Robert Smith, M.D
You already know that you need to examine your breasts regularly and have a mammographic examination yearly. And you’ve heard that breast cancer can be a deadly disease. But what are the real facts about breast cancer and early detection?
Currently, it is estimated that 13.4% (greater than 1 in 8) women will develop breast cancer in their lifetime with over 220,000 new cases detected and over 40,000 women dying from breast cancer in 2012(1). Early detection of breast cancer means early treatment and improved survival rates with a better chance of achieving complete remission or cure of the cancer.
So what can you do for early detection? First, perform a self breast exam. Look for lumps, knots, or skin thickening on your breast or underarm area. Also check for swelling, redness, or change in skin color. Note any change in size or shape of your breast and if there is pain or nipple discharge. Consult your physician if you find anything abnormal. Make sure you have a clinical breast exam performed by your physician on a regular basis. If you are between 20-30 years of age, you should have this exam every 3 years in the absence of abnormal findings on your self breast exam. If you are over age 40, you should combine clinical breast exam with mammography, since this will detect more cancers than mammography alone.
Current guidelines state that you should have mammograms every 1 or 2 years after age 40(2). You should perform self breast exams, have more frequently performed clinical breast exams, and have yearly mammograms if you have a strong family history of breast cancer, since you are at higher risk. When you schedule an appointment with a local imaging center or hospital for your mammographic exam, ask if the examination will be performed as a digital mammographic examination with computer assisted detection, since this will increase accuracy in the interpretation of your exam. With this technique, the computer scans the mammographic images and points out suspicious potential densities and lesions. Most facilities offer this type of mammographic exam. If they do not offer this exam, you should find another facility that performs this exam and schedule your appointment there. This does not involve additional cost, and virtually all insurance companies (including Medicare) will pay for this enhanced examination.
You may have heard of an exciting new mammographic technique called breast tomosynthesis or 3-D mammography. This enables the breast to be imaged in 3 dimensions, as opposed to 2 dimensions with conventional digital mammography. This is particularly beneficial to women with dense breast tissue, since it enhances visualization of cancerous lesions, which may be hidden by the dense tissue on conventional mammography. In the Oslo Screening Trial, it was reported that breast tomosynthesis resulted in a 27% improvement in breast cancer detection rates (3). Since breast tomosynthesis will result in an increased radiation dose to your breasts, you should first undergo a conventional digital mammographic exam to determine whether you have dense breast tissue, and then consult with your physician to decide if you wish to undergo breast tomosynthesis as a follow-up exam. The presence of dense tissue should be mentioned on the mammogram report. Follow this advice to assure quality breast care. Remember, early detection is very important, and an ounce of prevention is worth a pound of cure!
Robert Smith, M.D.is a board certified diagnostic radiologist and nuclear medicine physician with over 29 years of practice experience. He has previously served as Clinical Associate Professor of Radiology at the West Virginia School of Medicine. He is MQSA certified to interpret mammographic examinations and frequently performs breast interventional procedures. He currently practices in several facilities in central West Virginia.
Kanawha Valley Radiologists
333 Laidley St.
Charleston, WV 25301
- Breast Cancer Detection-WEB MD. www.webmd.com/breast-cancer/guide/breast-cancer-detection.
- Facts for Life-Breast Cancer Detection. www.Komen.org/uploadedFiles/Content_Bineries/
- 3D Digital Mammography. www.hologic3d.com