Given that the Centers for Disease Control and Prevention (CDC) reports that breast cancer is the most diagnosed cancer in women and that death rates from breast cancer are second only to those associated with lung cancer, every woman should be aware of her own risks and should take an active role in ensuring her health. But the studies and guidelines concerning screenings for breast cancer are constantly changing, and different organizations often have conflicting guidelines. Knowledge of current guidelines, as varied as they may be, is a woman's true ally against cancer.

Screening Basics

Despite the frightening statistics above, breast cancer can be treated and a woman can survive it – especially if the cancer is caught early. The CDC recommends various procedures to screen apparently healthy women for breast cancer.

  • Mammogram: An x-ray of the breast. Screening mammograms are often used for woman without symptoms of breast cancer, whereas diagnostic mammograms are used for women with symptoms.
  • Clinical breast examination (CBE): A doctor or nurse palpates the breast with his or her hands to determine whether there are lumps or other changes in a woman's breast.
  • Breast self-examination (BSE): A woman uses her own hands to check for lumps or changes in her breast.

Of these three, mammograms are the most recommended screening for breast cancer. Research indicates that clinical breast exams are good first indicators, but can easily miss symptoms. Although current studies are mixed regarding the effect of screening mammograms on mortality rates, many doctors agree that, despite the inherent difficulties, they can lead to early detection and treatment.

Basic Guidelines

Two major, trusted scientific and public health organizations recommend different guidelines for breast cancer screening.

The American Cancer Society recommends:

  • Women in their 20s should consider breast self-examinations. BSE familiarizes a woman with how her breasts look and feel.
  • Women should have clinical breast examinations every three years while in their 20s and 30s.
  • Women should commence yearly mammograms when 40, and continue them as long as in good health.

The U.S. Preventive Services Task Force (USPSTF), a group of health professionals who make public health recommendations based on their reviews of current research, recommends:

  • Women should not conduct BSE because there is little evidence that it is a helpful method of screening.
  • Women should not rely on CBE beyond screening mammography at age 40 or older, as there is little evidence to support its efficacy.
  • Women should make her own informed choice as to whether or not to begin screening mammograms before she is 50. Although the USPSTF agrees that regular mammograms can effectively screen for cancer, it also finds that some of the harms of mammography (anxiety regarding false positives, which may lead to unnecessary and expensive biopsies) may outweigh the benefits.
  • Women should have a mammogram every two years between the ages of 50 and 74.
  • Women should be aware that there is not enough evidence for or against continuing regular mammograms after the age of 75.

As you can see, the frequency of mammograms and the ways that BSE and CBE are performed are the major differences between the two organization's recommendations. Most other organizations opt to find middle ground between their recommendations. Breast health awareness, a combination of CBE and/or mammograms once a woman turns 40, and annual or biennial mammograms from the age of 50 to 74 are common recommendations.

Decide With Your Doctor

Women must be knowledgeable about and aware of their own risk of breast cancer. Gender and age are the most common risk factors. The Susan G. Komen Center for the Cure reports that 85 percent of women who develop breast cancer have no genetic history of the disease, but a woman with a first-degree relative (a mother, sister, or daughter) who has been diagnosed with breast cancer is twice as likely to develop it herself; those chances increase exponentially the more first-degree relatives she has who were also diagnosed.

Based on the variety of recommendations regarding screening, a woman should consult with her doctor as to when she should begin CBE and mammograms, and how often to continue them. She should take into account her own personal risk factors and the latest research before coming to a decision that seems appropriate and reasonable to her.