Diagnosing and screening breast cancer

What breast cancer may resemble

These non cancerous conditions may resemble breast cancer because of the presentation and on mammography examination

1. Fibrocystic changes of the breasts
2. Fibroadenoma
3. Hamartoma

What test are done to diagnose breast cancer

The healthcare provider will perform a series of tests including taking a detailed history and physical examination from the patient. Among the test done include:

• Breast ultrasound tests are done to demonstrate breast masses such as cysts.
• Aspiration cytology where a needle is inserted to the mass region and fluid aspirated and taken for microscopic examination to establish diagnosis
• Biopsy of the breast to remove the masses. The biopsy tissue is then taken for laboratory examination
• Other tests include; complete blood count, blood chemistry and scan of other regions to rule out metastatic spread.

The importance of mammography in breast cancer

About 30% to 50% of breast cancers are detected by screening using mammograms only. Breast cancer features with the highest positive predictive value for cancer are shown in mammograms as spiculated margins, irregular shapes of masses, linear calcium deposits (calcification)

Why mammogram after 40 years

Mammograms are more effective in detecting hard to notice cancers of the breast as patients begin to age. Here are some of the factors to consider when going for mammographic tests:

• In young patients, the breast tissue is denser. After 40 years or during menopause, the breast tissue is replaced with fat. In cases of dense breasts as in younger patients there is a risk of getting false-negative (where there result may be negative but the malignancy is present) and false-positive (where the malignancy may be positive when actually there is no cancer) results.
• Perimenopausal women are more likely to have breasts that are more glandular and thus denser.
• Timing for mammography is also important. The sensitivity may be increased by scheduling evaluation during the first 2 weeks of the menstrual cycle, corresponding with the follicular phase.
• Women on hormonal replacement therapy (HRT) during postmenopausal period may have increased breast density.

Screening for breast cancer

Screening fro breast cancer is an important factor in management and prevention of the disease. Studies show that screening reduces significantly the occurrence and recurrence rates of the neoplasm. It is recommended that screening mammography be done every 1 to 2 years in women 40 years of age and older. Physical examinations by a health care provider are normally part of all screening programs. Methods used for screening include:

1. Digital mammography in over 40 year old patients
2. Magnetic resonance imaging (MRI) of the breast
3. Radionuclide imaging with sestamibi
4. High-resolution ulrasonography

The American cancer society recommends the screening for breast cancer as follows:

• Those In age grouips20-29year to have 3yrly cancer screening program
• Women who are over 40 years of age and are of good health are recommended to have mammography every year.
• Women whoa re over 40year should have a clinical breast examination every year at the doctors office
• Women who are over 20years should have self –breast examination as an option but it is not a must. Studies done in Chinese women have shown no significant reduction in breast cancer after periodic breast-self examinations.
• Genetic tests for BRCA1 and BRCA2 are recommended in women who

1. Develop breast cancer at a young age
2. Women with a family history of breast or ovarian cancer
3. First-degree relatives
4. Women who are blood relatives of those with known BRCA1 or BRCA2 gene mutations. Experts do recommend that women with a strong family history of breast cancer have breast cancer screening done at an age 5 to 10 years younger than that of the youngest relative in whom breast cancer has developed