- Breast Cancer Screening and Diagnosis - A Synopsis | Mahesh K Shetty | Springer
- What is screening?
- Breast Cancer Screening and Diagnosis
Enlarge Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown. Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless, watery fluid called lymph. Lymph vessels carry lymph between lymph nodes. Lymph nodes are small, bean-shaped structures that filter lymph and store white blood cells that help fight infection and disease. Groups of lymph nodes are found near the breast in the axilla under the arm , above the collarbone , and in the chest.
See the following PDQ summaries for more information about breast cancer :. Women in the United States get breast cancer more than any other type of cancer except for skin cancer. Breast cancer is more likely to occur as a woman ages. It occurs more often in white women than in black women, but black women die from breast cancer more often than white women. Breast cancer rarely occurs in men.
Because men with breast cancer usually have a lump that can be felt, screening tests are not likely to be helpful. For information about risk factors and protective factors for breast cancer, see the PDQ summary on Breast Cancer Prevention. Scientists study screening tests to find those with the fewest harms and most benefits.
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For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage. A mammogram is an x-ray picture of the breast. Mammography may find tumors that are too small to feel. It may also find ductal carcinoma in situ DCIS. In DCIS, abnormal cells line the breast duct , and in some women may become invasive cancer.
Breast Cancer Screening and Diagnosis - A Synopsis | Mahesh K Shetty | Springer
Mammography is less likely to find breast tumors in women with dense breast tissue. Because both tumors and dense breast tissue appear white on a mammogram, it can be harder to find a tumor when there is dense breast tissue. Younger women are more likely to have dense breast tissue. Enlarge Mammography. The breast is pressed between two plates. X-rays are used to take pictures of breast tissue.
Many factors affect whether mammography is able to detect find breast cancer:.
Women aged 50 to 69 years who have screening mammograms have a lower chance of dying from breast cancer than women who do not have screening mammograms. Fewer women are dying of breast cancer in the United States, but it is not known whether the lower risk of dying is because the cancer was found early by screening or whether the treatments were better. MRI is a procedure that uses a magnet, radio waves , and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging NMRI.
MRI does not use any x-rays and the woman is not exposed to radiation. MRI may be used as a screening test for women who have a high risk of breast cancer. Factors that put women at high risk include the following:. An MRI is more likely than mammography to find a breast mass that is not cancer.
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Women with risk factors for breast cancer, such as certain changes in the BRCA1 or BRCA2 gene or certain genetic syndromes may be screened at a younger age and more often. Women who have had radiation treatment to the chest, especially at a young age, may start routine breast cancer screening at an earlier age. The benefits and risks of mammograms and MRIs for these women have not been studied. Breast cancer screening has not been shown to benefit the following women:.
Studies have been done to find out if the following breast cancer screening tests are useful in finding breast cancer or helping women with breast cancer live longer. A clinical breast exam is an exam of the breast by a doctor or other health professional. He or she will carefully feel the breasts and under the arms for lumps or anything else that seems unusual.
It is not known if having clinical breast exams decreases the chance of dying from breast cancer. Breast self-exams may be done by women or men to check their breasts for lumps or other changes. If you feel any lumps or notice any other changes in your breasts, talk to your doctor.
Doing regular breast self-exams has not been shown to decrease the chance of dying from breast cancer. Thermography is a procedure in which a special camera that senses heat is used to record the temperature of the skin that covers the breasts. Tumors can cause temperature changes that may show up on the thermogram. There have been no randomized clinical trials of thermography to find out how well it detects breast cancer or the harms of the procedure. Breast tissue sampling is taking cells from breast tissue to check under a microscope. Breast tissue sampling as a screening test has not been shown to decrease the risk of dying from breast cancer.
Clinical trials supported by other organizations can be found on the ClinicalTrials. Not all breast cancers will cause death or illness in a woman's lifetime, so they may not need to be found or treated. Decisions about screening tests can be difficult. Not all screening tests are helpful and most have harms. Before having any screening test, you may want to discuss the test with your doctor.
It is important to know the harms of the test and whether it has been proven to reduce the risk of dying from cancer. Screening test results may appear to be abnormal even though no cancer is present. When a breast biopsy result is abnormal, getting a second opinion from a different pathologist may confirm a correct breast cancer diagnosis.
What is screening?
Most abnormal test results turn out not to be cancer. False-positive results are more common in the following:. False-positive results are more likely the first time screening mammography is done than with later screenings.
For every ten women who have a single mammogram , one will have a false-positive result. The chance of having a false-positive result goes up the more mammograms a woman has. Comparing a current mammogram with a past mammogram lowers the risk of a false-positive result.
The skill of the radiologist also can affect the chance of a false-positive result. If a mammogram is abnormal, more tests may be done to diagnose cancer. Women can become anxious during the diagnostic testing. Even if it is a false-positive test and cancer is not diagnosed, the result can lead to anxiety anywhere from a few days to years later. Several studies show that women who feel anxiety after false-positive test results are more likely to schedule regular breast screening exams in the future.
Screening test results may appear to be normal even though breast cancer is present. This is called a false-negative test result.
A woman who has a false-negative test result may delay seeking medical care even if she has symptoms. About one in 5 cancers are missed by mammography. Some breast cancers found by screening mammography may never cause health problems or become life-threatening. Finding these cancers is called overdiagnosis. When these cancers are found, having treatment may cause serious side effects and may not lead to a longer, healthier life.
Being exposed to high radiation doses is a risk factor for breast cancer. The radiation dose with a mammogram is very low. Women who start getting mammograms after age 50 have very little risk that the overall exposure to radiation from mammograms throughout their lives will cause harm. Women with large breasts or with breast implants may be exposed to slightly higher radiation doses during screening mammography. During a mammogram, the breast is placed between two plates that are pressed together. Pressing the breast helps to get a better x-ray of the breast.
Some women have pain or discomfort during a mammogram. The amount of pain may also depend on the following:. Talk to your doctor or other health care provider about your risk of breast cancer, whether a screening test is right for you, and the benefits and harms of the screening test. You should take part in the decision about whether you want to have a screening test, based on what is best for you. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine.
Most summaries come in two versions.
Breast Cancer Screening and Diagnosis
The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish. The PDQ summaries are based on an independent review of the medical literature. This PDQ cancer information summary has current information about breast cancer screening. It is meant to inform and help patients, families, and caregivers.