“At what age should I begin screening for breast cancer?”
Screening tests are performed to detect cancer before symptoms appear. Regular screenings can aid in the detection and treatment of pre-malignancies and cancers before they spread. Breast cancer screening has a number of established benefits, limitations, and potential risks that all women should be aware of. Women should also be aware of how their breasts typically seem and feel, and report any changes to their health care practitioner as soon as possible. Because of their family history, a genetic predisposition, or other reasons, certain women should be examined with MRIs in addition to mammograms.
Early detection is important
The most essential measures for preventing breast cancer mortality are early detection and state-of-the-art cancer therapy. Breast cancer that is detected early, when it is small and has not spread, is more treatable. The most reliable approach to detect breast cancer early is to have frequent screening examinations. Nonetheless, Beginning at the age of 20, all women should consider doing a monthly self-breast exam and become familiar with their breasts so that they are better able to detect changes.
The objective of breast cancer screening tests is to detect the disease before it produces symptoms (like a lump that can be felt). Screening refers to tests and examinations performed to detect illness in persons who have no symptoms. Early detection refers to detecting and diagnosing an illness prior to the onset of symptoms.
Breast cancers discovered during screening tests are more likely to be small and localised. The size of a breast cancer and how far it has progressed are two of the most critical elements in determining a woman's prognosis (outlook).
Begin breast cancer screening at age 40
Women over the age of 40 should get a mammogram and a clinical breast examination every year. Women with dense breast tissue may be recommended with ultrasound. If a woman does not have a personal history of breast cancer, a significant family history of breast cancer, or a genetic mutation known to raise the risk of breast cancer, and has not undergone chest radiation therapy before the age of 30, she is considered to be at average risk for screening purposes.
For women who are at average risk for breast cancer, it is ideal to start having screening mammograms at age 40 (anytime in your 40s) or age 50. However, if you are at higher risk for breast cancer it is recommended to start screening earlier or whichever advised by a medical professional.
Breast cancer in young women
Women under the age of 40 may believe they are free from breast cancer, yet this age group accounts for 5% of all cases. Due to the density of breast tissue, diagnosis might be more challenging. Treatment can also have an impact on fertility. Every woman should be aware of her own personal breast cancer risk factors. A risk factor is a condition or activity that increases a person's chances of developing a disease. A woman's chance of developing breast cancer is increased by a number of factors, including:
A personal history of breast cancer or a biopsy-confirmed high-risk lesion
Breast cancer in the family, especially at a young age
They have a family history of a genetic condition that puts them at a greater risk for breast cancer.
Radiation treatment to the chest was used in the past.
A recognised genetic mutation that puts you at a greater chance of getting breast cancer.
Ashkenazi Jewish ancestry (one in 40 Ashkenazi Jews carry mutations in BRCA1 or BRCA2 - a gene mutation responsible for breast cancer)
Breast cancer diagnosis is more difficult in younger women (under 40 years old) since their breast tissue is typically denser than that of older women, and frequent screening is not suggested. Younger women's breast cancer may be more aggressive and resistant to therapy.
Breast cancer is more common among younger women, who are more likely to have genetic abnormalities that predispose them to breast and other cancers. Because they feel they are too young to have breast cancer, younger women with breast cancer may disregard warning signals such as a breast lump or atypical discharge. This can cause a delay in diagnosis as well as worse consequences. Breast lumps or other symptoms in young women may be dismissed by certain healthcare professionals, who may opt for a "wait and see" approach. Younger women have additional issues as a result of breast cancer therapy, which might include concerns with sexuality, fertility, and pregnancy.
Breast cancer screening under the age of 40
Mammograms are not advised for women under the age of 40, in general, but they (25-40 years) are advised to undergo annual clinical breast examination. However, women with genetic mutations can start screening at 25, while women with a family history of breast cancer generally start screening 10 years earlier than the first afflicted member in the family. In addition to mammography, breast MRI is frequently suggested to high-risk women.
Delay at 40 but it is a must at 50
As you become older, your chances of developing breast cancer increase. Women under the age of 50 have a reduced risk of breast cancer than those over 50. As a result, women in their 50s and 70s are more likely to benefit from mammograms than women in their 40s. It is important to note that some breast cancers may be missed by mammograms. Even with therapy, certain tumours that are discovered may still be fatal.
When there isn't any cancer, mammograms might provide an abnormal result (called a false-positive). This implies you may need more testing to be sure you don't have cancer, such as another mammogram, a breast ultrasound, or a biopsy. These tests can be dangerous and create a great deal of anxiety.
For women with a family history and genetic predisposition to breast cancer
It is advised that women with a family history of breast cancer get a:
Beginning no later than 10 years before the first illness in the family, a clinical breast exam every six months (but not earlier than age 25 and not later than age 40).
A yearly mammography beginning no later than ten years before the family's first diagnosis (but not earlier than age 25 and not later than age 40).
Supplemental imaging (e.g., ultrasound) for women with dense breast tissue.
Every six months, alternate between a breast MRI and a mammogram, as determined by your doctor.
It is recommended that women with a genetic predisposition to breast cancer to get:
A clinical breast exam every six months.
An annual mammogram starting at age 25.
An annual breast MRI.
Screening has the advantage of detecting cancer early on, when it is simpler to treat. False positive test results, on the other hand, can lead to further testing, which can be costly, intrusive, time-consuming, and create anxiety. Overdiagnosis can sometimes occur as a result of tests. All women with an above-average risk of breast cancer should talk to their doctor about extra screening tests, do a monthly self-breast check, so they know their breasts to observe changes sooner.
It is critical that women are educated about the advantages and potential risks of screening. However, realistic representations of false-positive rates and the incidence of over-diagnosis will demonstrate that the advantages outweigh the theoretical risks. Mammography screening detects cancer early on, when treatment is more successful. Screening mammography has been proven to be effective in several trials. Annual mammographic screening commencing at age 40 offers the greatest mortality reduction effect in terms of life years gained when compared to all other screening regimens.
Sources:
https://my.clevelandclinic.org/health/articles/16805-breast-cancer-in-young-women
https://www.mskcc.org/cancer-care/types/breast/mammograms-breast-exams/screening-guidelines-breast