Early Detection and Screening
Screening
The term 'screening' refers to tests and examinations used to find a disease (such as cancer) in people who do not have any symptoms. The goal is to find the disease early before it has a chance to spread. The size of the tumour and how far it has spread are the most important factors determining the final outcome for the patient.
Therefore, the early detection of breast cancer can be the key to survival or in other words, the earlier the cancer is found, the better the chances that treatment will work.
Breast self-examinations (BSE), clinical breast examinations (by a trained doctor or health care professional) and screening mammography are therefore important in detecting breast cancer at an early stage.
Who should be screened?
Screening can be done on:
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the whole population at risk (all women above 18 years of age) or
- on the population at highest risk.
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women with a past history of breast or ovarian cancer, |
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women with a family history of one or more first or second degree |
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relatives with breast cancer before the age of 50 years, |
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women in the age group of highest incidence, above 40 years, |
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women on Hormone Replacement Therapy (HRT) |
The guidelines on screening for breast cancer vary from country to country. These guidelines are drawn-up by health and economic professionals based on the incidence statistics, the 'at risk' population, available medical resources (including personnel and equipment) as well as the country's economic resources.
In Malaysia, population-based screening is not recommended. Screening, however, should be considered in high risk women. (as above)
The following link gives a summary of the current recommendations for screening in the USA. Please note that the incidence of breast cancer varies according to the population genetics as well as other environmental factors and these recommendations therefore cannot be extrapolated directly for use in other countries.
http://www.imaginis.com/breasthealth/earlydetection.asp
Which tests are useful for screening?
a) Self-Breast Examination (BSE)
Research has shown that BSE plays a small role in finding breast cancer compared with finding a breast lump by chance. In recent years, the American Cancer Society and other organisations no longer recommend that BSE is done monthly. This is because studies indicate that BSE does not increase the chances of survival from breast cancer. Despite this, these organisations suggest that if BSE is performed correctly, women can detect changes and can then bring them promptly to the attention of a medical professional. If you do BSE regularly, you get to know how your breasts look and feel normally and thus increase your chance of detecting any change early. Remember, finding a breast cancer tumour when it is smaller improves the chances of saving a breast by avoiding a mastectomy, and may reduce the need for extensive cancer therapy.
How and when to do BSE
b) Clinical Breast Examination
A clinical breast exam (CBE) is an examination of your breasts by a health expert such as a doctor or trained nurse. For this examination, you will need to undress from the waist up. The examiner will first look at your breasts for changes in size or shape. Then, using the pads of the fingers, she or he will gently feel your breasts for lumps. The area under both arms will also be checked. This is a good time to learn how to do breast self-exam if you don't already know how.
A small percentage of breast cancers are not detected by mammography but can be felt during a clinical breast examination. Therefore it is important that a woman have both her mammogram and clinical breast exam done in the same month.
For more information, please visit:
http://www.imaginis.com/breasthealth/earlydetection.asp#cbe
http://www.cancer.gov/cancertopics/wyntk/breast/page5
c) Mammography
A mammogram is a special type of x-ray of the breast using low-dose X-rays to create detailed images of the breast. The low-dose of radiation that a women is exposed to during a mammogram is extremely small and not a potential for causing cancer.
This test is used to look for breast disease in women who do not seem to have breast problems (screening mammography) and also when there are symptoms such as a lump, skin change, or nipple discharge (diagnostic mammography). Once a lump is discovered, mammography can be the key to evaluating whether the lump is cancerous
The US Food and Drug Administration reports that mammography can find 85 to 90 percent of breast cancers in women over 50 and in some cases, can discover a lump up to two years before it can be felt.
Screening mammography is recommended every one to two years for women once they reach 40 years of age and every year once they reach 50 years of age. It may also be recommended earlier in some with a strong family history of breast cancer.
During a mammogram pressure is put on the breasts and this can be uncomfortable or painful, depending on your own pain threshold. However, the discomfort is only for a few moments. The benefits of mammography far outweigh any discomfort or pain experienced during the procedure.
Visit the link below for more information on mammography - how it is performed and frequently asked questions.
http://www.imaginis.com/breasthealth/mammography.asp
For other tests that your doctor may have recommended (ultrasound, MRI, fine needle aspiration cytology or core-biopsy), please visit the link below.
http://www.cancer.org/docroot/CRI/content/CRI_2_2_3X_If_breast_cancer_is_suspected_5.asp?rnav=cri
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