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Get Screened

By Susan Peck, MSN, APN

Get Screened

The best way to reduce your risks of dying of breast cancer is being screened, despite current debate among the experts. If you are confused by what you’ve read about breast cancer screening lately you’re not alone. So, let’s look at what research says, and explore what a false positive test result from mammogram may mean for you.

Checking for Changes

Breast self-exam plays only a small part in catching breast cancer, says the American Cancer Society (ACS), which recommends that you start watching for changes in your breasts in your 20s. You should do a breast self-exam around the same time each month, and many women like to use their period to remind them to do a breast self-exam.

The goal is to watch for changes and report any you may find to your healthcare provider. The ACS also recommends that if you’re in your 20s or 30s, that you have an annual clinical breast exam to check for changes as well.

Get a Mammogram

Mammography remains the main imaging resource to detect early breast cancer before it causes symptoms. For a long time experts have advised that women begin mammography at age 40, and to have an annual mammogram. However, in the last several years, some groups have questioned the need for annual screening.

Still, the American Cancer Society (ACS), the National Comprehensive Cancer Network, and the American College of Obstetricians and Gynecologists (ACOG) continue to recommend initial mammography at age 40 and to continue annually regardless of age. The US Preventive Services Task Force recommends screening to begin at age 50 and to continue every two years until age 74. Their advice is based on the fact that most breast cancer is found in women ages 50 and older, and their concerns about potential harms cased by false positive screens in younger women.

If you’ve been told by your healthcare provider that you’re at higher risk for breast cancer, say for example, you have the known BRCA1 or BRCA2 gene mutation that causes breast cancer or you have a close relative such as your mom or sister who has had breast cancer, you may be asked to begin mammography in your 30s, say experts at the ACS.

When it comes to screening, mammograms aren’t your only option; talk with your healthcare provider about what’s best for you. Breast ultrasound is often used along with mammograms to evaluate a suspected mass, but it shouldn’t be used as primary screening by itself, say experts at the ACS.

Breast MRI is used primarily in women diagnosed with breast cancer to search for other sites of the cancer or to measure the size of the cancer. It’s also not recommended as a screening tool by itself and may not detect cancers that a mammogram will. In fact, it may increase the false positive rate by raising suspicions around a non-cancerous mass, for example.

New technologies such as thermal imaging, molecular breast imaging, and positron emission imaging need more study before we can be certain of their usefulness in detecting cancer.

False Positives

Have you ever had a “false positive”—a suspected mass or tumor that turned out not to be cancer (benign)? Earlier this year, the Journal of the National Cancer Institute published research that suggests that if you’ve ever had a false positive result with a mammogram, your breast cancer rates may be higher than other women. That’s because having suspicious patterns in your breast tissue may increase long term risks for developing a cancer (malignancy). If this happened on your first mammogram, you’re risk is not as high as if it occurred on a later or on more than one mammogram. If you’ve had a false positive test result, it’s more important than ever to be vigilant in getting screened for breast cancer.


Yes, there’s compression and maybe pinching of your breast tissue in the x-ray machine (even with digital x-rays), but this screen can save your life if breast cancer is caught early. Here’s what to expect when you get a mammogram:

  • You will be undressed from the waist up and wear only a wrap without your bra underneath.
  • The procedure takes about 20 minutes, during which time your breast will be positioned, one at a time, between two plates for imaging.
  • To get the best image, your breasts have to be flattened slightly, but this happens for just a few seconds.
  • You should have your results within the week.
  • If you’re called back for more tests, you’re still unlikely to have cancer. Less than 10% of women repeat screening are found to have cancer, the ACS says.
  • Some experts advise that you avoid having a mammogram right before or after your period when your breasts may be more tender.
  • Schedule your next mammogram before you leave so that you stay on track with annual screenings.

Start watching for changes in your breasts in your 20s. Do a breast self-exam once a month, and see your provider annually for a clinical breast exam.

Susan Peck, MSN, APN, is a nurse practitioner at the Robert Wood Johnson Medical School and an expert advisor to Healthy Mom&Baby.

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