Breast Health Screening

Breast health Screening versus diagnostic evaluation

A screening evaluates for breast cancer in someone with no symptoms to detect the disease early. A diagnostic evaluation is triggered when a patient has a specific symptom (like a lump or pain) or an abnormal screening. Screenings are routine, while diagnostics require a targeted investigation by a radiologist.

Why Breast Health Screening is Important?

It is widely chosen for the benefits of:

• Detecting breast cancer early
• Detecting changes before symptoms appear
• Increasing success of treatment
• Less invasive treatment when detected early
• Reducing breast cancer mortality
• Peace of mind

Who should do Breast Health Screening?

Gynaecologists recommend breast health screening for women in the following categories:

• Average-risk women: This category is for women who do not have a family history or genetic predisposition. As a general guideline, women aged between 40 and 74 years should have a mammogram every 1 to 2 years. Women aged 75 and older are recommended to continue screening if they are in good health and have a life expectancy of 10 years or more.
• Women at higher risk : This includes women with strong family histories of BRCA1/BRCA2 mutations, prior breast cancer, prior chest radiation, and dense breasts.
• Women with breast symptoms: The common symptoms requiring evaluation include breast lump, pain, nipple discharge, inversion, skin dimpling, breast swelling, changes in breast shape, redness, and thickening, blood stained discharge.

What are the Types of Breast Health Screening?

The main methods are mammograms (the gold standard), breast ultrasounds, breast MRIs, clinical exams and self-awareness. The best method depends on age, family history and breast density.

• Clinical breast exam (CBE): A clinical breast exam is a physical exam performed by a doctor, nurse or other health care professional. The provider physically examines the breasts and underarm areas for lumps, skin changes or other abnormal signs.
• Mammography: A mammogram is a low-dose x-ray of the breast tissue. It is the most common and effective primary screening tool for early cancer detection including microcalcifications. A 2D Mammogram takes a standard flat, two-dimensional image of each breast. A 3D Mammogram (Tomosynthesis) is different.
• Breast MRI: Magnetic resonance imaging (MRI) employs powerful magnets and radio waves to produce highly detailed, cross-sectional images of breast tissue. Its high sensitivity means it’s generally reserved for women at high genetic risk (such as those with BRCA mutations), or to further assess particular abnormalities found on a mammogram.
• Breast ultrasound: Ultrasound uses sound waves to make pictures of the inside of the breast. It is not a screening tool by itself but may be used as an extra test for women with dense breast tissue or to look at a specific lump found during an exam. It involves taking several pictures from different angles , developing a series of thin slices , providing a better view of the breast, especially if dense breast tissue is present.

Which Breast Screening Test Is Right for You?

The type of breast screening test you need depends on your age, family history and how dense your breast tissue is. For women at average risk, mammograms are the gold standard, but for women at high risk or with dense tissue, doctors frequently supplement mammograms with ultrasounds or MRIs.

How to Prepare for the Appointment?

To prepare for a breast health screening, schedule your appointment the week after your period when breasts are less tender. On the day of your test:

• Dress in two pieces
• Do not use deodorants or body powders before mammography
• If applicable, bring previous imaging
• Tell the doctor if you are pregnant or breastfeeding

What happens during screening?

This depends on the test.

• Mammogram: A technician will place one breast at a time on an x-ray plate. A clear plastic paddle will then press firmly on top of your breast for a few seconds while pictures are taken. This compression flattens the tissue to allow a clearer picture to be taken and helps to reduce radiation exposure.
• Ultrasound: You'll be asked to lie on your back or side on an exam table. The technician (sonographer) will apply a warm, clear, water-based gel to your breast and press a handheld wand (called a transducer) against your skin. You may have to raise your arm over your head or turn to your side to flatten the tissue to get a better view. You might feel the pressure of the wand but the scan should not hurt.
• MRI: For a breast MRI, you will lie face down on a padded table, with your breasts placed in special padded openings. An IV will be placed in your arm to give you contrast dye. The table will move into the MRI tunnel where powerful magnets and radio waves will take detailed pictures as you lie very still.

What are the Common Breast Conditions That Screening Can Detect?

Gynaecologists recommend breast health screening to detect breast cysts, fibroadenomas, fibrocystic breast changes, calcifications, intraductal papilloma, breast infections and early-stage breast cancers.

How to Maintain Good Breast Health?

Getting regular screenings and noticing any significant changes in breast skin and tissue while adopting a healthy lifestyle will help prevent chronic breast cancers. Maintain a healthy weight and be physically active. Rely on a balanced diet, limit alcohol, and avoid smoking. Further breastfeeding reduces the risk of cancer development.

Is breast screening painful?

A breast screening (mammogram) can be uncomfortable and sometimes painful, but the discomfort typically only lasts for a few seconds while the breast tissue is compressed. This fast compression is important to avoid radiation exposure and to get a clear accurate picture.

Can younger women get breast cancer?

Yes, younger women do get breast cancer. While it is more common in older women, about 10% to 16% of all new breast cancer cases are diagnosed in women under age 45. In fact, incidence rates in younger women have been slowly rising, and the disease is often more aggressive.

Do I need screening if I have no symptoms?

Yes. In fact, the very purpose of a screening test is to detect potential health conditions in people who have no symptoms. Screening mammograms, colonoscopies, blood pressure checks can catch problems early, when they’re far more treatable and survivable, and when you’ll have more options for treatment.

Can men develop breast cancer?

Yes, men can get breast cancer. Although rare accounting for less than 1% of all diagnoses men are born with breast tissue and can develop the disease, usually in their 60s or 70s. The most common symptom is a painless, hard lump in the chest area.

Can breast cancer be detected before symptoms appear?

Yes, breast cancer can be and often is detected before any symptoms appear. Routine screenings are important because they can detect abnormal changes, like microcalcifications or small tumors, years before you would be able to feel or see them.