Breast cancer screening
Recommended by Cancer Australia as a population-based screening tool, mammography is the only means of screening shown to reduce breast cancer mortality (Cancer Australia 2015b). In screening mammography, 2 views are taken of each breast; radiologists then study the images, looking for suspicious characteristics that require further investigation. Screening mammography, like screening tests used in other screening programs, is not intended to be diagnostic; rather, it aims to identify people who are more likely to have cancer, and therefore require further investigation from diagnostic tests.
Screening mammograms work well in older women as breasts become less mammographically dense as women age, particularly after menopause. This is why mammograms become more effective as women get closer to age 50. Incidence of breast cancer is also much higher in older women, with 81% of breast cancers occurring in women aged 50 and over (AIHW 2024b).
Mammographic screening is not recommended for women younger than 40 (Lauby-Secretan et al. 2015) as breast tissue in pre-menopausal women tends to be mammographically dense, which can make it difficult to correctly identify the presence of breast cancer by this means. The reduced accuracy of mammography in younger women has a high risk of false positive and false negative results, potentially resulting in high numbers of both unnecessary investigations and missed breast cancers (Irwig et al. 1997; Cancer Australia 2015b).
AIHW (2024b) Cancer data in Australia, AIHW, Australian Government, accessed 15 August 2024.
Cancer Australia (2015b). Early detection of breast cancer. Sydney: Cancer Australia. Viewed 11 August 2023.
Irwig L, Glasziou P, Barratt A & Salkeld G (1997). Review of the evidence about the value of mammographic screening in 40–49 year old women. Sydney: NHMRC (National Health and Medical Research Council) and NBCC (National Breast Cancer Centre).
Lauby‑Secretan B, Scoccianti C, Loomis D, Benbrahim-Tallaa L, Bouvard V, Bianchini F et al. (2015). Breast‑cancer screening—viewpoint of the IARC Working Group. New England Journal of Medicine 372(24):2,353–58.