Breast cancer affects:
4.3/1000 women aged between 35-44
15.7/1000 women aged between 45-54
24.2/1000 women aged between 55-64
33/1000 women aged between 65-74
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Breastscreen, Australia’s excellent breast cancer screening program, has detected breast cancer early for many women allowing earlier and lifesaving treatment.
A free mammogram is available 2 yearly for women aged 50-74. It is also free for interested women aged 40 and above, and over 75.
More info on Breastscreen here
Recent debate has centred around:
- The age at which breast cancer screening should commence
- The type of imaging available outside of the government mammogram program
- Whether screening should occur more frequently than 2 yearly
- Who needs additional screening outside of the government program
My approach is to consider the following:
- An individual woman’s risk
Risk calculators like iPrevent use factors such as family history, lifestyle (exercise and alcohol intake), and breast density to produce an individualised report.
Link to iPrevent
- Breast density
- Breastscreen has recently started reporting breast density for all women who undergo a screening mammogram https://informd.org.au/.
- The denser your breasts are, the less sensitive the government screening is, and your breast cancer risk is also slightly higher.
- Risks and benefits of the newer imaging modalities available
- Newer types of imaging such as 3D mammogram, MRI and ultrasound definitely pick up cancers more frequently and earlier. However, there is also increased radiation with some forms of imaging, increased cost, and false pick-ups which can lead to increased anxiety and further investigation.
- The absolute benefit of these “earlier diagnoses” is currently unknown as there hasn’t been enough time to prove a reduction in mortality. (That is, these early breast cancers could have been picked up later using traditional modalities, with no impact on health or lifespan due to the delay).
In summary, we have an excellent breast cancer screening program available and some exciting new tools available. However, it is important to keep in mind that all tests have limitations and no test is 100% perfect.
Let’s have a discussion together and work out what best suits you according to:
- Your personal risk of breast cancer and whether the simple and mostly effective government program is suitable for you
- Whether there is enough benefit in additional screening to undertake the extra expense, radiation and time
- Most importantly, how we can reduce your breast cancer risk or address factors that may be impacting your risk
References https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/cancer-prevalence