Breast Cancer Screening Recommendations

These are the guidelines:
For the general population, no family history of breast cancer:
Baseline mammogram at age 35 or 37. Mammograms every 1-2 years from 40-50, annual mammography above age 50.

I am sure that you are aware that there is a great deal of controversy regarding annual mammograms in the 40's. I believe that they should definitely be done. It is true that cancer is less common in this age group compared with women above 50, but unfortunatley we do see many cases in young women. Statistically, some argue that the mammograms are not reducing mortality, or saving lives. Well, in my opinion this is not the only criteria to measure, for example if you found an early cancer in a 46 year old women which will only require lumpectomy, but not mastectomy, or chemotherapy, (which might be the case had this only be diagnosed 4 years later), then we have done a great service to this patient and her quality of life. It is true that some of the cases diagnosed in the young women are particularly aggressive, and that the early detection may not save her life, but I do not think this is a reason for not offering it. Furthermore, some of the studies discouraging mammography discuss the anxiety related to additional workups (magnification views and spot views) and unnecessary biopsies, all valid arguments. But the anxiety can be allayed with proper discussions and education, and we are working on not biopsying findings that are not worrisome. But it is true that most biopsies are negative, still... we are doing our best with the technology we have, this may change in the future. I do not know the number of cancers I have identified in women under 50, on screening, but it is great! It is true that I have also biopsied many many benign nodules and calcifications, this is the trade-off.

In women with dense breasts and/or a family history of breast cancer, screening sonography should also be performed annually. Sonography may increase detection by 30% or so.

In women with a strong family history, or personal history of breast cancer, screening MRI should be performed, as well.

If both you and your mother have had premenopausal breast cancer, then genetic testing should probably be performed.
Good luck to you and your mom.

If the patient's mother, sister, or mother's sister had breast cancer you should start annual screening mammography 10 years younger than they were when diagnosed. If mother was diagnosed at 37, start annual screening mammography at 27. Even before that, though, the patient should receive a clinical breast exam once a year by her physician. Breast self examination can also be very helpful for individuals who are not freaked out by it. I don't know what the "high risk" factors are in this individual, but I would usually recommend screening ultrasound annually as well. It could be scheduled 6 months after the clinical breast exam so that you are being checked more frequently.