Since proven methods of prevention remain elusive, early detection of small tumors turns out to be the best weapon against breast cancer. Found and treated early enough, breast cancer is usually not fatal. Size really does matter here because larger, later-stage cancers have lower survival rates. It’s inspiring to know that breast lumps found through regular screening are consistently smaller — and easier to treat — than those found by chance.
Detecting breast cancer as early as possible takes a little effort. Currently, screening methods range from the do-it-yourself to the high-tech. Read on for details.
Breast self-exams (BSEs) are a woman’s first line of defense. Examining your own breasts delivers two benefits. First, it helps you become familiar with the state of your breasts (many women have a certain amount of lumpiness that is considered normal for them). Second, it gives you an important opportunity to discover any new changes as soon as they occur. Any lumps or thickenings that are new or unusual for you — while probably harmless — should be brought to your doctor’s attention as soon as possible.
Ask your gynecologist how to perform a BSE and then do one faithfully once a month, preferably a few days after your period ends when your breasts are least tender.
Here are some tips to keep in mind when doing your monthly BSE:
- Three in four breast cancers appear in the upper outer region of the breast, in the area under the armpit, or behind the nipple. So examine these areas extra carefully.
- If your breasts are normally lumpy, make a note of how many individual lumps you find and their locations. Check for changes or size increases each month.
- After examining your breasts by feel, be sure to do a visual check as well. Stand in front of a mirror and look for changes in shape or symmetry of your breasts, any dimpling or dents, or a nipple that draws inward or points in a new direction.
- See your doctor to evaluate any changes or new lumps that you find during your BSE — but remember that the majority of breast lumps turn out to be noncancerous.
Clinical breast exam
Self-exams are important, but they aren’t enough. A clinical breast exam(CBE) once a year is a second important screening test all women should have. This formal breast checkup needs to be performed by your gynecologist or other trained medical professional. Your doctor may automatically do a CBE during your yearly pelvic exam; be sure to ask for one if she doesn’t.
During the CBE, your doctor will examine your breasts by carefully feeling all around the breasts themselves as well as under both armpits, an area that also contains breast tissue. The CBE is a good time to ask your doctor about the normal state of your breasts (for example, you might ask whether she thinks they are especially lumpy), as well as to ask for a lesson in how to perform a BSE.
A mammogram is a specialized, low-intensity X-ray that can find early breast tumors too small for you or your doctor to feel. Getting a mammogram takes about a half hour; each breast is compressed between two X-ray plates for about 30 seconds. Two images are usually taken of each breast. While the procedure may be somewhat uncomfortable, it’s brief — and it may save your life. Available since the 1970s, mammography has been proven to improve breast cancer survival.
Screening mammograms offer one of the best chances to find breast cancer early. Some studies have shown that mammography detects about 40% of cancers not found by physical exam. However, mammograms can also miss up to 15% of breast cancers. And conditions that may or may not indicate cancer, such as calcium deposits, can also show up on a mammogram.
Screening mammograms are done periodically, often yearly, before any breast changes or lumps are noticeable. All women should have a screening mammogram once every year after age 40, according to the American Medical Association.
Diagnostic mammograms are performed after a breast change has appeared. Your doctor may also ask you to have a diagnostic mammogram if your regular screening mammogram results are abnormal or unclear, or if she feels something unusual during a clinical breast exam.
Digital mammography is a new twist on the way standard mammograms are read. Instead of developing the X-ray onto film, digital mammography sends the breast image directly to a computer.
Digital mammograms are processed and read more quickly than X-ray-to-film mammograms, and can even be scanned by the computer for abnormalities. Digital mammogram images offer better contrast (which makes viewing easier), especially for dense breast tissue. Digital images can also be manipulated easily. For example, the technician or doctor can zoom in on a questionable area of a digital image to get a better look.
Regular non-digital mammography is still the way that most women get mammograms, but that may change in the future. If you are interested in having a digital mammogram, ask your doctor, or call a local major hospital breast center.
Inherited in pairs, one set from each parent, your genes determine how your body looks and functions. Research shows that genes — particularly those that are faulty or mutated — also determine, along with other factors, how susceptible you are to certain illnesses including cancer.
Genetic testing is one of the most recent advances in breast cancer screening. Until now, gene testing was reserved only for already-diagnosed cases, to determine the type of cancer present. Now, some high-risk but healthy women are turning to gene testing to figure out their risk for developing breast cancer. Mutated forms of the tumor-suppressing genes BRCA1 and BRCA2, can be detected and often run in families. The BRCA1 mutation is often found in the breast cancers of women of Ashkenazi Jewish descent.
Since there are almost certainly other genes that indicate cancer risk, research is ongoing. Additional breast cancer-related genes may be located soon.