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Breast Screening

Health professional looking at mammogram image

About the Program

Regular breast cancer screening is an important part of a health routine. Here in BC, we have some of the best survival outcomes in Canada for those who do get breast cancer. This success is largely due to improved cancer treatments and participation in breast cancer screening.

Obtaining a regular mammogram is a key component of early detection – regular breast cancer screening can find cancer when it is small, which means:

  • there may be more treatment options
  • it is less likely to spread
  • there is a better chance of treating cancer successfully

The risk of breast cancer increases as you get older; over 80% of breast cancers in BC are found in women 50 years and older. BC Cancer is committed to finding breast cancers early through breast cancer screening through its population-based program.

The Breast Screening Program utilizes standard two-view bilateral mammography (x-ray of the breast) for breast cancer screening. Women ages 40-74 may self-refer to the program; however, it is recommended that by age 50, average-risk women have a screening mammogram every two years. Women are not eligible for a screening mammogram in BC if they have had breast cancer or breast implants, or if they currently have breast symptoms requiring a diagnostic investigation. These patients must speak with their health care provider and may be referred for a diagnostic mammogram.

Breast Screening Guidelines

Should my patient get a screening mammogram? 

Most women age 40 to 74 can have a screening mammogram every 2 years. For those at higher risk for breast cancer, screening should be considered as early as age 30. 

For people who have or have not had Chest Construction Surgery, or who have breast (chest) tissue from taking gender-affirming hormones, refer to the Screening Strategy Based on Anatomy Present section for more information. Screening is also available for Two-Spirit, transgender or gender-diverse (TTGD) individuals.

Average Risk

 
Routine screening mammogram is not recommended (refer to High Risk section below).

 
Screening mammography is available every 2 years. Speak with the patient about the benefits and limitations of mammography.

No referral required. Patient can call a breast screening centre directly or 1-800- 663-9203 to book their appointment.

 
Routine screening mammogram every 2 years.

No referral required. Patient can call a breast screening centre directly or 1-800- 663-9203 to book their appointment.

 
Screening mammography is available every 2 years if the patient is in good general health. Speak with the patient about the benefits and limitations of mammography.

No referral required. Patient can call a breast screening centre directly or 1-800-663-9203 to book their appointment.

Higher than Average Risk

 
First degree relative (parent, child, sibling) with breast cancer.
  • Routine screening mammogram every year.
  • No referral required. Patient can call a breast screening centre directly or 1-800- 663-9203 to book their appointment.

 
First degree relative (parent, child, sibling) with breast cancer.
  • Screening mammography is available every year if the patient is in good general health. Speak with the patient about the benefits and limitations of mammography.
  • No referral required. Patient can call a breast screening centre directly or 1-800- 663-9203 to book their appointment.
  • Screening mammography is available every year if the patient is in good general health. Speak with the patient about the benefits and limitations of mammography.
  • No referral required. Patient can call a breast screening centre directly or 1-800- 663-9203 to book their appointment.

High Risk

 
Thoracic radiation between age 10 to 30
Very strong family history: 

Two cases of breast cancer in biological relatives (parent, child, sibling, grandparent, aunt, uncle, great-aunt, great-uncle) on the same side of the family, with both diagnosed before age 50, or 

Three or more cases of breast cancer in biological relatives (parent, child, sibling, grandparent, aunt, uncle, great-aunt, great-uncle) on the same side of the family, with at least one diagnosed before age 50.
  • Routine screening mammogram every year
  • Initial referral required only, if patient is under age 40. Recommend referral to Hereditary Cancer Program if not done already.
Known pathogenic gene variant carrier (BRCA1, BRCA2, ATM, CDH1, CHEK2, NBN, NF1, PALB2, PTEN, STK11, TP53, Other). 
  • Routine screening mammogram every year
  • Initial referral required only, if patient is under age 40. Recommend referral to Hereditary Cancer Program if not done already.
Untested family member of a known pathogenic gene variant carrier (BRCA1, BRCA2, ATM, CDH1, CHEK2, NBN, NF1, PALB2, PTEN, STK11, TP53, Other).
  • Routine screening mammogram every year
  • Initial referral required only, if patient is under age 40. Recommend referral to Hereditary Cancer Program if not done already.

 
Patient is in good general health
  • Screening mammography is available every year. Speak with the patient about the benefits and limitations of mammography.
  • No referral required. Patient can call a breast screening centre directly or 1-800- 663-9203 to book their appointment.

Symptomatic

 
Do not screen. Refer for diagnostic imaging.

Symptoms include: 
  • A mass, lump, thickening or any change in the breast that is new or stays over time 
  • A lump that gets bigger or the whole breast gets smaller or bigger 
  • Nipple starts to draw in 
  • Dimpling or puckering of the skin of the breast 
  • Nipple changes or discharge 
  • Breast is red, swollen or hot 
  • A lump under the arm or in the armpit

Screening Strategy Based on Anatomy Present 

 
TTGD patient with NO history of chest reduction/chest construction surgery (bilateral subcutaneous mastectomy
  • Screen as per sex assigned at birth (refer to above).

TTGD patient with history of chest reduction surgery (simple reduction mammoplasty

  • Screen as per sex assigned at birth (refer to guidelines by age and risk level above).

 
TTGD patient with removal of most, but not all, breast tissue (some tissue used to contour shape of the chest) 
  • Screening mammogram is not recommended. Recommend regular follow-up. If at high-risk or other concern, consider physical exam and/or diagnostic ultrasound or other modality.
TTGD patient with breast implants
  • Ineligible for screening through the BC Cancer Breast Screening Program. Recommend regular follow-up. If at high-risk or other concern, consider physical exam and/or diagnostic ultrasound or other modality.

 
Taking estrogen for at least 5 years
  • Screen as per Breast Screening Guidelines (refer to guidelines by age and risk level above).
Management of Screening Mammogram Results

 

The patient will receive their results in the mail within 3 weeks. They will receive a reminder letter in the mail when they are due for their next mammogram.‎

 

 
More tests are needed to provide more information to help determine if any treatment is required. 

BC Cancer Breast Screening will send the results directly to you and facilitate the fast-track referral for the patient’s first round of diagnostic testing. A diagnostic facility will call the patient to book the additional recommended testing. Once complete, you will receive the diagnostic results to share with your patient.

 

Resources
Find patient education, promotional and program materials. 

Breast screening resources
SOURCE: Breast Screening ( )
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