Breast Cancer

BREAST CANCER

Breast cancer is the most common cancer among women in the United States, after skin cancer. It has a lifetime risk of 12.5%, and it is the second leading cause of cancer-related death in women. 

It is important that clinicians assess each patient’s breast cancer risk by taking a thor-ough history, because the recommendations for screening differ based on risk factors. A computer program called the Breast Cancer Risk Assessment Tool is available to es-timate a patient’s risk of developing breast cancer.

For women at average risk, there are two major screening examinations for breast cancer: clinical breastexamination and screening mammography. The American College of Obstetricians and Gynecologists (ACOG) recommends:

·  An annual clinical breast examination for all women

·  Screening mammography every 1 to 2 years starting at age 40, and yearly at age 50, for women at average risk.

The American Cancer Society (ACS) recommends:

·  Clinical breast examinations every 3 years for women between the ages of 20 and 39 years at average risk.

·  Annual clinical breast examination and screening mam-mography starting at age 40 for women at average risk.

Despite a lack of definitive data supporting or negating the efficacy of breast self-examination (BSE), BSE has the potential to detect palpable breast cancer and can be recommended.

Ultrasound and magnetic resonance imaging (MRI) have no current role in screening women at average risk. These imaging modalities are used for the assessment of palpable masses. MRI is also recommended, in addition toyearly mammography, for women at very high risk (greater than 20% lifetime risk).