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Breast Cancer & Early Detection

What is breast screening?

Mammography Remains The Gold Standard

Although the majority of breast disorders are benign (non-life-threatening), one of the disturbing aspects of breast cancer is that so little can be done to prevent it. Most risk factors can be predicted or controlled, especially genetically based premenopausal cancers.

Breast cancer screening refers to "testing" the breast in asyimptomatic women (with no symptom) for the purpose of detecting unsuspected breast cancer at a stage where early intervention can affect outcome.

There are many tools for imaging the breast:

-         Film Mammography.

-         Ultrasound.

-         Magnetic Resonance Imaging.

-         Xeromammography.

-         Computed Technology.

-         Thermography.

-         Transillumination.

-         Electropotentials (for palpable lesions)

Newer still are computer aided digital mammography and 3-d ultrasound.

Although several new technologies on the horizon show promise for improved capability to detect breast cancer, none have yet proved superior to traditional, x-ray film mammography in screening for breast cancer. A new report in March 2001 from the Institute of Medicine (IOM) and National Research Council of the National Academies of America reaffirms that despite its limitations, film mammography remains the “gold standard” against which, all newer imaging technologies will be measured.

Mammography or mammograms, as used in the rest of this leaflet refers to X-ray film mammography.

What are the Common Myths About Mammography?

In most studies, they found that the reason women most frequently give for not having a mammogram would be whether their primary health care doctor suggested it. If your doctor does not suggest mammography and you are in the correct age group, it is up to you to raise the issue.

The reality is, with today’s equipment radiation is minimal. It is far more dangerous not to find breast cancer at its earliest stage than to be exposed to a low dose of radiation. A typical standard mammogram would be equivalent to about 2 hours in the sun.

"No Woman has ever been shown to develop breast cancer as a result of mammography"

- Dr. Stephen Feig, Radiological Society of North America, December 1997

The reality is, if you are a woman, and getting older, you are at risk of breast cancer. 70 – 80% of women who have breast cancer do not have family history of the disease. A woman with family history of breast cancer should talk to her doctor about getting checked more often. But all women, once they reach the age of 40 should consider a regular mammogram.

Role of Self Breast Examination (SBE)

Natural Conditions

When examining yourself, you may find things that cause you concern. When doing SBE, it’s important to remember that each woman’s breast are different, and that changes can occur because aging, the menstrual cycle, pregnancy, menopause, or taking birth control pills or other hormones.

It is normal for breasts to feel a little lumpy or uneven. Also, it is common for a woman’s breast to be swollen and tender right before or during her menstrual period. It is therefore vital that you get to know your breast before you can detect changes.

Why SBE?

SBE does not replace your regular check up with your doctor. However, it helps in early detection because we are unable to predict when we might develop breast cancer. A mammography or physical check up once a year may prove normal but cancer may begin to develop or start to show itself any time between now and your next check up.

In addition, clinical examination by your doctor and SBE detect some breast cancers that may not show on mammography.

The moment you detect any change or abnormality in your breast, you should visit your doctor immediately.

Breast Facts:

-         9 out of 10 women with breast disorders have benign conditions.

-         Breast cancer is the No. 1 cancer in Malaysian women.

-         Breast cancer is the leading cause of death from cancer in Malaysian women.

-         60% of the breast cancers are in premenopausal Malaysian women as opposed to Western figures, where up to 80% occur after 50 years of age.

-         Male breast cancer is very uncommon but the incidence seems to be increasing.

What You Can Do & Discuss With Your Doctor?

(This applies to women only)

1. Monthly self test breast examinations (SBE), beginning at age 18.

2. Annual clinical breast examinations from your doctor after age 40 (every three years for women age 20 – 39)

3. At least 2 yearly mammograms in ladies between 50 and 69 years, however, women in the 40-49 year age group should have access to mammography as well.

4. Ask your doctor how to determine your personal risk for breast cancer.

5. If you suspect any abnormalities, see your doctor immediately. Be responsible for your own health!

Produced by: National Council of Women’s Organization (NCWO)

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