Breast cancer is one of the most common cancers diagnosed in women, with the American Cancer Society (ACS) estimating there to be approximately 287,850 new cases of invasive breast cancer in women in the United States.¹ Although the ACS reports that breast cancer death rates have decreased since 1989, they still estimate around 43,250 women will die of breast cancer in the US in 2022.
Detecting and diagnosing breast cancer early is the most effective way to reduce mortality rates. However, patients may not have all the information they need about whether they are at risk, when they should get checked, and the different ways breast cancer can be found. Healthy communication between health care professionals (HCPs) and patients on these topics can be helpful in educating patients. What can you tell your patients about breast cancer, specifically regarding early detection and the ways it is diagnosed?
How is Breast Cancer Detected?
The ACS recommends that women with an average risk of breast cancer start screening in the range of 40 to 44 years, and those with a more advanced risk of breast cancer start screening at age 30.² Consistent screenings are the most effective way of spotting breast cancer early, and knowing in advance what types of tests may occur may put patients more at ease. Here are some of the most common ways patients get screened for breast cancer.
A clinical breast exam, where a health care professional physically checks the breasts for any lumps or other abnormalities, may be performed at a breast care screening or physical. Patients may also perform a self-exam and report any abnormalities to their HCP.
While a breast exam is one of the more well-known forms of screening, there is debate regarding how effective it is at detecting cancer. The ACS does not recommend them as part of a standard breast cancer screening (though they don’t believe they should never be performed)², and the US Centers for Disease Control and Prevention (CDC) claim that these exams have not been found to lower breast cancer mortality risk.³
Regular mammograms, an X-ray of the breast, are typically seen as the most effective way to detect breast cancer at an early stage.⁴ Though mammograms are not perfect, at their most effective these X-rays can help detect cancer years before the development of any physical symptoms.² Mammograms can show certain abnormalities forming in the breast, such as masses, calcifications, and asymmetries.⁵
Should a mammogram find an abnormal area in the breast, HCPs will call patients back in for further testing, including potentially more mammograms, to further determine whether it is breast cancer. There are 2D and 3D mammograms, and the ACS claims that 3D mammography more often finds breast cancer and reduces the chance of patients being called back for additional testing.⁵
Breast magnetic resonance imaging (MRI) is often used in tandem with mammograms for women who are seen as being at higher risk for breast cancer. The ACS recommends women at high risk should start receiving these around 30 years old.³ They also advise against getting a breast MRI if your risk of breast cancer is seen as under 15%, in part due to an MRI being more likely to find abnormalities that turn out to be something other than cancer.
If any of the previously mentioned screenings find anything unusual, the only way to determine whether it is breast cancer is by performing a breast biopsy. These biopsies may be done via needle or incision, depending on factors such as the location and size of the abnormality.⁶
Can Blood Tests Detect Breast Cancer?
Blood tests are not used to detect the presence of breast cancer. However, if a patient is diagnosed with breast cancer, blood tests may be among the methods used to determine their overall health and current stage of cancer.⁷ Staging may also be done via further mammograms and breast MRIs, as well as a computerized tomography (CT) scan or positron emission tomography (PET) scan.
How Important is Early Detection?
The emphasis on early detection of breast cancer is due to the significant impact it has on the survival rate. Per the ACS, the 5-year survival rates for localized breast cancer (cancer that has not spread beyond the breast) is 99%.⁸ For patients with regional breast cancer (cancer that has spread to nearby lymph nodes), that number falls to 86%; for cancer that has spread to more distant parts of the body, the 5-year survival rate is just 29%.
Early detection and diagnosis is extremely beneficial; however, many patients struggle with access to the level of care needed to receive an early diagnosis. A study published in Cancer in 2021 examined the importance of early detection and the disparities many women face, and found that women in lower income areas worldwide struggle with access to care and receiving a timely diagnosis.⁹
Many lower income areas struggle to have mammogram machines, potentially deprioritizing them due to how expensive they are and the fact they are used exclusively for breast imaging. Lower income patients may struggle to afford a mammogram, or may not be able to travel to an office that has that capability. A late stage breast cancer diagnosis often correlates with economic struggles and larger health expenditures than early detection. The researchers concluded that more needs to be done to make these early screening methods more widely available and affordable for all women.
1. Breast cancer statistics | How common is breast cancer? American Cancer Society. https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html. Updated October 6, 2022. Accessed October 18, 2022.
2. ACS breast cancer screening guidelines. American Cancer Society. https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html. Updated January 1, 2022. Accessed October 18, 2022.
3. What is breast cancer screening? US Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/breast/basic_info/screening.htm. Updated September 26, 2022. Accessed October 18, 2022.
4. What is a mammogram? US Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm. Updated September 26, 2022. Accessed October 18, 2022.
5. Breast cancer mammogram | How does a mammogram work? American Cancer Society. https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/mammogram-basics.html. Updated January 14, 2022. Accessed October 18, 2022.
6. Breast biopsy | Biopsy procedure for breast cancer. American Cancer Society. https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/breast-biopsy.html. Updated January 14, 2022. Accessed October 18, 2022.
7. Breast cancer – diagnosis and treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/breast-cancer/diagnosis-treatment/drc-20352475. Updated April 27, 2022. Accessed October 18, 2022.
8. Survival rates for breast cancer. American Cancer Society. https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-survival-rates.html. Updated March 1, 2022. Accessed October 18, 2022.
9. Ginsburg O, Yip C, Brooks A et al. Breast cancer early detection: A phased approach to implementation. Cancer. 2020;126(S10):2379-2393. doi:10.1002/cncr.32887
This article originally appeared on Cancer Therapy Advisor