The best way to screen for breast cancer

Jul 09, 2017 Dr Zulfikar Bux, Features / Columnists

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By Dr Zulfikar Bux

Assistant Professor of Emergency Medicine

Breast cancer is the number one cause of cancer in women. It has a high death rate, especially in developing countries where detection is lower than developed countries. Today we will discuss the best way to screen for breast cancer and who needs to screen for it.  

WHAT IS BREAST CANCER SCREENING?

Breast cancer screening is a way in which doctors check the breasts for early signs of cancer in women who have no symptoms of breast cancer. The main test used to screen for breast cancer is a special kind of X-ray called a mammogram.

The goal of breast cancer screening is to find cancer early, before it has a chance to grow, spread, or cause problems. Studies show that being screened for breast cancer lowers the chance that a woman will die of the disease. 

WHO SHOULD BE SCREENED FOR BREAST CANCER?

Different experts have different recommendations for screening. Starting at the age of 40, it’s important to talk to your doctor about the benefits and drawbacks of screening and decide, with your doctor’s help, whether to get screening and when. If you’re under 40 but have a relative who got breast cancer at a young age, you should also talk to your doctor.

Women aged 40 to 74, and some older women who are healthy, might be offered screening with mammograms. Some women who are at high risk of breast cancer might need to begin screening at a younger age. This might include women who:

• Carry genes that increase their risk of breast cancer, such as the “BRCA” genes
• Have close relatives (such as a mother, sister, or daughter) who got breast cancer at a young age 

WHAT ARE THE BENEFITS OF BEING SCREENED FOR BREAST CANCER?

The main benefit of screening is that it helps doctors find cancer early, when it might be easier to treat. This lowers the chances of dying of breast cancer.

 WHAT HAPPENS DURING A MAMMOGRAM?

Before the mammogram, you will be asked to undress from the waist up and put on a hospital gown. Then your breasts will be X-rayed one at a time. Each breast is X-rayed twice. Each is X-rayed once from the top down and once from side-to-side so that the radiologist can get a good look at all the tissue. To make the breast tissue easier to see, a nurse or technician will flatten each breast between 2 panels. This can be uncomfortable, but it lasts only a few seconds. If possible, avoid scheduling your mammogram just before or during your period. Breasts are extra sensitive at that time. Also, do not use underarm deodorant or powder on the day of your appointment.

 WHAT IF MY MAMMOGRAM IS ABNORMAL?

If your mammogram is abnormal, don’t panic. Nine out of 10 women with an abnormal mammogram turn out not to have breast cancer. You will need more tests to find out what’s really going on.

If your doctor thinks your abnormal result is probably not due to cancer, he or she might suggest that you wait and have another mammogram in six months. If your doctor thinks the abnormal result might be due to cancer, he or she will probably send you for more tests. You might also have other tests if your doctor needs to get a better view of part of your breast. Other tests could include a more detailed mammogram, called a diagnostic mammogram, or an ultrasound of the breast. Ultrasound tests might also be suggested for women whose mammogram shows very dense breasts. That’s because dense breasts can make a mammogram harder to read.

If the other tests still show any suspicious findings, your doctor will probably order a biopsy. During a biopsy, a doctor takes samples of breast tissue and sends them to the lab to be checked for cancer. Biopsies are usually done by taking some tissue from the breast with a needle during a mammogram or ultrasound. But in some cases biopsies involve a small surgery. 

WHAT ABOUT BREAST EXAMS?

Most lumps that are found when a doctor examines the breast turn out not to be cancer. Also, studies have not found that doing both a breast exam and mammogram is better than doing a mammogram alone.

Some women want to do exams on their own breasts. No study has shown that breast self-exams lower the risk of dying from breast cancer, and most experts do not encourage self-exams. Still, if you decide to do breast self-exams, make sure you know how to do them the right way.

 HOW OFTEN SHOULD I HAVE A MAMMOGRAM?

It is not clear what the best schedule for mammography is. Many experts suggest screening every two years for most women. Some experts suggest yearly screening for younger women (under age 50 or 55). The schedule for screening might be different for women who have a high risk of breast cancer.

Routine screening with mammograms should continue as long as the woman is healthy and expected to live for at least 10 more years. This is the best way you will be able to decrease your chances of becoming another victim of breast cancer.

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