Breast Cancer Screening
Breast Cancer Screening
Cancer screening refers to the process of checking for cancer in individuals who do not yet show symptoms, with the goal of detecting it early when treatment is more likely to be successful. To emphasize, screening for cancer is done in completely “normal” individuals who have no health issues. Different types of cancer require different screening methods.
The logic behind cancer screening is based on the principle of early detection. Identifying cancer in its early stages often allows for more effective treatment, increasing the chances of survival and reducing the severity of treatment.
Breast Cancer screening is a very successful method as we have objective tests to identify the cancer in an early stage and also we have very effective treatments for the disease identified early thus saving lives.
Breast Self Examination
Women with family history of breast cancer in first degree relatives (mother, sister, aunts) need to be extra cautious
Women with known genetic abnormalities like BRCA positive might need screening at an earlier age.
When we review family history, it is important to be cautious when we have cancer of ovary or endometrium also in the first degree family.
Most breast cancers that are seen, are not actually, familial. Meaning, they occur in women who do not have any family history!
Early Detection Increases Survival
- Cancer grows over time: Most cancers start small and grow larger over time, eventually spreading (metastasizing) to other parts of the body. When cancer is detected early—before it has spread—treatment is more likely to be successful.
- Localized treatment: Early-stage cancers are often confined to a specific area. Treatments like surgery or localized radiation can effectively remove or destroy cancer cells before they spread, reducing the need for more aggressive systemic treatments like chemotherapy.
Screening Targets High-Risk Populations
- Population-based screening: The logic of cancer screening is often based on targeting specific populations that are at higher risk for certain types of cancer. For example, breast cancer screening (mammograms) is recommended for women aged 40 or older because the risk of breast cancer increases with age.
- Individual risk factors: Screening recommendations are also influenced by personal factors, such as family history, genetics (e.g., BRCA mutations for breast cancer).
Improved Treatment Options for Early-Stage Cancer
- Less invasive treatments: Treating cancer in its early stages often allows for less invasive treatment options. For example, a small tumor detected in a mammogram may be removed with a lumpectomy (removal of the tumor) instead of a full mastectomy (removal of the breast).
- Better prognosis: Early-stage cancers tend to respond better to treatment, with higher survival rates. For instance, the 5-year survival rate for localized breast cancer is about 99%, but it drops significantly once cancer spreads to other parts of the body.
How is screening done?
Screening consists of two tests that are done regularly and always together.
Mammogram: It uses x-rays to look at the breasts and identifies the calcium depositions within breasts. Based on the patterns of calcifications seen on the image, risk assessment is done.
Ultrasound: Along with mammogram, ultrasound is always done to look for changes of the breast not picked up by mammogram.
A report is given using BIRADS SCALE to quantify risk of cancer.
In Summary
The logic of cancer screening is rooted in the principle that early detection of cancer leads to better outcomes. Screening targets high-risk populations and focuses on detecting cancer at a stage where treatment is more effective, less invasive, and less costly.