Breast cancer: detection and diagnosis
Early detection
Early detection is a key factor that can boost your chances of surviving breast cancer. If a cancer is detected while still localised in the breast, your chances of 5-year survival are often higher than 90 per cent.
To aid your chances of early detection, be aware of changes in your breasts, such as changes to the shape of the breast or a nipple, scaly skin around the nipple, swelling, puckering or dimpling, discharge or a lump. Make sure you visit your doctor as soon as possible if you detect changes like these. However, try not to worry if you do detect a change as breast changes are common, and in most cases will not be due to breast cancer.
Breast self-examination
Some doctors believe that monthly breast self-examinations may not be as useful as previously thought. Some studies have shown that routine, systematic breast self-examination does not lead to fewer deaths from breast cancer and, in fact, may lead to unnecessary biopsies and concern. Cancer associations differ in their positions on whether women should do breast self-exams. One thing is for sure — doing breast self-exams makes you familiar with how your breasts normally feel.
The Cancer Council Australia recommends ‘breast awareness’ — being familiar with the normal look and feel of your breasts, and reporting any unusual breast changes to your doctor immediately.
Mammograms
BreastScreen Australia and the Cancer Council Australia recommend 2-yearly mammograms for all women aged 50-69. Mammograms (a procedure that uses low-level X-rays to detect abnormal areas in the breast) are one of the best methods of detecting breast cancer at an early stage.
BreastScreen Australia states that women aged 50-69 who have regular 2-yearly mammograms can reduce their risk of dying from breast cancer. So, BreastScreen Australia provides free screening mammograms to women aged 50-69 years. There are more than 500 screening locations around the country including mobile units.
Although the scientific evidence is not strong enough to recommend regular screening mammograms for women aged 40-49 (unless they have a family history of breast cancer) they may request a free screening mammogram at BreastScreen Australia.
Women over 70 are also eligible for free screening mammograms through BreastScreen Australia.
The breast tissue in women before the menopause is dense and makes mammograms difficult to read, so women under 40 do not usually have regular screening mammograms.
There are other screening mammogram services apart from BreastScreen Australia, so talk to your doctor if you think you need a mammogram.
Ultrasound
As mentioned, the breast tissue of younger women is dense and thick and it makes mammograms difficult for doctors to read, so in these cases ultrasound can be used to view the breast tissue. Ultrasound is often the doctor’s choice for women under 35.
Diagnosis
A biopsy will be performed if a breast lump that could be a cancer is detected on a mammogram or ultrasound. This could take the form of an aspiration biopsy or an incisional biopsy.
Aspiration biopsy
An aspiration biopsy (sometimes called fine-needle aspiration cytology) is when some cells are removed from the lump through a needle attached to a syringe. This procedure is sometimes guided by ultrasound, so that the doctor can view the lump and make sure the needle goes into it. The cells are then sent away for analysis.
Incisional and excisional biopsies
An incisional biopsy is when a small piece of tissue is removed and an excisional biopsy is one in which the whole lump is removed. You will generally not be required to go to hospital for a biopsy and usually only local anaesthetics are used. If cancerous cells are found, further tests will need to be conducted to determine the characteristics of the cancer. You will also need further examinations to find out whether the cancer has spread from the breast.
Last Reviewed: 04 August 2006
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