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Early detection of breast cancer and its best practices

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Koji Wada, Managing Director, Fujifilm India talks about the diagnosis of breast cancer and highlights the various screening methods used for the detection

In the year 2020 alone, there were 2.3 million women who were diagnosed with breast cancer and 685,000 deaths globally. By the end of year, there were 7.8 million women alive who were diagnosed with breast cancer in the past 5 years, making it the world’s most prevalent and commonly occurring cancer. There are more lost disability-adjusted life years (DALYs) by women to breast cancer around the world than any other type of cancer.  If this does not speak of the gravity of this silent pandemic, then we don’t know what does. There is a stigma around the disease and talking about it in our society is considered to be taboo. But it is time we change the public perception.

Why is it so common?

Breast cancer can be diagnosed in multiple ways, making a complete medical examination extremely important. Breast cancer is not a communicable or infectious disease. Women with abnormalities that persist for a regular period of time i.e. generally lasting more than a month should undergo tests including breast imaging and in some severe cases tissue sampling or biopsy to determine if a mass is malignant (cancerous) or benign. Unlike some cancers that have been known to have infection-related causes, such as human papillomavirus (HPV) infection and cervical cancer, a viral or bacterial infection has not yet been linked to the occurrence of breast cancer in humans.

Methods of prevention

Treating breast cancer can prove to be extremely effective, with the survival probabilities of the patients often reaching 90% or higher, especially when the disease is identified early. Breast cancer screening refers to regular check-ups of the breasts for signs of cancer before any symptoms appear. It is the most optimal way to prevent this deadly disease. Different medical professionals tend to provide a more suited approach to screening and imaging depending upon the recent medical history of the patient. They also often factor in the person’s age and other related factors. For example, the United States Preventive Services Task Force recommends that women aged 50–79 years at average risk of breast cancer get a mammogram every 2 years.

If the screening shows a result that is unfavorable to the patient, then there are a host of options available for treatment. The advanced treatment of breast cancer often consists of a combination of surgical removal, radiation therapy and medication (hormonal therapy, chemotherapy and/or targeted biological therapy) to target the microscopic cancer that has spread from the breast tumor through the blood streams. Such treatments prevent cancer growth and its spread, and therefore save lives.

Radio diagnosis plays an integral role in both early diagnosis of breast cancer, and the entire process of its treatment. The preliminary radiological methods of investigation include mammography and high-resolution ultrasound of the breast. It is an easily available investigation and even inexperienced hands can be used for identification of a breast abnormality and in differentiating benign and malignant natures depending on identifiable sonographic characters of the breast lumps.

Early detection is the key

Regular mammography checkups can help in timely diagnosis of the disease. Women however, refrain from the mammography checkup due to the fear of test results and the pain that X-rays cause during the examination. However, some new technological advancements have made new digital mammography systems painless and fearless. Thanks to digital imaging with modern detectors, mammograms today are much faster as well.

Additionally, one can also begin with self-examination in 5 easy steps listed.

  1. Look at your breasts in the mirror with your shoulders straight and arms on hips
  2. Raise your arms and look for skin changes such as skin dimpling, skin ulceration or elevation
  3. Look for nipple flattening or inversion. Do not try to express nipple discharge. But please see the doctor if you notice spontaneous, unilateral, bloody or watery nipple discharge
  4. Use the first few fingertips in circular motion to feel the breast, keeping the fingers flat together
  5. Feel the breasts while standing or sitting. The easiest way is to do this when the skin is wet or slippery

Types of screening

Mammogram: A scan that uses low dose X-rays to take an image of the breast – Mammogram is one of the best tests that doctors have available to find early signs of breast cancer. The procedure goes as follows. The patient stands in front of a special X-ray machine that flattens the breast tissue using two plates. This aids the machine in getting a uniform image of the breast. The process repeats for the other dimensions of the breast and again for the other breast.

Ultrasound: The more basic way is to undergo an Ultrasound, which uses sound waves to make an image of the inside of the breast. The technician puts a gel on the skin of the breast and then moves a handheld device over the skin. The device then sends out sound waves that bounce off the tissue, which is then processed through a computer.

Other tests – Some doctors may recommend more advanced test options in some cases. There are several new and experimental test options that one can experience, such as

  1. MRI
  2. breast tomosynthesis
  3. contrast-enhanced mammography
  4. molecular breast imaging
  5. electrical impedance imaging
  6. positron emission mammography

Is screening during the pandemic a risk?

The healthcare world has evolved and with every step along the way is supported by innovative technology and extremely able medical-health professionals.  Breast cancer screening techniques have not been altered during the COVID-19 pandemic and still remain extremely safe. The procedures continue to be available across markets and are done with strict infection prevention measures in place. The virus must not act as a hindrance for anyone who wishes to get themselves checked, as breast cancer will not wait for life to return to normal.

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