Last Updated: 27th December, 2020
Breast Cancer Screening Tests: The leading cause of death caused by cancer in Indian women is breast cancer (ductal carcinoma). One in 22 women in urban areas and one in 60 women in rural areas are expected to develop breast cancer during their lifetime, according to the National Cancer Registry Program. It is comprehended that breast cancer screening is an incredibly efficient way to detect ductal carcinoma because of the high prevalence rate.
There are, however, several concerns about what the accurate breast cancer screening tests are, who should go to a screening, how often you should have a screening done, and so on. Hence, to help you understand different breast cancer screening tests, we have explained and cleared some of the common doubts on breast cancer (ductal carcinoma).
What Is The Accurate Way Of Test Breast Cancer Or Breast Cancer Screening?
The best way to test breast cancer is through early screening. The numerous types of breast cancer screening tests include:
- Monthly Breast Self-Examination (BSE)
- Clinical Breast Examination (CBE)
- Magnetic Resonance Imaging (MRI)
1. Monthly Breast Self-Examination (BSE)
Breast self-examination, as the name suggests, is a breast cancer screening test that can be done by oneself and at home. It typically takes 5 – 10 minutes and should be done every month by all females above 15 yrs of age.
- Stand topless in front of a mirror with your hands on your sides and shoulders straight.
- Look at your breasts in the mirror for any visual changes in the breasts such as dimpling, inverted nipple, puckering, and changes in the size, shape or symmetry.
- Elevate your hands and place the palms on the back of the head to seek changes in the breast. Rehearse this by lifting one breast at a time.
- Feel your breasts by managing the pads of your fingers (not the tips). Apply pressure and move your fingers over the breasts in a orbital motion just like massaging the area. As you perform this, make your way to the collarbone, center of the breastbone and near the armpits.
- Inspect your breasts when lying down and again in the shower. The use of water and soap while taking a shower makes it easier for your fingers to glide over the skin and make it easy to feel the breasts.
- Rehearse the procedure by placing one hand over the back the head and massaging the breast with the other hand. Lastly, gently squeeze the nipple to check for any discharge.
The principle behind BSE is that if you recognize what is normal for your body, only then will you be able to figure out even the smallest abnormality, if any, in the breast. BSE is proven to aid in the early diagnosis of lumps and other changes (signs and symptoms) that happen in the breast, which could indicate breast cancer (ductal carcinoma).
Women in the menstruating age should do the self-examination on any day from day 5 to day 10 of the menstrual cycle (day one being the first day of periods). Postmenopausal women can do it on any day, but they also must do the self-breast examination without fail. Hence, it is advised to have a fixed day for BSE like the first day of every month or the first Sunday of every month.
2. Clinical Breast Examination (CBE)
A clinical breast exam is done by a doctor or a nurse. During this exam, the clinician uses his/her hands to detect any lumps, hardness, nipple discharge or any other changes in the breast. It should be done once in six months in women who are at a significant risk of breast cancer or at the earliest sign of any abnormality or symptoms of breast cancer. If you observe any abnormality during BSE, it’s advised to get a CBE done promptly to investigate further.
Mammography is principally an X-ray of the breast tissue. It should be undertaken by all women once a year after the age of 40 years or as advised by your doctor.
It is reported that breast density and age are important predictors of the accuracy of this test. This could be the reason why the results are more accurate in more elderly women and less sensitive in young women and those with dense breast tissue. Moreover, women in their 40s have a more reduced incidence of breast cancer and faster-growing cancers. Mammography alone is not useful in women with dense breasts. In these women, it has to be done in conjunction with ultrasonography or as advised by your doctor.
4. Magnetic Resonance Imaging (MRI)
This method uses magnetic and radio waves to take pictures of the breast and check for abnormalities. It is considered to be better than mammograms and CBE for screening women with a high risk of breast cancer like those with the BRCA gene mutation. For women in high-risk groups, MRI along with mammography and CBE is used as a screening tool. As breast MRIs may appear abnormal even if there is no cancer, they are unadvised for women who have an average risk of cancer.
When To Start Breast Cancer (Ductal Carcinoma) Screening?
Every woman should be screened for breast cancer, although the recommended age and frequency to start screening for ductal carcinoma might differ. The incidence of breast cancer in India begins rising in the early thirties and peaks during 50-64 years of age.
Breast self-examination can be started as early as above 15 years of age, especially for a woman who has a family history of breast cancer. Clinical breast examination (CBE) is usually part of routine annual care for women above 40 years. However, if you are at risk of breast cancer or embrace an established family history of ductal carcinoma, you may be recommended to undergo CBE every six months.
Generally, mammography screening should start at the age of 40 and must be repeated every year or two until 75 years of age. However, according to the US Centre for Disease Prevention and Control and the United States Preventive Service Task Force (USPSTF), women in the age group 50 – 74 years and at average risk of breast cancer should undergo a mammogram every two years. Women who are 40 – 49 years old should consult their doctor to know the pros and cons of the testing and when to start and how often to undergo a mammogram.
The MRI should be done solely as instructed by your doctor.
What Precautions To Be Taken Before Undergoing These Tests?
No, there are no such specific precautions a woman has to follow before undergoing a breast cancer screening test. However, it is always more satisfactory to get a clinical breast exam done before a mammogram or MRI so that the investigation can be targeted around the symptoms, if any, experienced by a woman.
What Positive Breast Cancer Screening Results Indicate?
The breast cancer screening test can assist us to know about any structural abnormalities in the breast tissue and aid in self-care. However, a positive report might not consistently indicate cancer. Hence, there is no need to be scared of the tests or the test results.
In case of any abnormality being detected in the screening tests, the woman might be directed to undergo further tests like a biopsy which will help to diagnose the condition.
Do Negative Screening Test Results Indicate No Risk Of Cancer?
No. A negative screening test may indicate there is no structural abnormality at present and that one should resume with routine screening to be safe. However, if a woman detects any changes in the breast even a few months after the screening tests, it is sensible to get a screening test done again. There is a significant chance that a woman might experience some internal symptoms, which can be detected between two different screening tests or mammograms.
Many women undergo breast cancer screening tests with huge anxiety and quite a few avoid these tests due to the fear of a cancer diagnosis. But what many women decline to believe are these tests can help in lump detection that is already present or any changes in the breast, which are unnoticed.
Although breast cancer screening tests do not prevent cancer, it can assist you to find ductal carcinoma early which in turn makes it easier to treat cancer. Hence, talk to your doctor about breast cancer screening tests that are right for you, and the ideal time to undergo a screening test.