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Breast Cancer Screening

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Handbook of Gynecology

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Abstract

It is expected that 281,550 women in the USA will be newly diagnosed with breast cancer and 43,600 women will die of the disease this year. The purpose of breast cancer screening is to identify preclinical disease in asymptomatic women as breast cancer survival is improved with early detection. Mammography remains the mainstay of breast cancer screening. Tomosynthesis (3D mammogram) has improved sensitivity with fewer false-positive studies, especially in women with dense breasts. Breast cancer screening recommendations have been in flux. Concerns have been raised about harms of false positives (repeat imaging and/or biopsies for benign findings), overdiagnosis of clinically insignificant breast cancers, and overtreatment. Thus, breast cancer screening recommendations range from initiation of screening at 40 years and performed annually to initiation at 50 years and performed biannually. Data behind breast cancer screening recommendations have been based on trials of primarily non-Hispanic White women, and may not be reflective of breast cancer risk in women of color.

All guidelines recommend cancer risk assessment with a physician and development of an individualized screening program.

Women with the strongest risk factor for breast cancer, including personal history of cancer or atypical breast biopsy or family history of breast cancer, should undergo annual screening mammography. Women known to carry a familial breast cancer gene or at a lifetime risk of breast cancer greater than 20% should undergo annual breast MRI in addition to annual mammogram. Screening should conclude when a woman’s life expectancy is less than 5 years.

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Author information

Authors and Affiliations

  1. Hoag Hospital, Orange County, CA, USA

    Heather R. Macdonald

  2. Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Heather R. Macdonald

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  1. Heather R. Macdonald
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Correspondence to Heather R. Macdonald .

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Editors and Affiliations

  1. Department of Obstetrics and Gynecology and Family Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA

    Donna Shoupe

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Macdonald, H.R. (2023). Breast Cancer Screening. In: Shoupe, D. (eds) Handbook of Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-17002-2_74-2

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  • DOI: https://doi.org/10.1007/978-3-319-17002-2_74-2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-17002-2

  • Online ISBN: 978-3-319-17002-2

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