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Understanding breast cancer screenings: When to start, symptoms to watch for, and the role of advanced mammography

Contrast-Enhanced Mammography particularly beneficial for women with dense breast tissue

A doctor reviews a mammogram at Ackerman Cancer Center. (Ackerman Cancer Center)

Breast cancer remains one of the most common cancers that affects women globally.

According to the American Cancer Society, about 42,250 women will die from breast cancer in 2024. In the United States, the overall average risk a woman will develop breast cancer in her life is about 13%.

Early detection is crucial to improve treatment outcomes and survival rates. Breast cancer deaths decrease by 40% in women who receive a yearly screening mammogram, compared to women who do not.

While traditional mammography is widely accessible and effective for most women to detect early signs of breast cancer, an advanced technique called Contrast-Enhanced Mammography is especially effective for women with dense breast tissue, an area where traditional mammograms might struggle to provide clear results, according to Ackerman Cancer Center.

When to begin breast cancer screenings

Before screenings ever begin, women should begin to regularly perform self-exams in their 20s. By doing this, it will help them to understand the normal feel and appearance of their breast. This can help them to detect changes more easily.

While the American Cancer Society recommends that women begin breast cancer screening between the ages of 40 and 44, the U.S. Preventative Taskforce announced this year that women should begin mammograms at the age of 40.

“What we’ve seen, say, the past 15 years now, is women being diagnosed with breast cancer at a younger age, and there has been an increase incident of women in their 40s being diagnosed with breast cancer,” said Dr. Scot Ackerman said. “I recommend women begin mammograms at age 40.”

After initial screenings, the typical guidelines are:

  • Ages 45-55: Regular mammograms should be conducted annually. At this age, screening and diagnostic mammograms help to detect breast cancer early, when it is more treatable.
  • Ages 55 and older: Women may opt for screenings every two years or continue annually, depending on their health and life expectancy.

For women at higher risk, such as a family history of breast cancer or other risk factors, earlier and more frequent screenings -- possibly including MRI scans -- might be necessary as early as the age of 30.

Ackerman Cancer Center. (Ackerman Cancer Center)

Recognizing signs and symptoms of breast cancer

Because early-stage breast cancer often does not present noticeable symptoms, it is vital for women to be vigilant.

The common symptoms to watch for are:

  • Lumps or thickened tissue. New lumps or masses in the breast or underarm area are common indicators. These lumps can be hard, painless and have irregular edges, though they can also be soft or round.
  • Changes in breast shape or size. This includes swelling, redness, skin dimpling or an orange peel texture of the skin.
  • Nipple changes: Look out for nipple pain, retraction (turning inward) or unusual discharge.

Despite the significance of these symptoms, many cases of breast cancer are asymptomatic in the early stages, which highlights the importance of regular screenings.

Traditional mammograms vs. Contrast-Enhanced Mammography

Traditional mammography uses low-dose X-rays to create images of the breast tissue. It is effective for most women and serves as the standard method for detecting early breast cancer. However, it has limitations, particularly for women with dense breast tissue, which can obscure abnormalities.

Contrast-Enhanced Mammography (CEM), is an advanced technique that involves the use of a contrast agent to highlight areas of increased blood flow, often associated with tumors.

“This method is particularly beneficial for women with dense breast tissue, where traditional mammograms might not provide clear results,” Ackerman said.

CEM, offers improved diagnostic accuracy by differentiating between benign and malignant tissues to reduce false positives. It is also ideal for women with inconclusive mammogram results. Ackerman Cancer Center is the first and only comprehensive breast center in Northeast Florida to offer the advanced mammography.

If you are unsure which mammography option is right for you, ask your health care provider.

Tips for breast health

Ackerman said there are several things women can do to contribute to their breast health before, during and after screenings:

  • Perform self-exams. Women should begin to perform regular self-exams starting in their 20s and continue throughout their life.
  • Live a healthy lifestyle. When women maintain a healthy weight, stay active and limit alcohol intake, it can help reduce breast cancer risk. A balanced diet rich in fruits, vegetables and whole grains, along with avoiding smoking, also contributes to overall breast health.
  • Seek out genetic counseling. Women with a family history of breast cancer or genetic mutations like BRCA1 or BRCA2 should consider receiving counseling and might need personalized screening plans, which could include earlier mammograms and MRIs.

Regular breast cancer screenings and awareness of potential symptoms are necessary for early detection and successful treatment. Advancements like CEM provides additional tools for women with dense breast tissue or higher risk profiles.

Always consult with a health care provider to determine the best screening strategy tailored to your individual health needs.

Click or tap here to learn more about breast health and which breast cancer screening and diagnostic services are right for you.