Breast cancer screening

Breast cancer screening is a way in which doctors examine breasts in order to detect early signs of breast cancer in asymptomatic women. The basic examination used in screening is mammography, a special type of radiological examination. Studies show that breast cancer screening reduces the likelihood that a woman will die from the this disease.

Who should undergo this screening?

– Women between the ages of 40 and 49 should consider the need for a mammogram in a conversation with a doctor, and the need is assessed by comparing the risk of developing breast cancer and the potential harmfulness of radiological examination.

Women between the ages of 50 and 70 should have a mammography every 2 years.

Women at high risk for breast cancer may need to start screening at a younger age. High risk have women who:

• carry genes that increase the risk of breast cancer, such as the “BRCA” gene
• have close relatives (mother, sister or daughter) who developed breast cancer at an early age.

What are the benefits of breast cancer screening?

– The main benefit of screening is that it helps doctors find cancer in early phase, when it is easier to treat. This reduces the chances of dying from breast cancer.

What are the disadvantages of breast cancer screening?

• Mammography sometimes gives “false positive” results. This means that they suggest that a woman could have cancer when she does not have it, which leads to unnecessary worries and excessive tests, including a biopsy. False-positive results are more common in women under the age of 50.
• Radiation exposure – Like all X-rays, mammography expose you to radiation. Studies show that the number of lives saved by early detection of cancer far outweighs the very small risks arising from radiation exposure.

What happens during a mammography?

– Before the mammography, you will be asked you to take off your clothes above the waist. Then your breasts will be filmed one by one. Each breast is filmed twice, once from top to bottom and once from side to side. To make the breast tissue easier to see, a nurse will flatten each breast between 2 plates. This can be annoying, but it only takes a few seconds. If possible, avoid scheduling mammography just before or during menstruation. At that time, the breasts are more sensitive.

What happens after a mammogram?

– When you receive the mammogram, inform your gynecologist and schedule a consultation.

What if my mammogram is not normal?

– If your mammogram is not normal, don’t panic. Nine out of 10 women with an abnormal mammogram turned out not to have breast cancer. You will need to do more tests to find out what is really going on. If other tests still show suspicious findings, your gynecologist will refer you for a biopsy. During the biopsy, a sample of breast tissue is taken and sent to a pathology specialist to check it for cancer. Sampling (biopsy) is usually performed with a special needle under the control of mammography or ultrasound. In some cases, a biopsy involves a small operation.

What about manual breast examinations?

– Clinical examination of the breast should be performed by a doctor at the regular annual examination of women older than age of 40. For women aged 20 to 39, an examination is suggested every 1-3 years. It is desirable that every woman performs a breast self-examination. Any change you find, you should immediately mention to your gynecologist.

How to properly perform breast self-examination?

Stand in front of the mirror. Put your hands on your hips. Pay attention to changes in the skin of the breast, the texture and indentations in the breast. Pay attention to the appearance of the nipples. Some women have retracted nipples and this is a normal unless it is a new finding.

Raise your arms above your head and turn to the side. Then look in the mirror at each breast as a whole. If necessary, lift each breast so that you can see the skin under the breast.

Lie down and place your left hand above your head (this flattens the breast and facilitates the examination). Examine the left breast with your right hand, starting from the upper part of the breast near the armpit and touch the breast with front of your fingers, going up and down over the breast, thus crossing the entire surface of the breast piece by piece. You perform the examination with the pads of three middle fingers of the hand, making small circles. Use your finger pads, not your fingertips. Move your finger circles up and down the breast tissue until you cover the whole breast and underarm area. Make three circles at each point: one very light, one slightly firmer in the breast, and one deep in the breast. Then switch hands and do the same on the other breast. Once you have finished, check your nipples for any irregularities. Using light but firm pressure, squeeze your nipple between your thumb and forefinger. Note any lumps or discharge.

It is important to become familiar with what is normal for you so that you can more easily detect any changes in your breast tissue. If you have any concerns contact us to schedule a more in-depth examination.

Can I have a breast ultrasound instead of a mammography?

– Ultrasound examination of the breast cannot replace mammography, but it can supplement it. Ultrasound tests are also suggested for women whose mammogram shows very thick breasts.

Can I do a breast MRI instead of a mammogram?

– You may have heard of MRIs breast exams, but they are not for everyone. Compared to mammograms, breast MRIs give more “false positive results” and sometimes lead to unnecessary biopsies. However, breast MRI is sometimes used to help find breast cancer in young women who are at high risk for breast cancer. It is not recommend an MRI breast screening of breast cancer in women who are not at high risk. An MRIs do not replace mammography.