By Dr. Shawn Andrews, Primary Care Medical Director and Primary Care Provider
Since the development of the first breast cancer screening equipment in 1965, much progress has been made, including improved quality of images, reduction of radiation exposure and improved patient experience. New mammography technology means that mammograms are far less uncomfortable than they used to be, and the imaging results are far more useful for providers.
You may have noticed that health screening recommendations, including recommendations for breast cancer screening, seem to change from time to time. This is due to the evaluation of how screenings and treatments impact patient lives. Thanks to the collection of over 50 years of this data, we can develop the most effective care for our patients.
You may have also noticed that there seems to be inconsistency between screening recommendations. This is because many different organizations including the American Cancer Society, American College of Radiology, American College of Obstetricians and Gynecologists, American Academy of Family Physicians, the US Preventative Services Task Force and many others all come out with their own recommendations, based on the evidence, and on their organizational missions.
Based on review of these recommendations, Summit Pacific’s primary care providers have agreed to the following:
- Screening mammography every two years for women ages 50 to 74.
- Screening as frequently as every year, depending on individual patient risk factors and patient preference.
- Screening to begin as early as age 40 depending on individual patient risk factors and preference.
- Patients with lifetime risk of breast cancer 20% or higher to be offered screening and/or genetic counseling for genes that increase the risk of breast cancer, with further screening recommendations based on test results.
- Consideration of screening for as long as breast cancer treatment (surgery, radiation, chemotherapy) would be considered by the patient.
Factors that increase the risk of breast cancer include advancing age, personal or family history of breast, ovarian, or tubal cancers, menstruation before age 12, menopause after age 55, first birth after age 30, alcohol consumption of two or more drinks per day, history of breast biopsy and others. Additionally, the research shows that progesterone or estrogen/progesterone combined increases cancer risk (3 additional cases per 1000 women on treatment for 5 years). Some evidence shows that certain types of progesterone have less risk.
Factors that are protective against breast cancer include breast feeding for 16 months or longer in total, regular exercise, having a body mass index lower than 23 (especially after menopause), having had 5 or more births.
In summary exercise, eat a healthy diet, limit your alcohol intake, breast feed (if you are reproductive age and are having children), and see your primary care provider yearly to discuss your individual screening needs and preferences.
If you have breast pain, a lump you can feel, discharge from your nipples or skin changes of the breast area, please schedule an appointment with your primary care provider right away to be evaluated.