Opinion: Screening for breast cancer can save lives

By Joshua Fenton

When it comes to our health, no one likes to be surprised. Cancer can strike anyone at any age, and breast cancer is most common among women. Although most abnormalities detected in the breast are not cancerous or life-threatening, most breast cancers are invasive, which is why early detection through screening is important. Think about this:

•  230,480 cases of invasive breast cancer in the U.S. were estimated to be diagnosed in 2011 in women and 2,140 in men. And 95 percent of the new cases will occur in women 40 years of age and older.
• According to the California Cancer Registry, 310 new breast cancer cases are expected in 2012 in Placer County and 150 in El Dorado County.
• According to the National Cancer Institute, there is strong evidence that mammography (X-ray of the breast) screenings for women between the ages of 50 and 69 lower the risk of breast cancer by 30 percent, and for women in their 40s, the risk of breast cancer is lowered approximately 17 percent.

However, studies on mammography have shown that false positives (when mammogram results are abnormal but no cancer is present) occur commonly. Meanwhile, the benefits of mammography are similar whether mammograms are performed every year or every other year. Over time, however, women getting mammograms every other year experience fewer false positives. Experts still agree that regular screenings are important for early identification before cancer spreads beyond your breast.

Although radiation exposure is a potential risk of mammography, keep in mind that one mammogram exposes you to roughly the same level of radiation as flying across the U.S. on a commercial jet.

How can you take charge and reduce your risk of breast cancer?

•  Know your family history, and share it with your doctor. If your mother or a sister had breast cancer, let your doctor know so they can factor that into recommendations for you. Eat healthfully, be physically active, and drink moderately (no more than one drink per day on average).
• Ask your doctor to thoroughly explain the risks of taking hormones, like estrogen and progestin, if you’re considering this treatment option for menopause.
• Take advantage of breast screenings. Talk with your doctor about how often you should get screened, and ensure the plan is tailored to your particular risks and age. Screening recommendations are based on several factors: age, genetic background or risks, family/personal history and breast density. Current evidence supports the following recommendations:
• If you’re between 40 and 50 years old, the decision to begin breast cancer screening is a personal one that should be based on your underlying risk and personal preferences. Your doctor can help you may make the right decision about initiating screening.
• If you’re between 50 and 74 years old, get a mammogram approximately every two years. Your doctor may also recommend a screening clinical breast examination prior to the mammogram.
• If you’re older than 74, screening may still be beneficial if you are in good health. Ask your doctor whether continuing with mammography makes good clinical sense for you.

While the benefits of breast screening are clear, women can also decrease their breast cancer risk by maintaining an active, healthful lifestyle.

Joshua Fenton is assistant professor in Family and Community Medicine at UC Davis and a member of the National Cancer Institute-designated UC Davis Comprehensive Cancer Center.