Breast Cancer Screening
According to the American Cancer Society, women have a 1 in 8 chance of developing breast cancer during their lifetime. Breast cancer is easier to cure if it is detected early. Mammograms, breast physical examinations and breast self-examinations are the screening tests used to detect breast cancer and save many lives each year.
Breast Examinations and Mammograms
Screening for any disease involves examining healthy people who have no symptoms. Screening tests are designed to find early signs of a disease and facilitate early diagnosis and treatment.
Women should begin screening for early signs of breast cancer at age 20 by conducting a monthly breast self-examination and being physically examined by a doctor at least every 3 years. Beginning at age 40, women should have a mammogram and a physical exam annually.
All women should begin breast self-examinations (BSEs) monthly starting at age 20. Performing this exam regularly allows a women to become very familiar with the normal look and feel of her breasts and be able to identify any changes that occur.
A BSE involves examining your breasts in a mirror and then feeling their entire surface to detect changes that could be early signs of breast cancer. These signs include new lumps or knots, changes in size or shape, swelling, nipple discharge and pain or tenderness. For instructions on how to perform a BSE, see Breast Self Exam, from nationalbreastcancer.org. Be sure and discuss any questions you may have with your doctor and ask him or her to demonstrate a BSE when you go in for a physical exam.
Women who are menustrating on their monthly exam date should wait a few days, as the breasts may be lumpy or swollen and inconsistent with their normal appearance. Women should continue to regularly examine their breasts during pregnancy and breastfeeding.
Though the majority of lumps or other changes do not turn out to be cancer, women should immediately contact their doctor to schedule a physical exam if they notice anything during a BSE.
Breast Physical Examinations
The American Cancer Society recommends that all women ages 20-39 have their breasts physically examined by a doctor at least every 3 years. Beginning at age 40, the exam should take place annually, and can often be scheduled in conjunction with the annual mammogram.
A regular physical exam plays an important role in detecting early breast cancer. Someone who is experienced in breast examination and recognizing abnormalities may find something that was missed during a self-exam.
Women should have their breasts physically examined monthly during pregnancy. During this time, the breasts increase in size, the areola and surrounding area become darker and the nipples become larger and more firm. It may be difficult to distinguish any abnormalities from the natural changes to the breasts that occur during pregnancy.
The American Cancer Society recommends that all women over 40 receive annual mammograms. Mammography, which is a low-dose x-ray examination of the breast, is the best method for detecting early breast cancer and the only exam currently approved by the U.S. Food and Drug Administration (FDA).
A screening mammography usually involves two views of the breast — from above and at an angle — and is performed to screen the breasts for abnormalities. If an abnormality is detected, a diagnostic mammography may be performed and x-ray views taken specifically to examine the abnormality. Additional breast imaging, such as biopsy or ultrasound, may be required depending on the results of the diagnostic mammography.
Mammograms and Breast Implants
All women over 40, including women with breast implants, should receive a mammogram annually. Women with breast implants should let the technician know about their implants so that a special technique can be used to see as much of the breast tissue as possible.
Technicians experienced in performing mammograms on women with breast implants use a special technique called "implant displacement views" that require more x-ray views to see as much of the breast tissue as possible. Still, implants may hide up to 25% of breast tissue from the x-rays, depending on where the implant is placed, the size of the implant and the amount of breast tissue. A study funded by the National Cancer Institute found that mammograms missed 55% of breast cancers in women with implants as compared to 33% in women without implants.
In rare instances, a breast implant can rupture due to compression of the breast during a mammogram. Your technician should exercise special care to avoid rupture when the breast is compressed.