Breast cancer is one of the most common types of cancer among women in the World today. Early detection is fundamental in the treatment and survival of breast cancer. When breast cancer is detected early, and is in the early stage, the 5-year relative survival rate is 100%. As previously discussed, many breast cancer symptoms are invisible and not noticeable without a professional screening, but some symptoms can be caught early just by being proactive about your breast health.
Early detection includes doing monthly breast self-exams, and scheduling regular clinical breast exams and mammograms.
Breast self-exam, or regularly examining your breasts on your own, can be an important way to find a breast cancer early, when it’s more likely to be treated successfully. While no single test can detect all breast cancers early, it is believed that performing breast self-exam in combination with other screening methods can increase the odds of early detection.
Breast self-examination is a useful and important screening tool, especially when used in combination with regular physical exams by a doctor, mammography, and in some cases ultrasound and/or MRI. Each of these screening tools works in a different way and has strengths and weaknesses. Breast self-exam is a convenient, no-cost tool that you can use on a regular basis and at any age. It is recommended that all women routinely perform breast self-exams as part of their overall breast cancer screening strategy.
Mammograms are probably the most important tool doctors have not only to screen for breast cancer, but also to diagnose, evaluate, and follow people who’ve had breast cancer. They are low-dose x-rays that can help detect breast cancer. It can detect breast cancer up to two years before the tumor can be felt by you or a medical doctor. Different tests help determine if a lump may be cancer.
Diagnostic mammograms are different from screening mammograms. Diagnostic mammograms focus on getting more information about a specific area (or areas) of concern -- usually because of a suspicious screening mammogram or a suspicious lump. Diagnostic mammograms take more pictures than screening mammograms do. A mammography technician and a radiologist work together to get the images your doctor needs to address that concern.
It is advisable that women age 40 - 45 or older who are at average risk of breast cancer should have a mammogram once a year, while women at high risk should have yearly mammograms along with an MRI starting at age 30.
Ultrasound is an imaging test that sends high-frequency sound waves through your breast and converts them into images on a viewing screen. Ultrasound is not used on its own as a screening test for breast cancer. Rather, it is used to complement other screening tests. If an abnormality is seen on mammography or felt by physical exam, ultrasound is the best way to find out if the abnormality is solid (such as a benign fibro adenoma or cancer) or fluid-filled (such as a benign cyst). It cannot determine whether a solid lump is cancerous, nor can it detect calcifications.
For women under the age 30, having a breast ultrasound may be recommended before mammography to evaluate a palpable breast lump (a breast lump that can be felt through the skin). Mammograms can be difficult to interpret in young women because their breasts tend to be dense and full of milk glands. Most breast lumps in young women are benign cysts, or clumps of normal glandular tissue.
It’s also an option if the individual is at high risk for breast cancer and it isn’t possible to have an MRI (Magnetic Resonance Imaging) done or pregnant so as not to be exposed to X-rays from a mammogram.
MRI, or magnetic resonance imaging, is a technology that uses magnets and radio waves to produce detailed cross-sectional images of the inside of the body. MRI does not use X-rays, so it does not involve any radiation exposure. Breast MRI has a number of different uses for breast cancer, including:
Screening examination such as mammogram and MRI, often along with physical exams of the breast, can lead medical doctors to suspect that a person has breast cancer. However, the only way to know for sure is to take a sample of tissue from the suspicious area and examine it under a microscope.
A breast biopsy is a test that removes tissue or sometimes fluid from the suspicious area. The removed cells are examined under a microscope and further tested to check for the presence of breast cancer. A biopsy is the only diagnostic procedure that can definitely determine if the suspicious area is cancerous. It is done by placing a needle through the skin into the breast to remove the tissue sample or probably through minor surgical operation.
However, biopsy is done using different techniques by the doctors, yet the choice of techniques is dependent on the individual and situation.
Fine needle aspiration (FNA) is the least invasive method of biopsy and it usually leaves no scar. The surgeon or radiologist uses a thin needle with a hollow center to remove a sample of cells from the suspicious area. In most cases, he or she can feel the lump and guide the needle to the right place.
In cases where the lump cannot be felt, the surgeon or radiologist may need to use MRI or mammograms to guide the needle if the lump can’t be felt to the right location.
Core needle biopsy uses a larger hollow needle than fine needle aspiration does. After numbing the breast with local anesthesia, the surgeon or radiologist uses the hollow needle to remove several cylinder-shaped samples of tissue from the suspicious area
However, same as the fine needle aspiration biopsy, a surgeon or doctor may need to use MRI or mammograms to guide the needle if the lump can’t be felt.
As with a core-needle biopsy, a surgical biopsy is done while the patient is under local anesthesia. Typically, this test is performed in a hospital setting where an IV and medications are administered to make the patient drowsy.
The surgeon makes a one- to two-inch cut on the breast and then removes all or part of the abnormal lump and often a small amount of normal-looking tissue, known as the “margin.” If the lump cannot be easily felt but can be seen on a mammogram or ultrasound, a radiologist may insert a thin wire to mark the suspicious spot prior to the surgeon performing the biopsy. Once again, a marker is usually placed internally at the biopsy site at the conclusion of the procedure.