Breast Cancer: When to Screen and Why

If I told you that you had a 12-20% chance of winning a multimillion-dollar lottery sometime in your lifetime but to win, you had to buy a one-dollar lottery ticket every year for the rest of your life. Would you buy a ticket every year? I think most of us would.

Now, if I told you that you had a 12-20% chance of contracting a deadly disease in your lifetime that would almost certainly kill you if you caught it too late for a cure, but that it would almost never kill you if you simply received a free screening test once a year for the rest of your life. Would you do the screening test? Surprisingly, 60-70% of area women are saying “no” to this lifesaving screening test.

The first story about winning the lottery is of course fiction but the second story about the deadly disease is true. The deadly disease is breast cancer and the annual screening test is 3D mammography that is paid for by Medicare and all health insurance companies without co-pay or a deductible expense to you.

There is no lack of controversy and misinformation about breast cancer and screening mammography in the news media these days causing significant confusion and anxiety among West Texas women. I would like to set the record straight with facts and figures from the medical world where I live and practice every day.

Fact #1: Breast cancer is a killer.

More US women will die of breast cancer this year than men and women combined from motor vehicle accidents on our nation’s roads. Estimated US deaths from breast cancer in 2018: 40,920. Estimated US deaths from motor vehicle accidents in 2018: 39,750. Both statistics are unacceptable and need to be reduced.

Fact #2: All breast cancers are curable if they are discovered early enough.

Thanks to modern medical procedures and treatments, breast cancer can be eliminated from your body with no chance of killing you if it is discovered at an early enough stage. Screening for breast cancer saves lives, one of which may be yours.

Fact #3: The only way to discover breast cancer early enough for a near-sure cure is to screen for it every year with mammography.

Unfortunately, most women wait until they feel a lump or have breast pain to come in for a mammogram. The problem with this practice is that early, curable breast cancer does not show up as a lump or breast pain. It is a microscopic, painless seed of destruction lurking in your breast for years becoming bigger and bigger until it shows up as a lump that you can feel. Unfortunately, 50% of all women who come for mammography because of a lump that turns out to be breast cancer on biopsy, have regional spread of the cancer to their underarm lymph nodes. This is stage 3 breast cancer by definition and is much harder to treat and cure than stage 1 or 2 that represents breast cancer before it can be felt. Screening for breast cancer every year helps to discover that small seed of cancer before it becomes a large mature cancer that can kill.

Fact #4: Breast cancer is more common in older women but is deadlier in younger women.

The older a woman gets, the more likely she will get breast cancer. The incidence of breast cancer peaks at 65-70 years of age but can be discovered in women as young as 20 years old (this is rare, except for women with a strong family history who have the BRCA gene). The breast cancers that form in older women tend to be slow growing with slow spreading over time. The breast cancers that form in younger women, however, tend to grow rapidly and spread like a wildfire in the body.

Fact #5: 75% of all breast cancers are found in women with no family history.

Therefore, even though you have no family history of breast cancer, that doesn’t mean that you won’t get it. It does mean that you are less likely to get it (only 12% or 1 in 8 lifetime risk) as compared with those who have strong family histories (20% or 1 in 5 lifetime risk or more). This deserves repeating: Most women who get breast cancer have NO family history. Screening only women who have a family history of breast cancer will potentially doom 75% of women who develop breast cancer to an early death, especially if they are young.

Fact #6: The best time to start screening for breast cancer (for a woman with no family history) is at age 40 with annual 3D screening mammography.

This annual practice will help prevent the less likely but deadlier event of breast cancer in younger women. Screening every year or every other year from age 50-80 will catch the more likely breast cancers, preventing untimely and completely unnecessary deaths in those women with potential decades of future high-quality life. Fact #7: The best time to stop screening for breast cancer is 5-7 years prior to expected death from other disease or old age. Therefore, if you are reasonably healthy, I would keep screening for breast cancer indefinitely.

With these facts in mind, what are you waiting for? Call 432-221-2300 to schedule your screening mammogram today. You may be lucky and win the lottery after all, and by having your annual mammogram, you’ll live long enough to spend all your lottery money.

This post was written by Dr. Jess Dalehite, Radiologist at The Breast Center.