What is breast cancer screening?
Breast cancer screening means investigations done in women without any symptoms or signs of breast cancer to detect disease in early stage. This allows early treatment which reduces suffering and death due to the disease.
What investigations are done for breast cancer screening?
Annual clinical breast examination by a doctor and yearly digital mammography (X rays of breasts) is recommended in average risk women. Screening ultrasound is done in patients with dense breast. MRI is used in screening women with high risk of breast cancer.
At what age and who should undergo breast cancer screening?
Every woman should undergo breast cancer screening!!
Average risk women should start breast cancer screening at the age of 40 and is continued yearly till the age 70 years. Then it becomes optional.
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Screening age is different in women with increased risk of breast cancer. Doctors assess the risk using a formula that takes into account woman’s present age, age when she had her first periods (menarche), age at which she gave birth to her first child or nulliparity (no child), number of close blood relatives (first-degree) with breast cancer, number of biopsies done for previous benign breast disease or finding of atypical hyperplasia (a type of finding when we see tumour cells under microscope) in a previous breast biopsy, and type of population she belongs to (race).
Women who previously had atypical hyperplasia is advised by the doctor to undergo annual MRI beginning at the age as early as 25-30 years.
In woman who has family member with breast cancer or genes that can cause breast cancer, MRI/tomosynthesis (CT scan) may be performed as a supplement to mammography for screening, starting from 10 years before the youngest family member was diagnosed with it but not before age 30.
In women, who have received previous chest radiation, annual MRI is recommended 10 years after radiation but not before age 25.
Mistakes a woman makes during self-breast examination:
1. Fast examination: During examination at least spend 5 mins on each breast. If you do it in hurry, that means you might have missed something.
2. Choosing wrong days of the month – During periods, the breast can become heavy/ tender due to hormonal changes, so it’s better to avoid self-breast examination on these days.
3. Using finger tips instead of pads to examine – Our finger pads are more sensitive than the tips, so if someone has difficulty in using pads then can use other sensitive areas of hands, such as pads of hand or back of fingers.
4. Doing it in wrong way – Women can take help of guiding pictures or videos to learn the patterns of examination.
5. Missing examination of underarms, underside of breasts and behind the nipples.
6. Not applying proper pressure during examination – If you want to feel the lump close to skin then light pressure is applied. The pressure is increased with the depth of tissue to be felt.
