Breast Cancer: diagnosis and screening
Breast cancer in women is the most common type of cancer in India, amounting to 14% of all cancers in women. There are a rising number of cases in both rural and urban India, with one woman diagnosed with breast cancer every 4 minutes. Studies have established that sociodemographic, epidemiological, and socioeconomic status also contributes to breast cancer, the risk of which increases with lifestyle choices such as low physical activity and consumption of high‑fat diet.
What is the benefit and cost of breast cancer screening?
Although breast cancer cannot be prevented, diagnosing breast cancer with a screening test may ensure early detection and a chance of easy treatment. A breast exam checks a woman’s breasts for cancer before she has symptoms or signs of the disease. Sometimes, screenings tests also detect cancer, which may be slow-growing and benign. Such cancers may not always cause illness or death. The cost of breast cancer screenings in India may be below 10,000 INR. The figure varies depending upon socioeconomic and regional factors.
At what age should you begin with breast cancer screening?
As the risk of breast cancer increases with age, it is recommended for women of ages 40 to 54 to start annual breast cancer screening. Women of 55 and above should consider a breast cancer check every two years, or even a yearly screening in case of family history. In India, 28% of women with breast cancer are in the 40 to 50 age group, while almost 48% of patients are below 50. With the current advancement in the field of medicine, there are fortunately several ways to diagnose breast cancer.
Key points to know about breast cancer screenings
- A screening test is taken when the woman shows no signs or symptoms of cancer.
- If a doctor recommends a screening test, it may not always mean that the woman has cancer.
- Women with family history and personal history of cancer may also have to undergo genetic testing.
- There are various types of screening tests for breast cancer. All women should be well-informed about the different kinds of screening tests and should be involved in shared decision making with the doctor.
- Screening tests only help to find breast cancer. Detection of breast cancer may not help in curing or improving the woman’s health.
Are there any risks of screening tests?
Breast Screening tests have their own set of risks, which may sometimes cause serious problems. It is vital to know the risks of the test before taking one, as every screening test has its own set of pros and cons. The patient should be involved in decision making and should get all the necessary information from the expert doctor before choosing the right screening test.
Are screening tests accurate?
False-positive test results and false-negative test results are a common phenomenon in breast cancer check. A false-positive test is one that shows there is cancer when there isn’t and is usually followed by more tests and procedures.
A false-negative test result may appear to be normal even though there is cancer. All screening tests are therefore not helpful, and proper information should be sought from expert doctors.
If the screening test result is abnormal, it is followed by a number of diagnostic tests. These tests further help locate the lump in the breast and evaluate whether it is cancerous. Such tests include mammogram, biopsy, etc.
What does a breast screening test include?
- Physical exam and history: The procedure checks a woman’s body for cancer signs, such as lumps or anything abnormal. The doctor will also note the patient’s health habits and past illnesses and treatments before the screening.
- Laboratory tests: The tests include test samples of tissue, blood, urine, or other substances.
- Imaging procedures: Such procedures take pictures of areas inside the body.
- Genetic rests: These tests involve examining cells or tissue for changes in genes or chromosomes, which may be a sign of the disease.
Watch the video as Dr. Rohan Khandelwal, Breast Cancer surgeon at the CK Birla Hospital, Gurgaon talks about different imaging techniques used in identifying breast problems.
What tests are used for screening breast cancer?
There are several ways to diagnose breast cancer. Below are the best ways to detect breast cancer at an early stage:
Mammography is the most common screening test to detect breast cancer. The procedure uses a mammogram—an X-ray of the breast. In the procedure, the breast is pressed between two plates, and X-rays are taken of the breast tissue. A mammogram helps in detecting even small tumours that may not be felt by touch. Taking regular mammograms decreases the risk of discovering breast cancer at a later stage.
2. Breast magnetic resonance imaging (MRI)
A breast MRI is another common breast cancer diagnostic test. It uses magnets and radio waves to take detailed pictures of the areas inside the breast. MRI, along with mammograms, is used to examine women at high risk of getting breast cancer. MRI does not use any X-rays and does not expose patients to radiation.
3. Clinical breast exam
During a clinical breast exam, the medical professional uses her hands to feel for lumps or other changes in the breasts, which may be signs of breast cancer.
In thermography, a special camera records the temperature of the skin that covers the breasts. Thermogram detects tumours that can cause temperature changes.
5. Tissue sampling
The procedure includes taking samples of cells from the breast tissue. These are then examined under a microscope for signs of cancer.
6. Self-check for breast cancer
Breast Self-Awareness and familiarizing with the look and feel of one’s breasts helps in realizing visible abnormalities. A breast self-exam is recommended by medical experts for women of all ages to self-check for lumps, pain, or changes in breast size, which may be signs of the disease. Reporting any such changes to a doctor minimizes the risk of detecting breast cancer at a later stage.
Finding cancers at an early stage, i.e. even before the symptoms appear, increases the chances of survival, ensures better treatment, and has optimistic chances of cure and recovery.
The need for breast cancer screening tests is emphasized, mainly because it increases the number of early-stage cancers while decreasing the number of late-stage cancers and thereby, the number of deaths from cancer.