Breast Cancer Testing
The three basic screening tests for breasts cancer are the self-examination, the clinical breast examination and mammography. Increased use of these techniques along with improved treatments has led to earlier detection of breast tumours and a dramatic improvement in the breast cancer cure rate.
Breast self-examination
About the test. This a simple five-minute procedure that you can do at home to check for abnormalities. Countless breast tumours are detected by women who perform self-examinations, but they can't replace regular mammography.
How is it done? First do a visual inspection. Stand in front of a mirror with your arms at your sides, checking each breast for any lumps, dimpling, swelling or new differences in size or shape.
Repeat with your arms raised and hands clasped behind your head, elbows pressed forward.
The second part of a breast self-examination involves the careful and systematic palpation of your breasts using one of the three palpation patterns illustrated below--up and down, spiral or pie-shaped wedges. Be sure to use the same pattern each month. Start by raising your left arm over your head. Using there or four fingers of your right hand, feel for any unusual lumps or thickening. Be sure to use the pads of your fingers (not the tips) and press firmly enough to feel all the levels of your breast and underarm and then examine the underarm itself. Also squeeze the nipple gently to check for any discharge or fluid. Repeat the steps above on the opposite side.
Finally, lie down on your back with your left arm raised and a rolled-up towel or pillow under your left shoulder. Repeat the palpation as above.
How often is it needed? The Australian National Breast Cancer Center recommends that all women age 20 and older perform breast self-examinations monthly. A good time is at the end of your period when your breasts aren't swollen.
Clinical breast examination
About the test. This is a physical examination and palpation of the breast performed by a doctor.
How is it done? In a clinical breast examination, the doctor palpates your breasts and under your arms to check for any lumps or changes. Doctors have experience in feeling for tumours and can usually differentiate normal from abnormal lumps. The next time you have a clinical breast examination, ask your doctor to show you how to feel the difference between normal and abnormal lumps so that you can learn to feel for any suspicious areas.
How often is it needed? women age 20 and over should get a clinical breast examination every three years. Beginning at age 40, clinical breast examinations should be done every year.
MammographyAbout the test. Mammography is currently the best tool available for detecting breast cancer at an early stage when it is most curable. The technique records X-rays images of the breast on film, which can then be read by a radiologist. Areas of increased density or with calcium deposits may be signs of a tumour and may require you to have a follow-up with a biopsy or other procedure. A mammogram can detect tumours a few millimeters in size, considerably smaller than can be felt by touch. Early detection is critical because it allows amny women the option of being treated with a breast-
conserving lumpectomy (surgical removal of just the tumour and some surrounding tissue) rather than a more extensive removal of breast tissue.
How is it done? Choose a facility that does a high volume of mammograms; the reading tend to be more accurate. You'll undress from the waist up then sit or stand while one breast at a time is flattened between two plates. The procedure takes about 15 minutes and ma cause some discomfort. Let the technician know about any breast problems you may have, or if you are pregnant.
A new technique called digital mammography which captures X-ray images on computer rather than on film, is showing considerable promise for improving the detection of breast tumours. Because it allows for the digital enhancement of the X-rays, even very small tumours can be spotted. It also lowers the number of false-positive results (lesions that look suspicious but turn out not to be cancerous). Another plus for this new technology is that the images can easily be sent by e-mail for review by specialists at distant medical centers.
How often is it needed? For women age 50 and older, a mammogram every two years is recommended. After the age of 70, your doctor may order them less often.
You'll need these tests more often if..
Magnetic resonance imaging
An MRI is an advanced technique using radio waves and magnetic fields to generate computerised images of the breast. The procedure is costly and requires lying still for up to 90 minutes inside the cylindrical MRI machine. (if you're claustrophobic, look for an 'open' MRI machine.) A breast MRI can be useful for follow-up if a suspicious area is found during mammography or palpation and for screening women who have had silicone breast implants, which can make mammography difficult.
MRI also helps determine a cancer stage or whether more than one number is present--critical in treatment planning.
Ultrasound
Also called sonography, ultrasound uses sound waves to take a three-dimensional picture of the breast. The skin is first covered with a gel then an instrument called a transducer is passed over the breast. Ultrasound may be useful for evaluating suspicious areas that are hard to see on a mammogram. The test may be especially helpful for younger women whose breast tissue is denser and hence hard to record on mammograms. Because ultrasound does not involve X-rays, it's commonly used for pregnant women.
Ductal lavage
A new procedure called ductal lavage uses a suction device to retrieve cells from the lining of the milk ducts, where most breast cancers originate. The cellls are then examined microscopically for any
cancerous changes. The technique is still undergoing testing but may be particularly useful for detecting recurrences is high-risk women who have already had breast cancer.
Breast self-examination
About the test. This a simple five-minute procedure that you can do at home to check for abnormalities. Countless breast tumours are detected by women who perform self-examinations, but they can't replace regular mammography.
How is it done? First do a visual inspection. Stand in front of a mirror with your arms at your sides, checking each breast for any lumps, dimpling, swelling or new differences in size or shape.
The second part of a breast self-examination involves the careful and systematic palpation of your breasts using one of the three palpation patterns illustrated below--up and down, spiral or pie-shaped wedges. Be sure to use the same pattern each month. Start by raising your left arm over your head. Using there or four fingers of your right hand, feel for any unusual lumps or thickening. Be sure to use the pads of your fingers (not the tips) and press firmly enough to feel all the levels of your breast and underarm and then examine the underarm itself. Also squeeze the nipple gently to check for any discharge or fluid. Repeat the steps above on the opposite side.
Finally, lie down on your back with your left arm raised and a rolled-up towel or pillow under your left shoulder. Repeat the palpation as above.
How often is it needed? The Australian National Breast Cancer Center recommends that all women age 20 and older perform breast self-examinations monthly. A good time is at the end of your period when your breasts aren't swollen.
Clinical breast examination
About the test. This is a physical examination and palpation of the breast performed by a doctor.
How is it done? In a clinical breast examination, the doctor palpates your breasts and under your arms to check for any lumps or changes. Doctors have experience in feeling for tumours and can usually differentiate normal from abnormal lumps. The next time you have a clinical breast examination, ask your doctor to show you how to feel the difference between normal and abnormal lumps so that you can learn to feel for any suspicious areas.
How often is it needed? women age 20 and over should get a clinical breast examination every three years. Beginning at age 40, clinical breast examinations should be done every year.
MammographyAbout the test. Mammography is currently the best tool available for detecting breast cancer at an early stage when it is most curable. The technique records X-rays images of the breast on film, which can then be read by a radiologist. Areas of increased density or with calcium deposits may be signs of a tumour and may require you to have a follow-up with a biopsy or other procedure. A mammogram can detect tumours a few millimeters in size, considerably smaller than can be felt by touch. Early detection is critical because it allows amny women the option of being treated with a breast-
conserving lumpectomy (surgical removal of just the tumour and some surrounding tissue) rather than a more extensive removal of breast tissue.
How is it done? Choose a facility that does a high volume of mammograms; the reading tend to be more accurate. You'll undress from the waist up then sit or stand while one breast at a time is flattened between two plates. The procedure takes about 15 minutes and ma cause some discomfort. Let the technician know about any breast problems you may have, or if you are pregnant.
A new technique called digital mammography which captures X-ray images on computer rather than on film, is showing considerable promise for improving the detection of breast tumours. Because it allows for the digital enhancement of the X-rays, even very small tumours can be spotted. It also lowers the number of false-positive results (lesions that look suspicious but turn out not to be cancerous). Another plus for this new technology is that the images can easily be sent by e-mail for review by specialists at distant medical centers.
How often is it needed? For women age 50 and older, a mammogram every two years is recommended. After the age of 70, your doctor may order them less often.
You'll need these tests more often if..
- You have had a previous diagnosis of breast cancer.
- You have a strong family history of the disease.
- You have cysts, areas of calcification or other signs or symptoms.
- ALL OF THE ABOVE: a biannual Pap smear and clinical examination; a mammogram at your doctor's discretion.
Magnetic resonance imaging
An MRI is an advanced technique using radio waves and magnetic fields to generate computerised images of the breast. The procedure is costly and requires lying still for up to 90 minutes inside the cylindrical MRI machine. (if you're claustrophobic, look for an 'open' MRI machine.) A breast MRI can be useful for follow-up if a suspicious area is found during mammography or palpation and for screening women who have had silicone breast implants, which can make mammography difficult.
MRI also helps determine a cancer stage or whether more than one number is present--critical in treatment planning.
Ultrasound
Also called sonography, ultrasound uses sound waves to take a three-dimensional picture of the breast. The skin is first covered with a gel then an instrument called a transducer is passed over the breast. Ultrasound may be useful for evaluating suspicious areas that are hard to see on a mammogram. The test may be especially helpful for younger women whose breast tissue is denser and hence hard to record on mammograms. Because ultrasound does not involve X-rays, it's commonly used for pregnant women.
Ductal lavage
A new procedure called ductal lavage uses a suction device to retrieve cells from the lining of the milk ducts, where most breast cancers originate. The cellls are then examined microscopically for any
cancerous changes. The technique is still undergoing testing but may be particularly useful for detecting recurrences is high-risk women who have already had breast cancer.
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