Breast Health Screening

Screening for breast cancer is one way to help identify breast cancer in its earlier stages. Screening for breast cancer is usually done beginning at the age of 40 and ending at the age of 74, although recent advice has indicated that breast screening should be done every other year after the age of 50 unless there is a reason to check for breast cancer earlier, such as family history of breast cancer or the presence of the BRCA1/BRCA2 breast cancer markers. In such cases, screening can take place as early as a woman in her twenties.

The primary screening test for breast cancer is a mammogram. This is an X-ray of the breast done with the breast squashed between two plates. It picks up areas of calcifications which can be from breast cancer. It can also detect lumps in the breast. Mammograms work best when they are compared to previous x-rays of the breast so it is best to have your mammogram done at the same place every time.

Doctors also can do a clinical breast examination. They have the patient lie down on a table and raise their arms above their heads. The breast is more spread out that way and the doctor can evaluate the axilla or armpit for the presence of swollen lymph nodes. Any lumps felt can be further evaluated using an ultrasound or mammogram or both.

Self breast exam is questionable. Some doctors still advocate checking your breasts yourself for breast cancer by palpating the breasts using your fingers. Other doctors don’t feel this is very helpful and feel that the clinical breast exam and mammogram is superior to the breast self examination.

An ultrasound is usually a secondary test done in the screening of breast cancer. If a lump is seen on mammogram, an ultrasound can be done in order to define whether or not the lump is solid or fluid-filled. Fluid filled lumps can be removed using ultrasound guided fine needle aspiration. Solid lumps are removed or treated by doing a needle biopsy.

A needle biopsy can identify the cells inside the lump. They can be fibrocystic cells representing noncancerous fibrocystic lumps in the breast or they can represent cancer. If cancer is found, surgery is done to remove the part of the breast involved or the entire breast, if necessary. Many women are having lumpectomies for small cancers, which is not as disfiguring as a total mastectomy or partial mastectomy.