Early detection of Breast Cancer
Screening for breast cancer before there are symptoms can be important.
Screening can help doctors find and treat cancer early.
Treatment is more likely to work well when cancer is found early.
Your doctor may suggest the following screening tests for breast cancer :
Screening Mammogram
A mammogram is the gold standard for breast cancer screening and early detection. Mammograms can often show a breast lump before it can be felt.
They also can show a cluster of tiny specks of calcium. These specks are called microcalcifications.
Lumps or specks can be from cancer, precancerous cells, or other conditions. Further tests are needed to find out if abnormal cells are present.
- Women in their 40s and older should have mammograms every 1 to 2 years. A mammogram is a picture of the breast made with x-rays.
- Women who are younger than 40 and have risk factors for breast cancer should ask their health care provider whether to have mammograms and how often to have them.
You may want to ask the doctor the following questions about screening :
Which tests do you recommend for me? Why?
Do the tests hurt? Are there any risks?
How much do mammograms cost? Will my health insurance pay for them?
How soon after the mammogram will I learn the results?
If the results show a problem, how will you learn if I have cancer?
Expert Quote:
"Mammography plays a critical part in diagnosing breast cancer. In the past, we'd often find that a woman had breast cancer when she came in with a lump. Today, the cancers radiologists find on mammography are usually detected early, before they can be felt by the patient, are smaller than cancers felt by patients, and have much lower levels of lymph node involvement."Susan Orel, M.D.
Mammograms are the best tool doctors have to find breast cancer early. However, mammograms are not perfect :
- A mammogram may miss some cancers. (The result is called a "false negative.")
- A mammogram may show things that turn out not to be cancer. (The result is called a "false positive.")
- Some fast-growing tumors may grow large or spread to other parts of the body before a mammogram detects them.
Mammograms (as well as dental x-rays, and other routine x-rays) use very small doses of radiation.
The risk of any harm is very slight, but repeated x-rays could cause problems.
The benefits nearly always outweigh the risk. You should talk with your health care provider about the need for each x-ray.
You should also ask for shields to protect parts of your body that are not in the picture.
To make up for these limitations, more than mammography is needed. Women also need to practice breast self-examination,
get regular clinical breast examination by an experienced health care professional.
Clinical Breast Exam
During a clinical breast exam, your health care provider checks your breasts.
You may be asked to raise your arms over your head, let them hang by your sides, or press your hands against your hips.
Your health care provider looks for differences in size or shape between your breasts.
The skin of your breasts is checked for a rash, dimpling, or other abnormal signs. Your nipples may be squeezed to check for fluid.
Using the pads of the fingers to feel for lumps, your health care provider checks your entire breast, underarm, and collarbone area.
A lump is generally the size of a pea before anyone can feel it. The exam is done on one side, then the other.
Your health care provider checks the lymph nodes near the breast to see if they are enlarged.
A thorough clinical breast exam may take about 10 minutes.
Breast Self-Exam
You may perform monthly breast self-exams to check for any changes in your breasts.
It is important to remember that changes can occur because of aging, your menstrual cycle, pregnancy, menopause, or taking birth control pills or other hormones.
It is normal for breasts to feel a little lumpy and uneven.
Also, it is common for your breasts to be swollen and tender right before or during your menstrual period.
You should contact your health care provider if you notice any unusual changes in your breasts.
Breast self-exams cannot replace regular screening mammograms and clinical breast exams.
Studies have not shown that breast self-exams alone reduce the number of deaths from breast cancer.
How to do a Breast Self-Exam?
• Step 1
Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.
Here's what you should look for:
- breasts that are their usual size, shape, and color
- breasts that are evenly shaped without visible distortion or swelling
- dimpling, puckering, or bulging of the skin
- a nipple that has changed position or an inverted nipple (pushed inward instead of sticking out
- redness, soreness, rash, or swelling
• Step 2
Now, raise your arms and look for the same changes.
• Step 3
• Step 4
Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast.
Use a firm, smooth touch with the first few fingers of your hand, keeping the fingers flat and together.
Cover the entire breast from top to bottom, side to side rom your collarbone to the top of your abdomen, and from your armpit to your cleavage.
Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. Be sure to feel all the breast tissue: just beneath your skin with a soft touch and down deeper with a firmer touch. Begin examining each area with a very soft touch, and then increase pressure so that you can feel the deeper tissue, down to your ribcage.
• Step 5
Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower.
Cover your entire breast, using the same hand movements described in Step 4.