When should you start breast cancer screenings?

When should you start breast cancer screenings?
Rachel Swart, MD, PhD and Michele Ley, MD, FACS, specialize in the prevention, treatment, and survivorship of breast cancer. (Source: Arizona Oncology)

TUCSON, Ariz. (KOLD News 13) - Breast cancer is the second-most diagnosed cancer among American women, yet it is treatable and survivable, especially when caught early, according to Arizona Oncology breast cancer specialists Rachel Swart, MD, PhD and Michele Ley, MD.

The Tucson-based physicians, who have been working with local cancer patients for over a decade, embrace National Breast Cancer Awareness Month as a time to remind Pima County residents that breast cancer screening is crucial.

In fact, Arizona Oncology recently endorsed the 2019 breast cancer screening recommendations from the American Society of Breast Surgeon (ASBrS), which take into greater account heredity and race-based risk factors.

Breast cancer is the second most diagnosed cancer among American women, yet it is treatable and survivable.
Breast cancer is the second most diagnosed cancer among American women, yet it is treatable and survivable. (Source: Arizona Oncology)

ASBrS Screening Guidelines

  • All women age 25 and older should have a formal risk assessment for breast cancer.
  • Women with an average risk of breast cancer should start annual screening mammograms at age 40.
  • Women with a higher-than-average risk of breast cancer should start annual screening mammograms at an earlier age and should be offered additional imaging each year.

The ASBrS guidelines depart from the American Cancer Society (ACS) and U.S. Preventive Services Task Force (USPSTF) recommendations for screenings starting at age 45 or older, which apply to women with average risk and are based on adverse effects thought to be tied to screening costs, the probability of inaccurate results and unnecessary medical procedures.

“Really women should start doing self-breast examinations in their 20s on a monthly basis,” suggests Dr. Swart. “When they hit their 30s, they should actually be seeing their primary care physician or gynecologist to do regular clinical breast examinations. And then after that, when they hit 40, they should be doing a yearly mammogram. Currently we do not have a cut-off age for when they should stop screening mammography,” she added.

“As a breast cancer surgeon, I have treated very young patients with late-stage breast cancer who would have greatly benefitted from a baseline risk assessment at age 25,” said Dr. Ley, who specializes in breast surgical oncology at Arizona Oncology.

“Today we thankfully have tools available like online risk calculators and genetic testing which can help determine a patient’s risk for breast cancer,” added Dr. Swart, “and this gives us the opportunity to prevent cancer or treat it in its earliest form.”

The goal of the new guidelines is the customization of screening to the patient’s estimated lifetime risk of breast cancer:

  • Women at average risk, should begin mammography at age 40. This younger age aims to account for breast cancer outcome disparities noted among diverse populations in the U.S. The goal is to improve survival rates among women whose cancer might have otherwise been missed.
  • Women with a very strong family history or risk over 20% should start imaging at age 35.
  • Women with a BRCA gene mutation or other germline mutation known to predispose to a high risk of breast cancer should have imaging starting at age 25.

“By acknowledging the needs of the diverse population of adult women in our country, physicians are empowered to minimize breast cancer disparities through earlier detection of cancer in all women," added Dr. Ley.

While most health insurers will cover some recommended strategies such as risk assessment and 3-D mammograms before age 50, the ASBrS specifically did not restrict guidelines to currently covered procedures.

About Arizona Oncology

Arizona Oncology is one of the largest medical groups in Arizona. With more than 60 practicing physicians devoted exclusively to providing comprehensive, compassionate and high-quality cancer care, Arizona Oncology specializes in Medical, Gynecologic, and Radiation Oncology, Breast Surgical Oncology, Hematology, Research, Genetic Risk Assessment, and patient ancillary programs. The physicians and their staff treat patients in many communities throughout the state including Tucson, Green Valley, Deer Valley, East Valley (Tempe and East Mesa), Flagstaff, Glendale, Goodyear, Peoria, Phoenix, Prescott, Prescott Valley, Scottsdale.

Arizona Oncology believes it is beneficial to provide cancer therapies in a community setting, close to patients’ homes and support systems. The physicians are supported by a talented clinical team sensitive to the needs of cancer patients and their caregivers. For more information, visit www.ArizonaOncology.com.

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