National Comprehensive Cancer Network® (NCCN®) published new NCCN guidelines for patients®: Breast cancer screening and diagnosis to help people understand their personal risk of breast cancer, when they should start screening and how often, so that cancer can be detected earlier, have more treatment options and better outcomes. With this information, they are able to have more informed conversations with their healthcare providers and make active decisions about their long-term health.
The Breast Cancer Screening Guidelines are the latest in the NCCN Patient Guidelines Library®which was published with funding from the NCCN Foundation® and are available for free at NCCN.org/patientguidelines and through the NCCN Patient Guides for Cancer App. The NCCN patient guidelines provide information on nearly 60 types of cancer, as well as topics such as treatment side effects, anxiety management, and survivorship.
There are many, often conflicting, recommendations surrounding breast cancer screening, causing much confusion and concern. These are the latest evidence-based recommendations from breast cancer screening and diagnosis experts from more than two dozen leading cancer centers in the United States.”
Therese Bevers, MD, Professor of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center; Chair of the NCCN Guidelines Panel on Breast Cancer Screening and Diagnosis
“Anyone who has breasts carries some risk of breast cancer, so knowing your risk is key,” said Dr. Bevers. “Most average-risk women should be screened every year starting at age 40, but if there are other risk factors, the provider may recommend an earlier start.” According to the guidelines, women should undergo a breast cancer risk assessment starting at age 25. The increased risk is based on a number of factors, including age and a family history of certain cancers – including ovarian and pancreatic cancer, not just breast cancer.
And regular screening and breast exams are safe and important for pregnant or breastfeeding women, added Dr. Bevers. “A lot of women think they have to put it off, but we can protect the abdomen and the radiation is very low and targeted. It’s important to keep up with screenings. Especially for women whose first pregnancy is in their 40s or older.”
“Annual mammography screening beginning at age 40 is associated with the greatest reduction in mortality among average-risk women,” said Mark Helvie, MD, active professor emeritus of radiology, University of Michigan; NCCN Breast Cancer Screening and Diagnosis Panel Member. “Regular screening and breast exams help detect breast cancer in the earliest, most treatable stages. Getting mammograms at infrequent or irregular intervals limits their effectiveness. For women at increased risk, the NCCN guidelines recommend screening earlier and often include breast MRI in addition to mammography.”
The NCCN Patient Guideline: Breast Cancer Screening and Diagnosis also addresses appropriate evaluation of breast symptoms, which most commonly present as a palpable lump, pain, or nipple discharge, although anything unusual about the breast should be discussed with the physician. Cancer symptoms can be similar to those from benign causes and can also occur in unique ways. So if a provider or patient finds anything unusual, the NCCN guidelines recommend immediate clinical and diagnostic workup with imaging and, in some cases, biopsy to make the correct diagnosis.
“These guidelines will help so many people,” said Sue Friedman, DVM, executive director of Facing Our Risk of Cancer Empowered. “There is general confusion about breast cancer screening guidelines and what people should follow for screening based on their risk. The NCCN Patient Guidelines are an easy way to access up-to-date expert advice in plain language.”
The NCCN Patient Guidelines are based on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), which are frequently updated by multidisciplinary teams of experts from various NCCN member institutions. The patient versions present unbiased expert advice in an easy-to-read format – with clear language, tables, images and a glossary of medical terms.
Patient guidelines are also available for colorectal cancer screening and lung cancer screening. For more information, visit NCCN.org/patients.
National Comprehensive Cancer Network
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