Breast cancer is the most common cancer in American women. Detecting breast cancer early and getting treatment at the right time are the most crucial strategies to prevent deaths from this disease. There are methods to detect breast cancer early, when it is small and has not spread. When the disease is detected in an early stage, chances of successful treatment and better outcomes are high due to the availability of increased number of treatments, longer survival and improved quality of life.
The American Cancer Society recommends screening guidelines for the early detection of breast cancer. Screening tests help find breast cancer before any symptoms (like a lump that can be felt) appear.
Screening involves performing tests and exams to find a disease in people who don’t have any symptoms. Early detection means finding and diagnosing a disease earlier than if your waited for symptoms to start. Breast cancer found during screening tests will be probably smaller and still restricted to the breast. Breast cancer size and the range of spread are crucial factors in estimating the prognosis of a woman with this disease.
The American Cancer Society recommends mammography, clinical breast exam, and breast self-exam as early detection methods for women at average risk. Average risk women are considered as the women who don’t:
- Have a strong family history of breast cancer.
- Have a strong personal history of breast cancer.
- Have a genetic mutation known to increase risk of breast cancer like in a BRCA gene and has not had chest radiation therapy before 30 years old.
The recommended detection methods for women at average risk are as follows:
- Mammogram: Mammogram is the most important screening test for breast cancer. It is a low-dose x-ray of the breasts. Having regular mammograms can help detect breast cancer at an early stage, when the treatment is most effective.
If your mammogram is normal, continue to get mammograms according to recommended time intervals. It helps the radiologists to compare your latest results with the previous results and can look for changes in your breasts. If your mammogram is abnormal, you will need more tests, mammograms, or exams to determine if the detected change is cancer or not. You will also be referred to a breast specialist or surgeon to diagnose the problems. They will do follow-up tests to diagnose breast cancer or to find that there is no cancer.
Generally, regular mammograms aren’t recommended for women under 40 years of age, in part because breast tissue tends to be dense and it makes the mammograms less effective. For younger women with a family history of breast cancer and other risk factors, the American Cancer Society recommends mammograms for women ages:
- Between 40 and 44 years of age should have a choice to begin screening mammograms yearly if they would like.
- From 45 to 54 should do mammograms yearly.
- 55 and over should continue getting mammograms every 1 to 2 years.
While mammograms are the best cancer screening tests, women should understand that they are not 100% accurate in showing if a woman has breast cancer. They can give a negative result even if the breast cancer is present and a positive result even though there is no cancer in the breast. So, it is important that women who do mammograms know what to expect and understand the benefits and limitations of screening.
Tips for getting a mammogram:
- Try not to get your mammogram during your periods or the week before you get your period because your breasts may be tender or swollen then.
- Don’t wear deodorant, perfume or powder on the day of your mammogram; these products will display as white spots on the X-ray.
- Clinical breast exam and breast self-exam: Clinical breast examination is the examination done by a trained health professional of woman’s breasts before the woman herself notes it. It is performed to detect if there is any changes on the breast like skin changes, nipple discharge, lumpiness, or change in shape or size. There is only a little evidence showing that this method is effective for early detection of breast cancer who are already undergoing regular mammogram screening. For women who are not getting regular mammograms, this method may be useful. This method is not recommended for breast cancer screening among average risk women at any age.
Regular breast self-exams or clinical breast exams are not recommended by the American Cancer Society as a part of a routine breast cancer screening schedule; but it doesn’t mean that these exams should never be done. In some situations, for women at average risks, healthcare providers still offer clinical breast exams along with offering counseling about the risk and early detection. Many women find it comfortable doing regular self-exams to keep track of the look and feel of their breasts. Keep in mind that there is a very little evidence showing that doing these exams routinely is helpful for women at average risk of breast cancer.
Women who are at high risk for breast cancer based on specific factors should get a mammogram and a breast MRI annually, starting age 30. Women who are considered at high risk are the one who have:
- A first degree relative (parents, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation and haven’t had any genetic testing themselves.
- Any syndromes like Cowden syndrome or Li-Fraumeni syndrome, Bannayan-Riley-Ruvalcaba syndrome or have any first degree-relatives with any of these syndromes.
- A known BRCA1 or BRCA2 gene mutation.
- A lifetime risk of breast cancer of about 20% to 25% or greater according to risk assessment tools (mainly based on family history) and had chest radiation therapy between the ages 10 and 30.
A woman should be familiar with how her breasts usually look and feel and consult the doctor if there are changes such as:
- A new lump or lumpiness, specifically one-sided.
- Change in breast or nipple size or shape.
- Unusual pain, specifically one-sided.
- Nipple discharge.
- Change in the breast skin.
There are risk factors for breast cancer that you can change and cannot change. Understanding these risk factors and taking steps to detect breast cancer early will help reduce your risk of developing breast cancer.