Early Screening: Improving Your Survival Chances

Fighting breast Cancer

Screening &
Detection

Standard Breast Cancer Screening Tests

Breast cancer can’t be prevented, but today there are many options available to help detect it earlier. 

Screening tests are used to find breast cancer before it causes any warning signs or symptoms. Screening tests can find breast cancer early, when the chances of survival are highest.

Regular screening tests (along with follow-up tests and treatment if diagnosed) reduce your chance of dying from breast cancer.

Breast Cancer Screening Tests

Discovering breast cancer early is one of the most important factors in terms of life expectancy and treatments.

Well documented research results estimate that regular screenings with mammography, have help reduced death cases by 30%.

Mammography is an important test, but it is far from perfect.

It often fails to detect tumors and it can’t identify non cancerous tumors.

These shortcoming are more common in women with dense breasts or women belonging to the High Risk Of Developing cancer Group.

In recent years, Ultrasound Tomography, a different technology using sound waves to create 3D images, has proven more accurate at detecting tumors principally in women with Dense breasts.

Tests & Diagnostics

Regular screening tests and subsequent  follow-up tests and treatment  (in case of positive diagnosis)  increase considerably your chances of not dying from breast cancer.

The most usual breast cancer screening tests for low risk women are clinical breast exam and mammography. For  women considered to be part of the higher than average risk of breast cancer category, breast MRI may also be used.

Sometimes a screening test finds something abnormal; when that happens it is important to explore the anomalies with the help of  follow-up tests.  In this situation, Sooner The Better.

 It’s important to get follow-up without delays, because. If breast cancer is found, early diagnosis and treating it  at the earliest possible stage have a direct correlation with higher survival rates.

Stanford Health care - Dr debra Ikeda & Dr Jafi Lipson
How To detect breast Cancer Early

Types Of tests

The Clinical Breast Exam 

A clinical breast exam is a physical exam performed by a healthcare professional  who has been the undergone training and developed the skills to recognize many different types of abnormalities and warning signs.  This primary physical is part of your regular annual medical check-up

This in-office exam will most likely be completed by your family physician or gynecologist at your annual exam. It is different in nature from the common Self-Exam. Your breast self-exam is something that every woman should try to learn as preventive measure and one that you should at least once at month at home. 

A Visual Check Of Skin And Tissue

During a clinical breast exam, your healthcare provider checks your breasts’ appearance. You may be asked to raise your arms over your head, let them hang by your sides, or press your hands against your hips. These postures allow your healthcare provider to look for differences in size or shape between your breasts. The skin covering your breasts is checked for any rash, dimpling, or other abnormal signs. Your nipples may be checked to see if fluid is expressed when lightly squeezed.

Manual Check For Unusual Texture or Lumps

Using the pads of the fingers, your healthcare provider checks your entire breast, underarm, and collarbone area for any lumps or abnormalities. It is worth noting that some women have breast tissue that appears to be full of tiny fibrous bumps or ridges throughout the breast tissue, known as fibrocystic breasts. Overall lumpy tissue is something your provider will want to note but is unrelated to cancer.

A suspicious lump –the type your physician is checking for– is generally about the size of a pea before anyone can feel it in the breast tissue. The manual exam is done on one side and then the other. Your healthcare provider will also check the lymph nodes near the breast to see if they are enlarged.

Exam Assessment Of ANY Suspicious Area

If a lump is discovered, your healthcare provider will note its size, shape, and texture. He or she will also check to see if the lump moves easily. Benign lumps often feel different from cancerous ones, but any lump found will likely need to be examined with further diagnostic measures.

It may be helpful to know that lumps that appear soft, smooth, round, and movable are likely to be either benign tumors or cysts. A lump that is hard and oddly-shaped and feels firmly attached within the breast is more likely to be cancer, but further tests are needed to diagnose the problem.

The Value of Clinical Breast Exams

Clinical Breast exams are an important part of early detection. Although most lumps are discovered through breast self-exams, an experienced professional may notice a suspicious place that fails to register as a warning in the patient’s mind.

 

Breast Exam Stanford Medicine
Dr. Paula Hillard - Prof. Of Obstetrics & Gynecology

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FOLLOW-UP AFTER AN ABNORMAL CLINICAL BREAST EXAM

For most women, the results of a clinical breast exam (CBE) will be good news. The exam will find no signs of breast cancer.

Abnormal Findings are not common;
however, when found, get follow up ASAP

MammoGraphy

What is a Mammogram?

Mammography uses X-rays to create images of the breast. These X-ray images are called mammograms.

radiologist trained to read mammograms studies the images to look  for early signs of breast cancer.

How does Mammograms help find lumps or tumors?

This technology is one of the best screening tools available today to detect Breast Cancer at early stages – when it is small- and the  chances of patient survival are the highest.

The diagnostic mammogram is used by specialists to check areas of concern found during screening tests such as mammogram or clinical exam.

In the past, mammogram images were stored on film (film mammography).  Today, the mammogram images are usually stored directly onto a computer (digital mammography).

What a radiologist is looking for in digital mammography is signs of cancer that can manifest.  The images can be lightened or darkened, and certain sections can be enlarged and looked at more closely. 

As images can be stored on computer disks, they can be shared easily with another radiologist for review.

Why Do You Need a mammogram?

Mammograms can often show a breast lump before it can be felt and that is an important factor to take into consideration.

They also can show tiny clusters of calcium called microcalcifications. Lumps or specks can be caused by cancer, fatty cells, or other conditions like cysts.

A mammogram is good at finding breast cancer, especially in women ages 50 and older. However, the technology is not perfect.

There have been cases in which a  woman patient was found to have breast cancer that doesn’t show on a mammogram. That is why it is important to know how your breasts normally look and feel.

If you notice any change, see your doctor and tell the technologist about any changes at the time of your mammogram

Further tests are needed to find out if abnormal cells are present.

Women with a family history of breast cancer or other concerns should talk their doctor for directions about when to start getting mammograms.
 
 

Recommendations for all women:

  • Women 40 and older should have mammograms every 1 or 2 years.
  • Women who are younger than 40 and have risk factors for breast cancer should ask their healthcare professional whether mammograms are advisable and how often to have them.

Even women who have no symptoms and no known risks for breast cancer should have regularly scheduled mammograms to help detect potential breast cancer at the earliest possible time.

Image Source: US National Institutes of Health - National Cancer Institute

what Should i do If My Results Are Abnormal?

FOLLOW-UP AFTER AN ABNORMAL CLINICAL BREAST EXAM

For most women, the results of a clinical breast exam (CBE) will be good news. The exam will find no signs of breast cancer.

Abnormal Findings are not common;
however, when found, get follow up ASAP

MammoGraphy

What is a Mammogram?

Mammography uses X-rays to create images of the breast. These X-ray images are called mammograms.

radiologist trained to read mammograms studies the images to look  for early signs of breast cancer.

How does Mammograms help find lumps or tumors?

This technology is one of the best screening tools available today to detect Breast Cancer at early stages – when it is small- and the  chances of patient survival are the highest.

The diagnostic mammogram is used by specialists to check areas of concern found during screening tests such as mammogram or clinical exam.

In the past, mammogram images were stored on film (film mammography).  Today, the mammogram images are usually stored directly onto a computer (digital mammography).

What a radiologist is looking for in digital mammography is signs of cancer that can manifest.  The images can be lightened or darkened, and certain sections can be enlarged and looked at more closely. 

As images can be stored on computer disks, they can be shared easily with another radiologist for review.

Why Do You Need a mammogram?

Mammograms can often show a breast lump before it can be felt and that is an important factor to take into consideration.

They also can show tiny clusters of calcium called microcalcifications. Lumps or specks can be caused by cancer, fatty cells, or other conditions like cysts.

A mammogram is good at finding breast cancer, especially in women ages 50 and older. However, the technology is not perfect.

There have been cases in which a  woman patient was found to have breast cancer that doesn’t show on a mammogram. That is why it is important to know how your breasts normally look and feel.

If you notice any change, see your doctor and tell the technologist about any changes at the time of your mammogram

Further tests are needed to find out if abnormal cells are present.

Women with a family history of breast cancer or other concerns should talk their doctor for directions about when to start getting mammograms.
 
 

Recommendations for all women:

  • Women 40 and older should have mammograms every 1 or 2 years.
  • Women who are younger than 40 and have risk factors for breast cancer should ask their healthcare professional whether mammograms are advisable and how often to have them.

Even women who have no symptoms and no known risks for breast cancer should have regularly scheduled mammograms to help detect potential breast cancer at the earliest possible time.

Image Source: US National Institutes of Health - National Cancer Institute

what Should i do If My Results Are Abnormal?

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what Should i do If My Results Are Abnormal?

Findings on a mammogram

The  X-ray images produced by  mammograms appear in shades of black, gray and white,  similar to other x-ray images.  What influences the image quality and results are Breast tissue density and fatty breast tissue. Depending on the density of the tissue, results may have a different  look on a mammogram.

A mammogram may show:

  • No signs of breast cancer
  • A benign (not cancer) condition
  • An abnormal finding that needs follow-up tests to rule out cancer
 

Abnormal Mammograms

Follow-up after an abnormal finding on a screening test may include a diagnostic mammogram, a breast MRI and/or a breast ultrasound. It’s important to get follow-up without delay.

Although these follow-up tests may be called “diagnostic tools” and may be able to rule out breast cancer, they cannot diagnose breast cancer. 

If the mammogram shows an abnormal area of the breast, your doctor will order additional tests offering clearer, more detailed images of that area.

Although lumps are usually non-cancerous, the only way to be certain is to perform additional tests, such as an ultrasound or MRI. If further tests show that the mass is solid, your radiologist may recommend a biopsy, a procedure in which cells are removed from a suspicious area to check for the presence of cancer.

 
Image Source: http://newsroom.gehealthcare.com/mammography-system-mammo-techs-patients/

Mammograms are very reliable test,
But they aren't perfect.

Breast MRI

BREAST MRI

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QUALITY OF SCREENING TESTS

Sensitivity and specificity

The quality of a screening test is described in terms of:

  • How well the screening test tells who truly has a disease (sensitivity)
  • How well the screening test tells who truly does not have a disease (specificity)

The goals of any screening test are:

  • To correctly identify everyone who has a certain disease (100 percent sensitivity)
  • To correctly identify everyone who does not have the disease (100 percent specificity)

A perfect test would correctly identify everyone with no mistakes. There would be no:

  • False negatives (when people who have the disease are missed by the test) 
  • False positives (when healthy people are incorrectly shown to have the disease)

The trade-off between sensitivity and specificity

No screening test has perfect (100 percent) sensitivity and perfect (100 percent) specificity. There’s always a trade-off between the two.

A test that’s very sensitive will pick up even the slightest abnormal finding. This means it will miss few cases of the disease, but it will also mistake some people as having the disease when they don’t.

These false positive findings can lead to further testing and some anxious moments for people who don’t have the disease. 

A test that’s very specific, on the other hand, will have few false positive results, but will miss more cases of the disease.

This balance between sensitivity and specificity is important for all screening tests, including mammography.

Screening Recommendations
FOR women & Men

Women

Breast cancer screening is important for all women.

If you’re at higher than average risk of breast cancer, you may need to be screened earlier and more often than women at average risk

.

SCREENING FOR WOMEN AT AVERAGE RISK

Men

Breast cancer screening is not recommended for most men. It’s only recommended for some men at higher than average risk due to an inherited gene mutation or a strong family history of breast cancer.

Learn about breast cancer screening recommendations for men at higher than average risk

Screening Questions to ask your doctor

QUESTIONS FOR YOUR PROVIDER – BREAST CANCER SCREENING

Articles Sources

CA:  Cancer Journal for Clinicians – American Cancer Society Guidelines for the Early Detection Of Cancer

Cancer Care – Early Detection and Breast Cancer

Maurer Foundation for Breast Health Education – The Stages Of Breast Cancer & the importance of Early Detection

American Cancer Society – Breast Cancer Early Detection and Diagnosis

American Cancer Society – Imaging Tests To Find Breast Cancer section

Center For Disease Control and Prevention – What is a Mammogram?

National Breast Cancer Foundation – Mammogram & Breast Cancer Diagnosis

Medical News Today – What Breast Cancer Look Like on a Mammogram?

American Cancer Society – Breast Density and Your Mammogram Report

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