Breast Cancer (Part Two)
Step II. Raise your hands up in front of the mirror and check your breast for the same changes.
Step III. While you are in front of the mirror look at your breast nipple for any fluid discharge like: blood, milk, watery or yellowish discharge.
Step IV. Lie down and with your left hand examine the right breast while with your right hand the left breast. Make sure to examine the entire breast. You can start from the nipple and with circular movements cover the whole surface of the breast from the inside out. You can also examine your breast with vertical movements from top to bottom. This latter method seems easier for most women.
Step V. Examine your breast while you are sitting or standing. Most women find it easier to self-examine their breast while it is wet and slippery, therefore they prefer to examine under the shower. It is important to examine the whole breast.
Mammography has two main uses:
- Screening of asymptomatic women for early detection of breast cancer.
- Evaluation of breast abnormalities in symptomatic patients.
Screening includes:
- clinical examination (self-examination and examination by an oncologist)
- mammography.
The American Cancer Society recommends that women aged 20-39 be clinically examined every three years, mammography is not recommended.
Women aged 40 and over should be clinically examined every year, and have a mammography every year as well.
A false negative mammogram results in 9-16% of breast cancer cases, cancers which are detected through clinical examination.
A false negative mammogram can result for various reasons such as:
- The palpable lesion is not included in the mammogram film.
- The breast is too dense and makes it difficult to visualize the lesion.
- The tumor is not visible on mammography.
It is recommended that women aged 40 and over undergo mammographic screenings every 1-2 years.
Fig. 1. View of breast cancer on mammography
The incidence of breast cancer increases with age. There is no specific age at which screening by mammography should be discontinued. For elderly women, screening by mammography is evaluated based on the health status and quality of life of the patient.
The goal of screening asymptomatic women is to diagnose cancer as early as possible. The earlier the disease is diagnosed, the greater the chance of survival.
The minimal size of a breast cancer that can be caught in clinical examination is 1.5 to 2 cm.
In the case of a palpable lesion in the breast in clinical examination but with a negative mammogram, other examinations such as ultrasound or magnetic resonance are required.
Ultrasound provides the possibility of diagnosing clinically palpable breast cancers but with a negative mammogram. It is more cost-effective (it costs less).
The principle of its operation is based on the use of ultrasound waves that are harmless to the patient. It allows the examination of the breast also in young women under 39 years old or pregnant women who are symptomatic.
It provides the possibility of taking material from the clinically palpable lesion and further examining it through biopsy.