Breast cancer is one of the most common cancers among women with an overall lifetime risk of 12%. One out of every eight women in the United States will be afflicted with breast cancer. Breast cancer is also a disease that carries an overall mortality rate of 17% (American Cancer Society 2007). However, when caught in the early stages the five-year survival rate is greater than 98%. In honor of the 25th anniversary of Breast Cancer Awareness Month the following reviews the tests every woman should be aware of for optimum breast health.
When should every woman start checking for breast cancer? 1. Beginning in your early 20s, you should start monthly breast self-examinations. Definitely ask your physician for the benefits and limitations of this exam. 2. In your 20s-30s, a clinical breast examination is recommended at least every three years. 3. At age 35, you should start having annual mammograms along with a yearly clinical breast exam. The mammogram is a great screening tool for clinicians as it provides a picture of the breasts, and the newer digital x-ray technology are even more accurate with regard to breast tissue. As with any test there are risks, but those risks are minimal. The radiation received from an annual mammogram is equal to the radiation received from three months of daily living. Sometimes the mammogram is not clear enough for a physician to make a clinical decision. In order to gain more information about his or her patient, your physician may need to order an ultrasound or MRI. What is an ultrasound? An ultrasound or sonography is a test that uses high frequency sound waves to look inside the body. The sound waves travel through the breast and reflect echoes, which are displayed on a screen. Even though the ultrasound is a painless, radiation free test, it is not a screening test to be used alone. Clinicians will often use ultrasounds along with mammography to get a more comprehensive picture of the breast. What is a MRI? An MRI or magnetic resonance imaging is an additional test that can be used to detect certain cancers. However, MRIs can also miss basic cancers that are easily picked up by mammograms. MRIs are not recommended as a screening test, except when used in conjunction with mammography in high-risk women. In addition, your insurance company might not cover the MRI, so it is best to let your physician decide case by case if an MRI is warranted. Who should get a MRI? Women with strong family history of breast or ovarian cancer, BRCA1 and BRCA2 genetic mutations, prior chest radiation therapy, or an overall lifetime risk over 20-25% (as determined by your clinician) are recommended to have an MRI in addition to an annual mammogram. What is a diagnostic test for breast cancer? If your imaging studies show abnormalities that warrant further review, your clinician may recommend an additional study or suggest that a biopsy be taken. Diagnostic studies include additional imaging, and a biopsy is basically a tissue sample from the area of abnormalities. Usually an instrument is guided by MRI, stereotactic (imaged from multiple angles) mammography or ultrasound to the location in question. Then a small sample of tissue is taken to be interpreted under a microscope by a pathologist. The pathologist can determine exactly if the cells are benign or require further work-up. Breast cancer is a disease that can be detected and stopped early if the correct screening tests are conducted. Thanks to better treatment, management, and detection the mortality rate of breast cancer has been dropping ever since 1990. Early detection with yearly mammography is the key to optimum breast health.
