Early detection of breast cancer

This position statement applies to the early detection of breast cancer in asymptomatic women (women without breast changes). The statement does not apply to diagnostic tests used to assess individual women presenting with breast changes.

Summary of recommendations

It is recommended that women of all ages, and regardless of whether they attend mammographic screening, are aware of how their breasts normally look and feel and report any new or unusual changes promptly to their general practitioner.

No one method for women to use when checking their breasts is recommended over another.

Mammographic screening is not recommended for women younger than 40 years of age.

Women aged 40–49 years and 75 years and over are eligible to receive free screening mammograms through the BreastScreen Australia Program but they do not receive an invitation to attend. In deciding whether to attend for screening mammography, women in these age groups should balance the potential benefits and downsides for them.

For women of all ages who are at increased risk† of developing breast cancer it is recommended that an individualised surveillance program be developed in consultation with the woman’s general practitioner and/or specialist.

It is recommended to reduce the risk of death due to breast cancer that women aged 50–74 years attend the BreastScreen Australia Program for free two-yearly screening mammograms having considered the benefits and downsides.

It is important that women of all ages understand the importance of finding and treating breast cancer early. Detection of breast cancer while it is still small and confined to the breast provides the best chance of effective treatment for women with the disease. Benefits of early detection include increased survival, increased treatment options and improved quality of life. For women, increasing age is one of the strongest risk factors for breast cancer with about 75% of cases found in women aged 50 years and older. However, in younger women, tumours are likely to be larger and more aggressive and overall survival is lower than for older women with the disease.4-6 The early detection methods covered by this position statement are:

breast awareness – awareness by a woman of the normal look and feel of her breasts

clinical breast examination – physical examination of an asymptomatic woman’s breasts by a medical or allied health professional

screening mammography – use of mammography in asymptomatic women to detect breast cancer at an early stage (BreastScreen Australia is the national mammographic screening program).

The position statement has two sections – a review of evidence to date about the benefits of these methods in reducing mortality from breast cancer, and recommendations based on this evidence. Recommendations are made for women of different ages who are at population risk* and for women of all ages who are at increased risk† of developing breast cancer. In making the recommendations, Cancer Australia considered the importance of translating population-based evidence into messages that are relevant for individual women. source: canceraustralia.gov.au