Before finding ways you can prevent breast cancer, the best way to fight the disease is early detection. The earlier a tumor is detected, the greater the likelihood of effective treatment and long-term survival. That’s why breast cancer screening is so important.
Breast cancer screening, the ultimate goal of which is to reduce breast cancer mortality in the population. The screening can take the form of opportunistic screening, where women come forward or voluntarily go to a health care facility that offers breast screening, or group screening, where women of appropriate age are offered breast exams in the community or in an organized setting. The following is a detailed description of how to get screened.
Breast cancer screening, what is done?
Breast self-exam
Doctors and women’s health organizations have long emphasized the need for routine breast self-examination in promoting early detection of tumors. Many women may find some early breast cancers that do not show symptoms through breast self-examination or by finding a breast lump in an incidental situation. Therefore, many organizations continue to support self-examination as part of a comprehensive screening procedure. Although many studies confirm that routine breast self-examination does not reduce the mortality rate associated with breast cancer, this does not mean that breast self-examination is useless; its more important role may be to increase women’s awareness and attention to their own breast. It is recommended that premenopausal women perform breast self-examinations 7 to 14 days after their monthly menstrual period. If abnormalities are found, seek prompt medical attention.
Clinical Physical Exam
Although screening mammography is often the first test patients with breast disease receive, there is no evidence that this approach alone as a method of breast cancer screening improves early breast cancer diagnosis and reduces mortality. However, it may still be an option in the initial outpatient setting, when equipment is limited, and subsequently needs to be combined with imaging.
Mammography (x-ray)
A mammogram is a low-dose x-ray examination of both breasts to look for suspicious lumps or areas of change in the breast. The mammogram usually examines each breast in two directions: from the top down (axial) and from the inside out (lateral oblique). Because younger women in China have denser breasts, mammography screening is highly accurate in women over 50 years of age and less accurate in those under 40 years of age and those with dense breasts. Therefore, mammography is not routinely recommended for women under 40 years of age who do not have clear risk factors for breast cancer or who have no abnormalities on clinical examination. It is important to emphasize that the low radiation dose of routine mammography is not harmful to women’s health, but normal women do not need to have repeated mammograms in a short period of time.
Breast ultrasound
Ultrasound can tell if a breast lump is cystic or solid. In Europe and the United States, the use of ultrasound is greatly limited by the large size of the female breast gland. In contrast, the glands of the female breast in China are dense, and breast ultrasound is important for breast cancer screening and diagnosis.
Magnetic resonance imaging (MRI)
Molybdenum and ultrasound are slightly less effective in detecting smaller tumors or in finely resolving the relationship between the tumor and the surrounding area, and MRI has an advantage in this regard. MRI has a detection rate of more than 90% for breast lesions and can detect some occult lesions, making it important in the early diagnosis of breast cancer and in screening for breast cancer in women at high risk. Enhanced MRI can often be performed with intravenous contrast and is more likely to detect areas of lesions with abnormal blood vessels.
Other inspections
While many institutions are performing tests such as near-infrared scans of the breast, nuclear scans, ductal lavage, and blood oxygen testing, the current evidence does not support the use of these tests as breast cancer screening.
When to start breast cancer screening?
- For women in general, opportunistic screening is generally recommended starting at age 40;
- For those at high risk of breast cancer, opportunistic screening can be started earlier than 40 years of age, or individualized in consultation with your physician, and can benefit from earlier screening and the use of other screening methods (e.g., MRI);
- There is no recommended age for cohort screening domestically, and the international recommendation is to start at 40 to 50 years of age.
Who is at high risk for breast cancer?
- Women who test positive for the BRCA1 and BRCA2 mutations.
- Women who are from families with the BRCA1 or BRCA2 gene but have not been tested.
- Women with a lifetime risk of ≥20% and a family history of breast cancer.
- Women with atypical hyperplasia or ductal carcinoma in situ.
- Women who received chest wall radiotherapy between the ages of 10 and 30 years.
Where should I go to get screened for breast cancer?
Breast cancer screening relies on both the screening device and the interpretation of the test results by the provider. Therefore, when choosing a breast cancer screening facility, women should consider the overall strength of the facility, with the cancer prevention department of a large oncology center or the medical screening center of a general tertiary hospital being relatively reliable choices.