Definition and Purpose of Breast Cancer Screening.
Screening, or screening, is a population-based cancer prevention measure for asymptomatic people, while a medical examination for symptomatic people is called diagnosis.
Breast cancer screening is an effective, simple, and economical way to screen asymptomatic women for early detection, early diagnosis, and early treatment of breast cancer. The ultimate goal is to reduce the mortality rate of breast cancer in the population.
Starting age of women for breast cancer screening.
The general recommendation is to start at the age of 40 years.
Those with a significant genetic predisposition to breast cancer, BRCA1/2 mutation carriers, and patients with atypical hyperplasia of the breast and lobular carcinoma in situ can participate in breast screening earlier.
Mammograms.
Breast cancer screening must include mammography. Its role in reducing breast cancer mortality in the screened population has been recognized by most scholars both at home and abroad.
It is recommended that each breast should routinely be taken in two positions, the cephalopodial (CC) and lateral oblique (MLO) positions.
Mammograms should be independently reviewed by two or more specialized radiologists.
Mammography has poor penetrating power to young dense breast tissues, therefore, it is generally not recommended for women under 35 years of age who have no clear risk factors for breast cancer or no abnormalities are found on clinical examination.
Routine mammography has a low radiation dose and is not harmful to women’s health.
Clinical physical examination of the breast.
It is not effective as a screening method for breast cancer alone, and there is no evidence that it improves the early diagnosis of breast cancer and reduces mortality.
It is generally recommended as a combined screening measure with mammography screening and can compensate for missed mammography screening.
Breast self-examination.
It is not effective as a measure of breast cancer screening alone and cannot improve the early diagnosis rate of breast cancer and reduce the mortality rate.
To increase women’s awareness of cancer prevention, primary care providers are still encouraged to teach monthly breast self-examinations to women at risk, and premenopausal women should be advised to choose 7-10 days after their menstrual period.
Breast Ultrasound.
Alone as a measure for breast cancer screening has yet to be proven. May be beneficial for mammography in younger women and dense breasts.
May be used as a combined screening measure with mammography screening or as a supplemental screening measure for those with BI-RADS-0 mammography screening results.
Breast magnetic resonance imaging (MRI).
It can be used as a supplemental screening measure for suspected cases detected by mammography, clinical breast examination or breast ultrasound.
It is expensive and time-consuming. It can be used in combination with mammography for breast cancer screening in certain high-risk groups, such as those with a significant genetic predisposition to breast cancer, BRCA1/2 gene mutation carriers, and patients with atypical hyperplasia of the breast and lobular carcinoma in situ.
Other tests.
Current evidence does not support the use of near-infrared scans, nuclear scans, and ductal lavage as breast cancer screening methods.
Recommended breast cancer screening methods for Chinese women.
General Women
Women aged 40-59 years: 1 mammogram and clinical examination per year.
Women aged 60-69 years: 1 mammogram and clinical checkup every 1-2 years
Women under 40 years of age in general: 1 breast clinical examination every 1-3 years.
Encourage the teaching of 1 breast self-examination per month to women
Combined mammograms and ultrasounds are recommended.
Women at high risk
Definition: Those with a significant genetic predisposition to breast cancer, BRCA1/2 mutation carriers, and patients with atypical hyperplasia of the breast and lobular carcinoma in situ
Regardless of age, it is recommended to receive a clinical breast examination every 6-12 months and an annual mammogram under the guidance of a medical professional, with a shorter interval between mammograms or combined with breast ultrasound or MRI if necessary. It is recommended that women at high risk be taught to self-examine their breasts once a month.