What is breast cancer screening?

Breast cancer screening is performed to check women without any symptoms for early signs of breast cancer. Mammography, a specialised type of X-ray is mainly used to screen, combined with regular breast examinations performed by a doctor or nurse.

The purpose of breast cancer screening is to detect cancer before the patient even notices it and before it grows and spreads. This can lower the chances of mortality due to disease as it may catch the cancer earlier.

Who should be screened for breast cancer?

Breast cancer screening is recommended for women around age 50 to 70. Screening should involve physical examination by a doctor or nurse along with mammograms.

Women at a higher risk of breast cancer need to start screening at age 40 or even at younger age. This includes individuals who are:

• Carriers of genes that increase the risk of breast cancer (BRCA genes for example)
  
• Closely related to someone who developed breast cancer at a younger age
  

Discuss with your doctor in detail to know the best time to start your screening.

What are the benefits of being screened for breast cancer?

Screening helps identify the disease in its early stage, making it easier to control and treat and reducing the chances of mortality due to breast cancer.

What are the drawbacks of being screened for breast cancer?

Certain drawbacks of screening for breast cancer include:

False positives

Sometimes women not having breast cancer can be suggested to have it, resulting in unnecessary worry and more investigations including biopsy. False positive results are more likely to occur in women under 50 years of age.

Radiation exposure

Mammograms is a type of specialised X-ray investigation, exposing you to the same radiation. However, the benefits and lives saved by early detection due to mammograms are far greater than the small risk from radiation.

What happens during a mammogram?

Patients need to undress waist up before the mammogram. Each breast is then X-rayed twice individually, once from the top down and once from the side, getting a picture from both angles. During the procedure, the nurse or technician might flatten the breast between 2 panels for a few seconds, which can be slightly uncomfortable. Breasts are extra sensitive during the periods, so avoid scheduling mammogram during that time if possible. Do not use any deodorant or powder on breasts or underarm on the day of investigation.

What happens after a mammogram?

Mammogram results are usually available on the same day, or within a few days, once the radiologist has reviewed it. Do not assume your mammogram to be normal if you don’t get any results, contact your doctor and ask them for the results if you hear nothing.

What if my mammogram is abnormal?

First of all don’t panic! 9 out of 10 women with abnormal results in mammogram turn out to not have breast cancer. However, you’ll need more investigations to find out the exact abnormality in the mammogram.

If your doctor considers that the abnormal results in your case isn't likely due to cancer, they might suggest a repeat mammogram after waiting for around 6 months. If they consider the abnormality to be likely due to a breast cancer, they’ll send you for more investigations. These tests might include diagnostic mammogram (mammogram in more detail) or a breast ultrasound.

If the investigations result in suspicious findings, a biopsy might be done in which the doctor will take breast tissue samples and send them to the pathologist. A biopsy is usually performed during an ultrasound or mammogram using a needle. Some cases might need a small surgery to sample the abnormal breast tissue.

What about breast examinations?

Breast examinations are a part of the breast cancer screening program and are performed on regular basis by a doctor or nurse. During the breast examination, the doctor or nurse examines the breasts visually and then palpates both the breasts and arm pits for any lumps, tissue or skin changes, nipple discharge, or any other signs of abnormality.

Breast examination should also be performed by women themselves. However, it’s necessary that you perform it the right way after learning the technique in detail. Self-examination isn’t linked with lowering mortality due to breast cancer and is debatable.

Can I have a breast MRI instead of a mammogram?

Breast MRIs result in more false positives than mammograms, leading to unneeded biopsies. However, breast MRI are still useful in high-risk young patients.

Breast MRIs aren’t a replacement of mammogram; instead they’re used along with mammograms for high-risk patients who might need it.

How often should I have a mammogram?

Women starting breast cancer screening at age 40 are advised to screen every year until age 50. For women of age 50 and above annual or 2 yearly examinations are recommended, depending upon the risk category of that patient.

Routine screening for breast cancer using examination and mammogram should be continued even if a woman feels completely healthy.