Screening for breast cancer
There is no doubt that the best chance for curing breast cancer is through early
detection. Early detection relies on a program of screening, which involves
breast self-examination (BSE), clinical breast examination, and mammography.
Women who have not had any breast problems should
probably have their first baseline mammography examination at age 35. After
that, they should follow the general screening schedule of a mammogram every
year for women age 40 and over.
Mammograms are the standard of care to detect breast
cancer before it can be felt during a breast examination. Research has shown
that mammograms can increase breast cancer survival, although exactly how much
has been the recent controversy. Recent data did find that mortality rates were
reduced by 25%. However, not all breast cancers can be detected on mammography.
This is especially true for younger women who have denser breast tissue. Thus,
it is important to include a breast examination (by BSE and an examination by a
doctor or nurse) as part of the screening process.
Recognizing normal, hormonal changes
Breast physical examinations can be very challenging. Breast tissue changes
during a woman's entire life. It is particularly sensitive to estrogen and
progesterone hormone influences.
In some women, changes in hormone balances during
normal, monthly cycling can create symptomatic breast changes that are referred
to as "fibrocystic change." This is a general term that consists of a number of
different findings, including breast swelling, tenderness, pain, nodularity
(tissue resembling or containing small nodules), thickening, lumps, and masses.
Fibrocystic changes can occur in one or both breasts.
The changes are often prominent during a woman's 30s and 40s. It is relatively
uncommon for postmenopausal women to have symptomatic breast changes due to a
lack of hormone stimulation of the breast tissue.
Detecting breast changes through breast self-examination
Many women are anxious about practicing breast self-examination. They wonder
what is normal and what is not normal. The best way for a woman to become
familiar with her breast tissue is to practice BSE regularly.
Breast self-examination should be performed at the
same time each month. For premenopausal women, the best time is usually 3-5 days
after the end of a menstrual period. Over time, women who practice BSE become
familiar with how their breast tissue changes from month to month. This can help
them to be more alert to any changes that are not normal.