Who Should Be Screened?

What is 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.

Screening can be done on:

i. the whole population at risk (all women above 18 years of age) or
ii. on the population at highest risk.

for example:

  • women with a past history of breast or ovarian cancer,
  • women with a family history of one or more first or second degree
  • relatives with breast cancer before the age of 50 years,
  • women in the age group of highest incidence, above 40 years,
  • 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.