By Kari Danziger, MS, CGC

Reviewed By Beth Crawford, MS, CGC
Last Updated August 25, 2000

Screening for breast cancer should be an important part of every woman's health care routine because all women are at risk for developing the disease, especially as they grow older. Although all breast cancer screening takes advantage of the same three tools — breast self-examination, clinical breast examination, and mammography (breast X-ray) — women who appear to be at higher risk for the disease (either because of a personal or family history, or due to other risk factors) are recommended to begin screening at an earlier age and to do so more frequently. The breast cancer screening guidelines detailed here are those recommended for women who are at average risk for developing breast cancer — that is, they have no family history of breast or ovarian cancer. Screening for ovarian cancer in the general population is currently not recommended.

Screening Methods

As is the case with other cancers, the earlier a breast cancer is found, the more likely it can be treated and stopped before the disease spreads to other parts of the body. Thus, the most important thing you can do to prevent breast cancer is vigilantly screen for the disease. The following procedures can help you and your physician screen for early signs of breast cancer.

• Breast self-examination. By regularly examining your own breasts, you can detect any changes early on and bring them to the attention of your health care provider. It should be noted, however, that researchers have not yet conclusively proved that performing regular breast self-exams significantly reduces cancer mortality or is particularly effective for diagnosing early stage breast cancer
• Clinical breast examination. By examining a woman's breasts in a clinical setting, physicians can detect changes or suspicious masses that may be a sign of early-stage cancer. Healthcare providers have received training in breast examination, which is likely to make them more effective at detecting cancerous lumps. The sensitivity of clinical breast exam is affected by the stage and size of the tumor, and the experience of the examiner. Overall, studies have shown that approximately 63 percent of breast cancers may be detected by clinical breast exam alone.
• Mammogram. By using low-level-radiation X-rays, physicians are able to look for evidence of cancer in women who are not yet displaying any symptoms of the disease.
  
  

Screening Guidelines

Breast Cancer Screening

The following table summarizes the American Cancer Society's screening guidelines for women who are at average risk for breast cancer:

Ovarian Cancer Screening

Doctors often perform a pelvic exam on women as part of their yearly examination. Although a pelvic exam can occasionally detect ovarian cancer, it often misses cancers or only detects the cancer when it is farther advanced and harder to treat. In addition, abnormalities found during pelvic exams often do not turn out to be cancer. For these reasons, pelvic exams are not considered an effective screening method for ovarian cancer, although they are an important part of an annual exam because they allow the doctor to screen for cervical cancer.

Other ovarian cancer screening methods that are available — including ultrasound or CA-125 testing — are also unreliable and are not recommended for people in the general population. Sometimes these methods fail to detect cancer when it's present, and other times they falsely identify benign conditions as cancer, including pregnancy, endometriosis and benign ovarian masses. These errors can cause unnecessary anxiety for patients and require expensive and unpleasant follow-up (such as biopsies) to clarify the results.

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More on Screening Procedures for Ovarian Cancer

Learn How to Perform a Breast Self-Examination

American Cancer Society Breast Cancer Resource Center

References

US Preventative Services Task Force(1996) Guide to clinical preventive services. (2nd ed.) Alexandria, VA: International Medical Publishing.

Leitch A.M. et al. (1997). American Cancer Society guidelines for the early detection of breast cancer: update 1997. CA Cancer J Clin. 47(3):150-3.

American Cancer Society. (1993). Guidelines for the cancer-related checkup: an update. Atlanta: American Cancer Society.

Smith R.A. et al. (2000). American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin. 50(1):34-49.

National Institutes of Health Consensus Development Panel (1997). National Institutes of Health Consensus Development Conference Statement: Breast Cancer Screening for Women Ages 40-49, January 21-23, 1997. National Institutes of Health Consensus Development Panel. J Natl Cancer Inst. 89(14):1015-26.

Andolf, E. et al. (1990) Ultrasound examination for detection of ovarian carcinoma in risk groups. Obstet Gynecol. 75(1):106-109.