I. Can breast cancer be detected early? Breast cancer is a common and frequent disease among women. Breast cancer is a common malignant tumor among women worldwide and its incidence is increasing year by year. According to the statistics, about 2.5 million people are diagnosed with breast cancer and 500,000 people die from breast cancer every year worldwide. In recent 10 years, the incidence of breast cancer in Beijing, Tianjin, Shanghai and other major cities in China also ranks the first among female malignant tumors, so early detection, early diagnosis and early treatment are the keys to reduce the mortality rate of breast cancer. So, can breast cancer be detected early? The answer is yes, according to the World Health Organization survey, breast cancer is the tumor that can reduce the mortality rate through secondary prevention after cervical cancer, and its prognosis is better. In some developed countries in Europe and America, the detection rate of early breast cancer has been greatly improved due to regular mammograms. the mortality rate of patients aged 40-49 years has been reduced by 20%, and that of patients aged 50-69 years can be reduced by 20%-40%, therefore, the World Health Organization has listed breast cancer as one of the human tumors with effective screening. Screening and detection of breast disease in women is crucial to improve women’s health. Second, how to detect breast cancer early? How to conduct screening to detect breast cancer? This is a question of concern to the majority of women. It is a conscious method of self-care, which has the advantages of being economical, convenient, not limited by time and not damaging to human body. It is helpful to detect breast cancer by paying attention to whether there are lumps in your breast, whether there are enlarged lymph nodes in your armpit, whether there is overflow from your nipples and what kind of overflow. However, breast self-examination is affected by the difference of self-examiners’ own awareness of breast cancer, and most of them are in the middle and late stage of breast cancer when lumps are found, thus delaying the treatment and reducing the survival rate. Apart from self-examination, women can also go to the hospital and ask a breast surgeon with rich clinical experience to perform breast palpation, which can also detect some breast cancers. However, either self-examination or palpation by a surgeon can only detect breast cancer that manifests as larger lumps. For smaller breast lumps that are not easy to palpate, mammography (mostly molybdenum or molybdenum-rhodium double target at present), breast MRI, breast ultrasound and other ancillary examinations should be performed. Currently, the most effective and reliable method for early diagnosis of breast cancer is mammography, which is widely accepted by the medical community. In the United States and Canada, the Mammography Quality Control Association requires women over the age of 40 to undergo regular mammography examinations every year. 3. Why can mammography detect early breast cancer? This is because on one hand, mammography can not only show clinically palpable breast lumps for surgery and puncture positioning, but on the other hand, it can show clinically inaccessible lumps and in some cases, can detect early breast cancer two years earlier than experienced physicians. The lump of breast cancer is different from benign lesions. It usually appears as a “burr” or “lobulated” lump with blurred or clear edges on X-ray, and sometimes there are small calcifications inside the lump. The lump is often hard on clinical palpation, relatively immobile, and sometimes adherent to the skin. Another important aspect of mammography is to show microcalcifications within the breast lesion and to accurately localize and characterize them. In some cases, calcifications may appear together with structural distortions and asymmetric densities. Do I need to suspect breast cancer if I find calcification in the breast? There are two types of calcifications in breast tissue, benign and malignant. Benign calcifications are mostly scattered, with clear and uniform edges, transparent ring-shaped calcifications in the center, “popcorn”-like calcifications, rut-like calcifications along the blood vessels, short curved calcifications, etc. Most of the calcifications in breast cancer are scattered, with clear edges and uniform density. In contrast, most of the calcifications in breast cancer appear as clusters of fine-grained calcifications (i.e. sediment-like calcifications), and calcifications distributed along the ducts can appear as short rod-like, worm-like and branched-like, etc. Some women are nervous when they go to the hospital and find calcification in the breast through X-ray. The correct approach is to ask a radiologist who specializes in the diagnosis of breast diseases to evaluate the X-ray film comprehensively and meticulously, and for calcifications suspected to be breast cancer, puncture can be performed under X-ray positioning for early diagnosis. Therefore, women should not be nervous to find calcification in the breast, but should ask relevant experts for further examination and evaluation. A lot of studies and decades of practice have proved that regular mammography is the most effective and reliable way for early diagnosis of breast cancer, however, in China, this kind of examination is still not given sufficient attention, and most breast cancer patients find the lump by themselves instead of through mammography machine, which delays the best diagnosis and treatment period. In fact, most of the early stage breast cancers are curable, and their five-year survival rate is over 90%. In the diagnosis of breast cancer, we must abandon the traditional concept that “a lump cannot be diagnosed as cancer if it is not palpable” and establish the new concept that “a lump may not always be palpable in the early stage of breast cancer”. For the sake of yourself and your family, it is recommended that women over the age of 40 should have regular mammograms every year or two.