#Title

Breast cancer screening

NO bother AT ALL
SCREEN EARLY, SCREEN OFTEN
Breast cancer is the number one cancer among women in the world. In Singapore, 2000 women are diagnosed with breast cancer every year. Early detection through screening, however, can improve chances of survival.
SCREENING: WHY BOTHER?
Dr Wong Chiung Ing from Parkway Cancer Centre talks about the importance of early detection of breast cancer in women.
Breast cancer is the most common cancer among women around the world, including Singapore. According to the World Health Organization International Agency for Research on Cancer, an estimated 1.67 million new breast cancer cases are diagnosed per year, accounting for 25 per cent of all cancers.
Closer to home in Singapore, breast cancer constitutes 30 percent of all cancer diagnoses in women, with an estimated 2000 new cases diagnosed per year.
The risk of breast cancer increases with age; the highest incidence rate of diagnosis seen among women aged between 50 and 59 years. Survival rates, however, are generally improving as a result of earlier detection and better treatment methods.
Screening usually involves checking your breasts for cancer even before there are any signs and symptoms. While screening cannot prevent breast cancer, it can help you to detect the cancer early, so that it can be treated earlier. Talk to your doctor about which screening tests to do and when you should do them.
In general, screening tests include —
MAMMOGRAM
This is the most common and primary screening tool for detecting breast cancer. It detects changes such as abnormal densities or calcium deposits in the breasts.
As the procedure involves having the breasts compressed to spread the tissue so that small abnormalities are not obscured, some women may find mammograms uncomfortable or painful. But these two minutes or so of discomfort could save your life.
WHAT’S INVOLVED?
In a mammogram, low-dose X-rays are used to create images of the breast. The radiographer will position each breast in the mammography unit and compress it for a few seconds to take different views of each breast.
It is recommended that you go for a mammogram when your breasts are the least tender, which is usually about a week following your period.
Depending on the mammogram results, the doctor may recommend further tests such as another mammogram to take different views of your breasts, and a breast ultrasound scan to examine the breast tissue.
When should you go? Women above 40 years of age should go for a mammogram every year, while those above 50 years old should do it every two years.
ULTRASOUND SCAN
An ultrasound scan is a supplemental test for women with very dense breasts, which make it difficult for a mammogram to detect small abnormalities. It can tell between a solid mass (which may be cancerous) and a fluid-filled cyst (which is usually not cancerous).
When done in addition to a mammogram and breast self-examination, it can help the doctor decide if more tests such as a biopsy is needed. However, while it may be less painful than a mammogram, an ultrasound scan should never be used to replace a mammogram, and vice-versa.
What’s involved?
Ultrasound scans use high-frequency sound waves instead of X-rays and are safe for pregnant women and mothers who are breastfeeding. A gel is put on the skin of the breast, followed by moving a small hand-held probe across the breasts to produce detailed images of the inside of the breasts. The scan usually lasts between 10 and 30 minutes.
When should you go? Women above 40 years old can do both a mammogram and ultrasound scan as part of their annual screening. Those above 50 can include an ultrasound scan during their two-yearly mammography screening. Check with your doctor on whether an additional test of ultrasound scan is needed or not.
BREAST MRI
MRI, or magnetic resonance imaging is a scan that is usually used in further evaluation of patients who have been diagnosed with breast cancer. For certain women at high risk of breast cancer (either because of a very strong family history or a gene abnormality), a MRI screening is recommended along with a yearly mammogram.
WHAT’S INVOLVED?
MRI uses radio waves and strong magnets to make detailed, cross-sectional pictures of the breast. You will need to lie on your stomach on a motorised table with cushioned openings for your breasts. Each opening is surrounded by breast coil which is a signal receiver to help create the images. The scan takes about 30 to 45 minutes. You will hear a loud noise whilst in the MRI machine and if you are claustrophobic, you may find the scan difficult to tolerate.
When should you go? Breast MRI can only be recommended by doctors after determining if the woman is at high risk for breast cancer. It is not recommended as a screening test for women at average risk of breast cancer.
BREAST SELF-EXAMINATION (BSE)
Examining your breasts on your own regularly is an important step you can take to detect breast cancer early.
WHAT’S INVOLVED?
Take these steps for a self-examination. The best time to examine your breasts is the week after your period ends, when the breasts are least likely to be swollen and tender.
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