2 min read
26 May

According to the National Breast Cancer Foundation, when breast cancer is detected early (stages 0-1) and has not spread beyond its original location, the 5-year survival rate is 100%. 

Most of us are aware of valiant and brave women who have heroically battled later stage breast cancer. Their images haunt us and, rightfully so, have caused us to fear a breast cancer diagnosis and treatment.  But as my breast surgeon said to me, “We have got to get the word out to women about how relatively easy treatment is for early stage breast cancer.”  

The importance of routine preventive breast screenings is to utilize the x-rays of the breast (the mammogram) to identify signs or symptoms of breast cancer while it is still in stage 0-1.  Meaning, finding cancer when it is still very small, undetectable to the human touch, and contained.   Remember the great news?  100% 5-year survival rate if detected and treated at Stages 0-1!  But in order to find Stage 0-1 breast cancer, you have to leverage x-ray images to find it.  

When should I be screened? While preventive screening guidelines (see the illustration below), are typically set by country (or insurer), women should ask to begin preventive screenings earlier or more frequently than recommended if they fall within the category of being at high risk for developing breast cancer.  

Risk factors may include: 

  • Positive genetic mutation found in the BReast CAncer (BRCA1 or 2) testing
  • Personal history of chest radiation before age 30
  • Family history of breast cancer 
  • Active duty military service, or training in austere environments

Amazing work is underway to create algorithms to improve the accuracy of identifying women who are at high risk and thereby align her mammogram screening protocol to her level of risk.  However, this capability is still some years away from actual practice.  In the meantime, talk with your provider if you have any questions or concerns regarding the guidelines of breast screening if you think you are at risk.  Remember the great news about early detection! 

Preventive screenings really took a hit during COVID-19 due to the inability to schedule appointments and perform screenings.  If you are one of those women who missed her breast screening please be diligent in getting your appointment rescheduled.  

Want to know how early stage cancer is found? Upon arrival at your screening appointment, you will check in and provide any requested information.  Once this is complete, you will be asked to wait to be called back for your appointment.  

  • Once you are called back, you will undress from the waist up and put on a modesty gown or cape
  • Your female mammogram technician will escort you into the mammogram room where she will position you onto the x-ray machine to capture the various angles of images
  • Once the images are captured, they are placed into an electronic queue for the radiologist(s) to read (in the US the images are read by one radiologist while the images are read by two radiologists in the UK) 
  • If the image is clear and the radiologist(s) determines there is no evidence of cancer you receive the “all clear” communication  
  • If there is a question about the image quality (technical recall) you will be asked to return for a second mammogram to ensure a clear image is captured
  • If the US radiologist locates something that is suspicious, you will be invited to return to the imaging center for more in-depth screening 
  • If the two radiologists in the UK are not aligned in their findings a third radiologist will read the image and determine whether you are “all clear” or need to be invited to return for more in-depth screening   
  • The in-depth screening will include an ultrasound and may also include a second mammogram
  • Upon receipt of the ultrasound results, the radiologist(s) compares the results to the mammogram to confirm whether there is a suspicious finding
  • If there is a suspicious finding, the woman is referred for a biopsy (which may be performed by the radiologist who read her mammogram or by a physician) 
  • All mammogram and ultrasound images are then saved into a radiology image archive for future reference

Remember the great news?  If caught early in the mammogram screening, Stage 0-1 breast cancer has a 100% 5-year survival rate.  In addition, the treatment of early stage cancer ranges from ongoing monitoring to a lumpectomy with, and in some cases without, radiation, and rarely chemotherapy.  

So, next time you hesitate to schedule your mammogram just remember the great news about early detection of breast cancer! 

Illustration: Breast Screening Guidelines 

American Cancer Society US Preventive Services Task Force National Health Service 
Age 40 - 44 Option to begin annual mammograms
Age 45 - 54 Annual mammograms
Age 55+ Option to either maintain annual screening or reduce mammograms to every other year (if a  low risk) 
Age 40 - 49 Opt into screening
Age 50 - 74 Every other year screening for women with average risk of breast cancer
Age 50 - 53 Initial screening invitation (If at high risk, example: family history of breast cancer, you may be invited to screen prior to age 50)
After first screening, every three years
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