Breast Cancer: Early Detection and Screening

One in seven women will be diagnosed with breast cancer during her lifetime. Worldwide, breast cancer is the second leading cause of cancer deaths in women, after lung cancer.

Over 75% of women diagnosed with breast cancer are age 50 and older. All women are at risk of breast cancer and must know that the most important factor in treating breast cancer is to find it early.

Regular breast self-examination is recommended and clinical examination by a healthcare professional should be performed urgently if a breast lump is found. Mammography has also developed so that it is now the most effective way to find breast cancer early; often a lump is even large enough to be felt.

Who is at risk of getting breast cancer?

Some women are at more risk than others:

• Most breast cancers occur in women over the age of 50. The risk of breast cancer increases as a woman gets older.

• A woman who has a family history of breast cancer has a higher chance of developing breast cancer.

• Women who have taken hormone replacement therapy for a long time have a higher risk of developing breast cancer.

One percent of all breast cancers occur in men.

What is the best method of detecting breast cancer?

Combining regular breast self-examination, clinical examination and a high-quality mammogram is the most effective method for detecting breast cancer.

What will happen when I come for my breast screening visit?

You will be seen by a doctor who will discuss your situation and make an assessment of your risk factors, including your family history. A careful examination of your breasts will be preformed. This is important as many abnormalities can be detected this way. It can also identify areas of your breast where extra attention must be taken when the mammogram is performed. You will also be instructed in the importance and technique of breast self-examination. Many women feel uncertain about how this should be done and worry that they are not doing the examination correctly. We will teach you how and when it should be performed. Following this clinical examination, you will be sent for a mammogram.

What is a mammogram?

A mammogram is a low-dose x-ray picture of the breast. Advances in technology now offer  a digital system that produces a more precise image and exposes you to less radiation.

What is the advantage of digital mammography?

• Digital images can be stored and retrieved electronically, which makes long distance consultations with other specialists easier.

• With this technique, subtle differences in the tissues can be better visualized and detected by the radiologist.

• The number of follow-up procedures can be reduced, therefore reducing overall radiation exposure.

Who should have a screening mammogram?

Most guidelines recommend that women age 40 and older with no breast complaints or symptoms of breast cancer should have a yearly mammogram and should continue to do so for as long as they are in good health. Women with a higher risk of breast cancer or who have a family history of breast cancer should discuss the timing of their mammograms with their doctor as they may need to have a baseline mammogram at an earlier age. Women who have breast symptoms, an abnormality during physical examination, or breast implants require a diagnostic mammogram for better evaluation of their breasts.

What should I do on the day of the mammogram?

Do not use deodorant, talcum powder, creams or lotions on your breasts or underarms. These products leave a residue that can make your mammogram difficult to read. Bring any previous mammogram films with you, if possible, to allow the radiologist to assess any changes.

How is a Screening Mammogram performed?

A mammogram usually takes 10-15 minutes to perform. Two images of each breast are taken while utilizing compression or pressure. The compression can be a little uncomfortable. However, it is essential for obtaining quality images. To reduce discomfort, it is recommended that women do not schedule their mammogram for one week prior to their menstrual period since breasts are usually more sensitive at this time.

What if the mammogram is abnormal?

An abnormal mammogram does NOT mean cancer. The majority of abnormal mammograms are caused by a benign process. When a mammogram detects a suspicious area, you may be advised to obtain further mammograms of that area, have a breast ultrasound, or see a specialist surgeon. If there is any real concern, a biopsy will be recommended.

Take charge of your health. Examine your own breasts.

Many women believe that breast self-examination is a difficult procedure and that do not have enough medical training to examine themselves. This is NOT the case. Nobody knows your body better than you do and you are the best person to notice any changes.

Remember, the best time to perform the breast self-examination is in the week after your period.

Take your time, relax and do the following:

First, take a good look at your breasts. Stand in front of a mirror with your arms by your sides and look for unusual changes in your breasts: any areas that seem bigger, any areas that seem to be withdrawn, any wrinkling of the skin or any redness or scaliness of the nipples.

Raise your arms above your head, place them behind your bank and look again from different angles.

Lie down. Put your right hand behind your neck. Using your left hand, examine your right breast. Use the finger pads, not the fingertips, and press the breast tissue against the chest wall. Examine in an up-and-down pattern, feeling for any lumps or thickening. Examine your entire breast. Feel into your armpit, checking for any small lumps.

Repeat the examination, this time working around the breast in a circular manner. Starting from the edge, work around in circles, moving towards the center. Do this twice, once using light pressure, the second time pressing more firmly.

Squeeze the nipple and look for any unusual discharge (small drops of colostrums are normal, bleeding is abnormal).

Bring your arm down and again feel your armpit carefully for any lumps.

Repeat the examination of the other breast.

Do regular breast self-examination. See your doctor if you find any abnormal or worrisome areas. See your doctor once a year for a clinical examination. Remember, a mammogram is a helpful diagnostic method which may be recommended for you when you reach 40 years, or earlier if there is breast cancer in your family.