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Breast imaging

Breast imaging is used for the investigation of women with breast symptoms as well as for screening asymptomatic women. Clinicians are encouraged to refer asymptomatic women aged 50–69 years to the national mammographic screening program.

Evidence from randomised trials demonstrated that mammographic screening could reduce deaths by up to 30% in women aged 50–69. The benefit for women aged 40–49 is less clear. Currently available data suggest that screening 10,000 women aged 50–69 over 10 years will prevent approximately 18 deaths, compared to preventing seven deaths in 10,000 women aged 40–49.

As a result, BreastScreen Australia targets women aged 50–69 and advocates two-yearly mammographic screens, however women aged 40–49 and over 70 are also eligible to attend. Apart from population screening, situations in which clinicians may wish to screen for occult cancer include women at high risk of developing breast cancer and those in whom a screening check to exclude evidence of cancer may inform management decisions – for example, an asymptomatic woman scheduled for breast reduction or augmentation surgery.

The use of breast imaging in women at high risk should be in accordance with agreed national guidelines, where they exist. High-risk groups include women with a:

Previous diagnosis of invasive breast cancer.
Previous diagnosis of ductal carcinoma in situ (DCIS).
Previous diagnosis of lobular carcinoma in situ (LCIS) or atypical hyperplasia (AH).
Strong family history of breast cancer.