Breast Cancer Prevention (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Introduction to breast cancer prevention
- What are the biological causes of breast cancer?
- What are the risk factors for developing breast cancer?
- What is the importance of early breast cancer detection?
- What are the advantages and limitations of mammography?
- How frequently should women undergo mammography and breast examinations?
- What is the risk of radiation with repeated mammography screening over the years?
- Are there any controversies in the area of breast cancer screening?
- How helpful are BRCA1 and BRCA2 genetic tests in identifying women at risk?
- What is the link between estrogen and breast cancer?
- What are breast cancer prevention treatments?
- Are there other breast cancer prevention measures?
- Conclusion
What is the risk of radiation with repeated mammography screening over the years?
With modern mammography equipment, the amount of radiation exposure is extremely small. Although there is no level of radiation without some theoretical risk, there is no evidence of increased breast cancer risks from mammography performed in the recommended manner. Furthermore, the benefits of early detection far outweigh these theoretical concerns.
Are there any controversies in the area of breast cancer screening?
The screening guidelines described above from the ACS and the USPSTF differ in their recommendations for when screening mammograms should begin. The ACS recommends yearly mammograms starting at age 40, while the USPSTF recommends mammograms every two years beginning at age 50.
There is further debate over the issue of mammography screening in young women, as discussed previously. There is also the issue of the emotional trauma of receiving false positive mammogram reports (mammograms that show abnormal changes in the breast that subsequently prove to be noncancerous). However, after evaluating women who have gone through this process, there does not appear to be a lasting problem.
There is no agreement about the practice or importance of breast self-examination, which in the past was recommended for all women. The ACS now states that this practice is optional, while the USPSTF recommends that the practice not be taught to patients.
There is also no standard recommendation for screening women with high risks such as women with a positive family history of breast cancer or those who have inherited defective BRCA1 or BRCA2 genes. After careful counseling, some patients with BRCA mutations may eventually elect to undergo preventive mastectomy to reduce the risks of breast cancer. For those patients who elect monitoring, it is generally accepted that more frequent breast clinical examinations and perhaps, periodically, more involved imaging (ultrasound and MRI) are the minimum measures.
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