the issue of the emotional trauma of receiving false positive mammogram reports (mammograms that show abnormal changes in the breast that subsequently prove to be noncancerous). However, after evaluating women who have gone through this process, there does not appear to be a lasting problem.

There is no agreement about the practice or importance of breast self-examination, which in the past was recommended for all women. The ACS now states that this practice is optional, while the USPSTF recommends that the practice not be taught to patients.

There is also no standard recommendation for screening women with high risks such as women with a positive family history of breast cancer or those who have inherited defective BRCA1 or BRCA2 genes. After careful counseling, some patients with BRCA mutations may eventually elect to undergo preventive mastectomy to reduce the risks of breast cancer. For those patients who elect monitoring, it is generally accepted that more frequent breast clinical examinations and perhaps, periodically, more involved imaging (ultrasound and MRI) are the minimum measures.

Reviewed by William C. Shiel Jr., MD, FACP, FACR on 4/16/2012

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Breast Cancer Prevention - Mammograms Question: How often do you get a mammogram?
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