Cancers detected in their early stages are most successfully treated.
Since the introduction of the Coronavirus in the United States, many women have pushed cancer screenings to the back burner. It’s important to keep screenings up to date. With this month’s attention to Breast Cancer Awareness, it’s timely for women to focus on screenings that can be life-saving.
“Mammogram recommendations have changed,” said Anjali Mahoney, MD, MPH, a family medicine physician with Keck Medicine of the University of Southern California (USC) in Los Angeles who has a special interest in women’s health. “The American College of Obstetrics and Gynecology recommends women receive a mammogram every one to two years, beginning at age 40, based on shared decision-making with their health care provider until they are at least 75 years old.”
She added, “It is very important that women receive the screenings available to them. My practice is seeing more later stages of breast and cervical cancer due to women putting off important preventive screenings during the pandemic. I urge women not to delay their cancer screenings.”
In some instances, women can benefit from more intensive screenings, according to Mary Yamashita, MD, a clinical professor of radiology at the Keck School of Medicine of USC. “Women with dense breasts can benefit from more thorough breast screenings because dense breasts put them at a higher risk of developing breast cancer. Additionally, it can be challenging to determine the difference between the dense breast tissue and cancer on a mammogram, leading to missed cancer diagnoses.”
For that reason, Yamashita suggests more detailed screenings. “I recommend that all women, especially those with dense breasts, ask for a 3D mammogram (digital breast tomosynthesis), which can detect small cancers hidden within dense breast tissues. Scientific literature indicates that by adding a 3D mammogram, there is an increase in invasive cancer detection rates by 40% to 50%. Additionally, for the most accurate results, all women should request that a dedicated breast radiologist read their mammograms,” she said.
Yamashita described two other options for women with dense breasts, including a whole-breast screening ultrasound, which can be performed in addition to a mammogram. A breast MRI is recommended for women at a high risk of developing breast cancer, alternating with a mammogram every six months. “Any woman with dense breasts and at high risk should consult with her doctor to determine the best course of screening unique to her situation and background,” she said.
Women also need to remain vigilant with respect to gynecologic cancer screenings. “The recommendation for cervical cancer screenings has changed over the years,” said Annie Yessaian, MD, who specializes in gynecologic medical oncology at the Keck School of Medicine of USC.
“There is only one type of gynecologic cancer for which routine screenings are proven to detect early cancers and prevent death—cervical cancer,” she said. “Cervical cancer is slow-growing and typically preventable with regular pap tests (or pap smears), which look for abnormal cells that can lead to cancer. A newer screening, the HPV (human papillomavirus) test also screens for cervical cancer. Both screenings can be done during the same visit.”
Current guidelines suggest women aged 21 to 29 should receive a pap smear every three years. Women aged 30 to 65 should receive both the pap and HPV screenings every three to five years, depending on any history of abnormal test results. Women aged 65 and over, depending on their health history, can often stop having cervical cancer screenings. Discussions with their providers can determine their necessity.