We continue with Day 3 of Breast Cancer Awareness Week. Today I am going to focus on breast examinations. There are different types of examinations, and I will provide you with details on a few of them. One exam in particular is the self examination.
Breast self-exam (BSE) is not recommended as a screening tool for breast cancer. However, it is important to become familiar with the way your breasts normally look and feel. Knowing what is normal for you may help you see or feel changes in your breasts.
What’s the evidence for breast self-exam?
Breast self-exam seemed promising when it was first introduced. However, studies on its effectiveness at finding breast cancer early and improving survival showed it did not offer the benefits of other screening tests.
A meta-analysis combined results from the two largest randomized controlled trials on breast self-exam to date (one in Shanghai, China and one in Russia). The Shanghai study included about 266,000 women and the Russia study included about 122,000 women. The combined analysis found no difference in rates of breast cancer death after 15 years between women who did routine breast self-exam and those who did not. The breast self-exam groups had more false positive results, leading to nearly twice as many biopsies with benign (not cancer) results as the other groups.
If you feel a lump in your breast, do not panic. Most lumps are not breast cancer, but something less serious, like a benign breast condition.
Some lumps will go away on their own. In younger women, lumps are often related to menstrual periods and will go away by the end of the cycle. However, if you find a lump, it is best to see your health care provider to be sure.
Mammography (ma-MAH-gruh-fee) is a screening tool that uses X-rays to create images of the breast. These images, called mammograms (MAM-o-grams), are used to find early signs of breast cancer such as a dense mass or clusters of calcium (microcalcifications)
Mammography is the best screening tool for breast cancer used today. It can find cancers at an early stage, when they are small (too small to be felt) and the chances of survival are highest.
Where to get a mammogram
Mammograms can be done in:
- Radiology and imaging centers
- Mammography clinics
- Hospital radiology departments
- Mobile vans
- Some physicians’ offices
What to expect
Before your mammogram, you will undress from the waist up, so it is a good idea to wear a shirt you can remove easily. Avoid using deodorants, antiperspirants, perfumes, powders or lotions on the breast and underarm areas on the day of the exam. Ingredients in these products can show up on a mammogram and make it harder to interpret.
Getting a screening mammogram takes about 15 minutes. During the procedure, each breast is pressed between two plates and an X-ray image is made. Two views of each breast are taken, one with the X-ray beam aimed from top to bottom and the other from side to side.
Sometimes, the pressure can be uncomfortable, but it only lasts a few seconds. Tell the technologist if you feel any discomfort. Taking acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) about an hour before the exam may help. If you have concerns, talk to your health care provider about other ways to help ease discomfort (or anxiety) during a mammogram. And, before the exam, let your technologist know your concerns.
Findings on a mammogram
Mammogram images appear in shades of black, gray and white, depending on the density of the tissue. Very dense tissue, like bone, shows up as white on an X-ray. Fat looks dark gray on an X-ray. Breast cancer and some benign (not cancer) breast conditionsare denser than fat and appear a lighter shade of gray or white on an X-ray image.
Dense breast tissue can look white or light gray on a mammogram. This can make mammograms harder to interpret in younger women, who tend to have denser breasts. After menopause, breast density decreases, making the mammograms of postmenopausal women easier to read.
Some younger women may have lower breast density after an oophorectomy (removal of the ovaries) or hysterectomy (removal of the uterus). And, women who use menopausal hormone therapy (MHT) often have higher breast density until they stop using MHT.
For women with dense breast tissue, digital mammography is more accurate than film mammography.
Ultrasound and breast MRI (in combination with mammography) are being studied to learn whether they improve detection in women with dense breasts compared to mammography alone.
Some common benign breast conditions (such as cysts and fibroadenom) may show up on mammograms as round or oval patches with distinct borders.
If a finding is abnormal, or the mammography image was not clear enough to interpret the results, you will be called back for a follow-up visit. Follow-up may include another mammogram, an ultrasound or a breast MRI. In some cases, a biopsy may be needed.
The recall rate of a mammography center is the percent of women who are called back for further tests. Some centers may share their recall rate with you and this information may help you understand your chances of being called back. It is not uncommon to be called back for an abnormal finding. Although there is no “gold standard” recall rate, on average, 10 percent of women are called back.
If you are called back, don’t panic. Most abnormal findings are not breast cancer.
When to expect mammography results
Some centers may give you the results of your mammogram at the time of your screening. However, depending on the center, it may take up to two weeks to get your results.
If you do not get your results within two weeks, follow up with your health care provider or the mammography center. Don’t assume the results were normal because you haven’t gotten a report.
Tomorrow my article will focus on different facts and statistics about breast cancer.
Make sure you check out the step by step video below on how to do a self examination.