Screening for Breast Cancer

The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.

Screening Tests

Breast Self-examination—Examination of your own breasts is called breast self-examination (BSE). You are encouraged to perform a BSE regularly and notify your doctor immediately if you notice any changes.

Many women complain that they don’t ever feel anything or their breast is so lumpy that they wouldn’t know what something wrong would feel like. Because a woman can palpate her breast far more regularly than a physician, it is very important that she performs a BSE.

What a woman should focus on is anything new or different. A particularly lumpy portion of the breast should be felt by a woman, and she can develop what it feels like in her mind’s eye. Go back a month later and feel it again. If it is different, contact the doctor. If there is a question, feel it in another week. Sometimes cysts appear and disappear. Masses that come and go are generally not cancerous.

The American Cancer Society has a kit that is available. It is very useful because it has model breasts in it that contain cancer both deep and superficially within the model. Other than new lumps, other things a woman should look for are nipple discharge (either clear or bloody), dimpling of the skin, thickening of the skin, redness of the skin, pain, new lumps, or a fullness feeling in the armpit. Lastly, it is important to keep in mind that this kit is not a substitute for a clinical exam.

Clinical Breast Examination—During your routine physical examination, your doctor or healthcare professional may do a clinical breast examination (CBE). During a CBE, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes.

Mammogram—A mammogram is a special x-ray of the breast that can often find tumors that are too small for you or your doctor to feel. Your doctor may suggest that you have a mammogram, especially if you have any of the risk factors listed above.

The ability of mammography to detect cancer depends on such factors as the size of the tumor, the age of the woman, breast density, and the skill of the radiologist.

Ultrasonography—During ultrasonography, sound waves (called ultrasound) are bounced off tissues and the echoes are converted into a picture (sonogram). Ultrasound is used to evaluate lumps that have been identified by a BSE, CBE, or mammography. Ultrasounds are not used as a screening tool.

Magnetic Resonance Imaging (MRI)—A procedure in which a magnet linked to a computer is used to create detailed pictures of areas inside the body. MRIs are used to evaluate breast masses that have been found by BSE or CBE, and to recognize the difference between cancer and scar tissue. The use of breast MRI has increased lately, but this test is not for all women, and a complete discussion of who it will most benefit should be left to your doctor.

Screening Guidelines

Screening guidelines for breast cancer—in particular, mammography—are still being debated by various professional organizations.

Recommended screening guidelines from the American Cancer Society and National Cancer Institute include:

  • Women should have their first screening baseline study between ages 35-40.
  • Women in their 40s should be screened every 1-2 years with mammography.
  • Women aged 50 and older should be screened every year.
  • Women who are at higher than average risk of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and the frequency of screening.

References:

American Cancer Society website. Available at: http://www.cancer.org . Accessed January 27, 2006.

National Cancer Institute website. Available at: http://www.cancer.gov . Accessed January 27, 2006.



Last reviewed April 2007 by Jondavid Pollock, MD, PhD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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