Everything you need to know about breast cancer screening guidelines

No one can ever accuse me of “pink-washing.” (As in only caring about breast cancer awareness during October—and hoping to snag a few more followers in the process.) I’ve always made a big deal about BCA because this disease has literally been part of my life since I was in my mother’s uterus, but this is my first October as a breast cancer survivor (and I’m pretty thrilled about that).

You’ve heard it before and I’ll tell you again, early detection is key not only for surviving breast cancer, but for optimal quality of life after cancer as well. I am continually shocked by questions I get from smart, savvy, highly educated women—so I thought I’d bring in one of the country’s leading breast cancer and breast surgery experts, Dr. Heather Richardson of the Bedford Breast Center in Los Angeles. If you won’t listen to me, hopefully you’ll listen to her!

InsiderBeautyBuzz: Let’s set the record straight… If you’re over the age of 40, you should be getting a mammogram every year, right?
Dr. Heather Richardson: Yes, and this is agreed upon by all of the governing bodies, including the American College of Radiology, American Society of Breast Surgery and American College of Obstetricians and Gynecologists. We all believe that it’s best to detect breast cancer as early as possible. If you have very dense breasts, your doctor may order an ultrasound as well. This is NOT a cause for alarm, even if it’s ordered after your mammogram. The point of annual screenings is to visualize and follow subtle changes within the breasts, and make sure that they are not part of an unhealthy pattern.  

IBB: What about women who have a family history?
Dr. Richardson: As a general rule of thumb, if your mother, sister or aunt had breast cancer, you should begin screening 10 years before they were diagnosed, or at the age of 40 (whichever comes first). However, it’s important to keep your paternal side of the family in mind as well. For example, if your father’s sister had breast cancer in their 30s or 40s, this can carry the same weight of risk. (Your dad’s aunt in their 70s, not so much.) This is why doctors approach risk analysis on a case by case basis and try to identify a pattern.

IBB: What would indicate a need for more frequent or additional screenings such as gene testing or MRIs?
Dr. Richardson: Ideally, someone with a personal history of cancer should be tested for genetic mutations, but there are many more than just the BRCA gene (which only accounts for 5-10% of breast cancers). If someone is found to have a broken or mutated gene, then the people related to them should be tested to see if they share it. Other important markers are early and/or aggressive breast cancer diagnoses on either side of the family, even if you’re BRCA negative.

IBB: For those who send their annual mammogram results to your primary care physician or OB/GYN… When is it time to step up to a breast specialist?
Dr. Richardson: If you don’t have a family history and you don’t have “complicated” (i.e. very dense) breasts, you can stay with your PCP or OB/GYN. Odds are these doctors will refer you to a surgeon or specialist if your breasts are deemed complicated. However, if your doctor feels something and follow-up imaging is inconclusive, it may be best to see a specialist for a second opinion. And if your PCP or OB/GYN recommends any sort of urgent or aggressive treatment from the get-go, definitely schedule an appointment with a breast specialist before you make any decisions.