There are several ways of screening for breast cancer. The best way (for now) is by mammograms. A breast is compressed between two plates and two xray images, top-to-bottom and side-to-side, is taken. It can be a little painful, so taking a painkiller before the exam can help.
There are two ways mammograms are done today: standard mammography captures images on film whilst digital mammography captures images in the computer. Digital mammography can detect cancer more accurately for women who with dense breast tissue, or are near menopause, or are under 50. Otherwise, there is no difference in detection accuracy between digital and standard mammography.
Different major health organizations have different recommendations with regards to breast cancer screening. Some organizations such as the American Cancer Society and National Cancer Institute both recommend starting breast cancer screening at age 40. On the other hand the US Preventive Services Task Force recommends breast cancer screening at age 50.
The Hong Kong Department of Health (as of Sept 2010) does not recommend routine mammography for the normal female population in HK. Instead, they recommend that all women, be of average or at increased risk, should be breast aware. A doctor should be consulted as soon as possible if early symptoms of breast cancer appear. These symptoms include:
- Sudden onset of pain or discomfort in one part of the breast or armpit that does not go away
- Lump or thickening in the breast or underarm area
- Change in breast size, shape or color (sudden redness)
- Change in skin texture, for example, skin looks like orange peel.
- Appearance of a rash or ulcer on or around the nipple
- Nipple discharge for nonlactating women
They also recommend breast cancer screening by mammography for women at increased risk such as those with a family history of breast cancer, or those who have had exposure to chest radiation (not xrays), or those with genetic mutations (BRCA1/2 carrier status). For these women, screening is recommended starting 35 years of age, or 10 years before the youngest relative who had breast cancer was diagnosed, whichever is earlier, but not earlier than 30 years old.
While different health organizations have slightly different recommendations, all of them agree that self-breast examination is no longer recommended as a screening tool. Moreover, all women should be familiar with what normal breasts look and feel like. This way, whenever early symptoms of breast cancer appear, a cancer specialist can be consulted and the cancer caught.
National Cancer Institute at the National Institutes of Health. Breast Cancer. http://www.cancer.gov/cancertopics/types/breast. Accessed 11 June 2012
Pisano ED, Hendrick RE, Yaffe MJ, et al. for the DMIST Investigators Group. Diagnostic accuracy of digital versus film mammography: exploratory analysis of selected population subgroups in DMIST. Radiology. 246(2):376-83, 2008.
Department of Health, The Government of the Hong Kong Special Administrative Region. Updated Recommendations on Breast Cancer Screening (2010) http://www.chp.gov.hk/files/pdf/recommendations_on_breast_cancer_screening_2010.pdf. Accessed 13 June 2012.
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