Breast cancer screening

Breast cancer screening refers to checking ("screening") for potential breast cancer before any symptoms appear, in the hopes of detecting any existing cancer early enough in its development that effective treatment can be given.

Clinical breast exams, in which a health-care provider checks for abnormalities in the patient's breasts, are recommended annually. Additionally, genetic testing for the BRCA1 and BRCA2 genes, which are tied to increased levels of breast cancer, is possible; this is generally only recommended for women with a particularly high rate of family breast cancer or a known cancer pathology.

Breast self-exam

Breast self-examination is effective for detecting breast cancer at an earlier stage. The women taught self-exam tended to detect more breast nodules than those in the control group. The women taught breast self-exam were mostly likely to detect benign or early stage breast disease.

X-ray mammography

Mammography is still the modality of choice for screening women for early detection of breast cancer, since it is relatively fast, reasonably accurate, and widely available in developed countries. Breast cancers detected by mammography are usually much smaller (earlier stage) than those detected by patients or doctors as a breast lump Mammography has been estimated to reduce breast cancer-related mortality by 20-30%.

Women with one or more first-degree relatives (mother, sister, daughter) with premenopausal breast cancer should begin screening at an earlier age. It is usually suggested to begin at an age 10 years younger than the age when the relative was diagnosed with breast cancer.

Mammography is not as an effective screening technique for women less than 50 years old. Part of the difficulty in interpreting mammograms in younger women stems from breast density.Some authors speculate that part of the contribution of estrogen hormone replacement therapy to breast cancer mortality arises from the issue of increased mammographic breast density.

Enhancements to mammography

In general, digital mammography and computer-aided mammography have increased the sensitivity of mammograms, but at the cost of more numerous false positive results

Computer-aided diagnosis(CAD) Systems may help radiologists to evaluate X-ray images to detect breast cancer in an early stage. CAD is especially established in US and the Netherlands. It is used in addition to the human evaluation of the diagnostician.

Mammograms and Health Programs

All organized breast cancer screening programs in Canada offer clinical breast examinations for women aged 40 and over and screening mammography every two years for women aged 50-69.

The NHS Breast Screening Programme, the first of its kind in the world, began in 1988 and achieved national coverage in the mid-1990s, provides free breast cancer screening mammography every three years for all women in the UK aged 50 and over.

Breast MRI

• Strong family history of breast cancer
• Evaluation of women with breast implants
• History of previous lumpectomy or breast biopsy surgeries
• Very dense or scarred breast tissue

• In March 2007, an article published in the New England Journal of Medicinecontralateral breast was clinically and mammographically tumor-free, MRI could detect breast cancer. Sensitivityspecificity 88%. demonstrated that in 3.1% of patients with breast cancer, whose for detection of breast cancer in this study was 91%,

• In August 2007, an article published in The Lancet compared MRI breast cancer screening to conventional mammographic screening in 7,319 women.

Breast Cancer and Developing Countries

For instance, as South America has developed so has the amount of breast cancer. “Breast cancer in less developed countries, such as those in South America, is a major public health issue. It is a leading cause of cancer-related deaths in women in countries such as Argentina, Uruguay, and Brazil.

BRCA testing

• "recommends against routine referral for genetic counseling or routine breast cancer susceptibility gene (BRCA) testing for women whose family history is not associated with an increased risk for deleterious mutations in breast cancer susceptibility gene 1 (BRCA1) or breast cancer susceptibility gene 2 (BRCA2)" The Task Force gave a grade D recommendation.

• "2 first-degree relatives with breast cancer, 1 of whom received the diagnosis at age 50 years or younger"
• "3 or more first- or second-degree relatives with breast cancer regardless of age at diagnosis"
• "both breast and ovarian cancer among first- and second- degree relatives"
• "a first-degree relative with bilateral breast cancer"
• "a first- or second-degree relative with both breast and ovarian cancer at any age"
• "a history of breast cancer in a male relative."