Breast Cancer Screening Requires Conversations

(CTN News) – Breast cancer screening can be confusing. At what age should women have a screening mammogram? Is there a benefit or a risk? It is imperative to provide clear information to people.

Since health history, patient preferences, and values should be discussed with your health provider in what’s called shared decision making, there is no one answer to these critical questions.

In Canada, over 28,000 people are expected to develop breast cancer this year, and 5,500 will die from it. The outlook for those diagnosed with breast cancer has improved with more effective treatments.

Early detection of breast cancer can be achieved through screening – which includes a specialized X-ray called a mammogram – to check for signs of cancer before symptoms appear.

The Canadian Task Force on Preventive Health Care published a guideline in 2018 regarding breast cancer screening for individuals aged 40-74 at average risk.

In addition to offering best-practice recommendations, the guide aims to help people understand both the benefits and harms of screening.

Starting at the age of 40, it’s always a person’s choice whether or not to get screened based on their own preferences and discussions with their health-care provider.

As a person ages, the likelihood that the benefits of screening will outweigh the harms increases, up to the age of 74.

People at an increased risk of breast cancer, such as those with family histories of breast cancer or who carry gene mutations, are not covered by this guideline.

Breast cancer screening recommendations vary by province and territory in Canada. There are some provinces that recommend screening at 40, while others recommend screening at 50.

Why not just have a mammogram?

False positives can occur when a screening test returns a positive result even though there is no actual disease present.

The result can be anxiety and the need for further unnecessary investigations or more invasive tests like biopsies. Science tells us that not all early cancers progress as we once thought. This can mean life-changing treatments for some people.

Canadiantaskforce.ca offers resources to help patients and health-care providers have the conversation.

As advanced scientific research is conducted, we learn more about the harms and benefits of screening. To provide up-to-date information and updates, the task force reviews its guidelines every five years. It is scheduled for review in 2023.

As of right now, the guidance is: if a person prefers a mammogram, they should have a mammogram guided by shared decision-making with their doctor.

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