Breast Cancer - Screening

A. Mammography and physical examination are complementary

1. 1. Mammography is more sensitive, but false negative rate of approximately 15%.
2. 2. Physical examination is quite sensitive to lesions over 1 cm.
3. 3. Mammographic screening
   a. Decrease in mortality with mammography in women 50 and older is accepted.
   b. A similar impact on mortality in women ages 40-50 has not been established.
   c. No evidence for value of "baseline" study at age 35.
   d. Screening Guidelines
   
   • i. Begin physical examination at or before age 40.
   • ii. Mammography before 50 if: a) personal history of breast cancerb) family history of early breast cancerc) hard to examine
   • ii. Annual physical examination and mammography from age 50

4. Breast self-examination recommended monthly after age 20