Breast Cancer Screening: What You Should Know

Early detection could help save your life, but that's not all there is to know about breast cancer screening

Before you make your next -- or first -- mammogram appointment, know that a screening test only attempts to detect the possibility that cancer may be present. The results are not definitive. That means that getting an all-clear mammogram every year doesn't necessarily mean you're clear of breast cancer. And the opposite can be true as well -- a mammogram result that indicates a suspicious mass doesn't necessarily mean you have breast cancer.

Traditional film mammography remains one of the best bets for early detection for most women, but there are several drawbacks to be aware of:

• Film mammography cannot be enhanced to clearly discern differences in tissue.
• The process is uncomfortable for most women.
• Mammograms, like all x-rays, expose you to a dose of radiation.

Also, traditional mammograms are less effective in women with dense breast tissue.

That said, traditional film mammography is still the current gold standard screening method. But if your breast cancer risk is low, and you want to get a mammogram anyway, consider the following before you make an appointment: the stress or damage of potential false-positive or false-negative test results; the consequences of exposure to potentially harmful radiation; and overdiagnosis and overtreatment of nonexistent or low-risk cancers.

If you receive results that are positive, be sure to ask your doctor what the next steps are to find out if the test result is true or if it is a false-positive result. If you receive results that are negative, talk to your doctor about your specific risk factors and the chances that the test result may be falsely negative.

The decision to be routinely screened for breast cancer is a highly personal one and should be based on factors such as age and family history of breast cancer. Take the RealAge Breast Cancer Assessment to determine your risk of this disease.

New Technologies

In the future, healthcare providers may offer quicker, more effective, and more comfortable ways to detect breast cancer in the early stages. To date, none of these new methods has proved more effective than traditional mammography for the general population -- but three methods are currently under investigation for their potential to improve both comfort levels and efficacy: digital mammograms, magnetic resonance imaging (MRI), and ultrasound.

Digital mammography is a lot like conventional mammography in the way it is performed. It involves the same positioning, compression, and imaging of the breast using x-rays. The difference is that a digital mammogram converts the x-rays to an electrical signal, which can be viewed on a high-resolution computer screen.

Since the digital image is stored electronically, it can be adjusted to detect subtle differences in breast tissue, which could prove especially helpful in women with dense breast tissue. The images can also be stored, retrieved, and transmitted electronically.

Studies suggest that digital mammography may be of greater benefit to women with very dense breasts; pre- or perimenopausal women of any age; and women under 50, regardless of the density of their breasts.

MRIs use radio waves and a large magnet to create images of areas within the body, including organs, bone, and soft tissue. The three-dimensional images tend to be very clear and may be a better option than conventional mammograms for high-risk or younger women.

MRIs do not require breast compression and thus avoid the discomfort of regular mammograms. Research has shown that MRIs may detect more tumors than regular mammograms in women with a high inherited risk of breast cancer. But because of the large number of false-positive results, MRIs are not used as a screening test for women who are at average risk for breast cancer.

The American Cancer Society (ACS) suggests that women at high risk for breast cancer have both an annual MRI and a mammogram, and that women at moderately high risk discuss the pros and cons of the test with their physicians.

Ultrasound is a technique that uses high-frequency sound waves to create images. This method can be helpful in determining if a mass discovered during a breast exam or seen on a mammogram is solid (possibly cancerous) or filled with fluid. However, the accuracy of this method depends on the skill of the technician or physician performing it.

The Future of Saving Lives

The new technologies mentioned above for breast cancer screening look promising. If they prove to be better than conventional mammograms for the early detection of cancerous lumps, these techniques may even be shown to save lives. It is also possible that a combination of screening methods -- a digital mammogram followed by an ultrasound, for example -- may prove to be more accurate than either test alone. And the ability of these new methods to offer a pain-free screening experience is a welcome bonus.