Right Action for Women. The Christina Applegate Foundation

American Cancer Society Screening Recommendations for Women with Average Risk

• Breast self-awareness. With an average risk for breast cancer, the most important action to take is to know what your breasts feel like. That way, if there are any unusual changes, you can get them checked right away. Report any breast change promptly to your health care provider.
• Clinical breast exam (CBE) about every 3 years in your 20s and 30s and every year from age 40 and over. A CBE is when a healthcare professional checks your breasts for abnormalities.
• Mammography every year starting at age 40 and continuing for as long as you're in good health. Sure, it's uncomfortable. But it can find breast cancer early so JUST DO IT!

National Comprehensive Cancer Network Screening Recommendations for Women with Potentially High Risk.

• Monthly breast self-exam beginning at age 18. Checking your own breasts every month, you get to know what they feel like, so you can recognize anything unusual or abnormal right away.
• Clinical breast exam every 6 months beginning at age 25. Having a healthcare professional examine your breasts for lumps or abnormalities adds another layer of screening that can help detect abnormalities early.
• Mammography every year beginning at around age 25. The recommended age for mammograms depends on how early your family members were diagnosed with breast or other cancers, as well as other factors. Talk to your doctor and genetic counselor about when to start taking mammogram action yourself.

The important thing to remember is that if you're at potentially increased risk, you have to start getting mammograms earlier than women with average risk. This is because when you have a high inherited breast cancer risk, you're also more likely to get breast cancer relatively early in life (the average age for getting breast cancer is around 62; for women with high inherited risk, breast cancer risk starts to increase in the late 20s or early 30s).

The problem with mammograms is that they can miss abnormalities, especially in younger women's breasts that have a lot of dense tissue. That's why it is recommended to combine regular mammograms with regular MRIs for the best possible screening coverage.

• MRI every year beginning at age 25. MRI is the latest addition to the breast cancer screening arsenal. If you test positive for BRCA mutations, you should definitely add MRIs to your screening actions. If you have other family/genetic risk factors, it's not so clear-cut. A genetic counselor can tell you about the pros and cons of MRI and if they are the Right Action for you. Here are some things to consider.

MRI pros

• MRIs can find breast cancers that mammograms might miss.
• Together with regular mammograms, MRIs give young women at high risk the best screening coverage available.

MRI cons

• MRIs can result in "false positives." And lead you to get a biopsy just to find out you didn't need it. For women with average breast cancer risk, getting an MRI probably isn't worth the risk of getting a false positive and having unnecessary procedures. But for women with higher-than-average breast cancer risk, the advantages far outweigh the disadvantages. Because detecting cancer early is the best way to beat it.
• MRIs are expensive. A lot of insurance plans cover MRIs for women with a highter risk of inherited breast cancer but not all. Your doctor's office and genetic counselor can help support your claim if your insurance company first tells you they won't pay. And if they refuse MRI coverage, there are organizations that can help. Learn more about financial support here.