On Saturday night at the inaugural Stars of the Beaches event to raise funds for the…
Breast cancer prevention and screening
Breast cancer is the most common cancer in women worldwide, affecting 1 in 8 women.
While almost 80% of new cases are in women over the age of 50**, women under 40 are certainly not exempt, in fact, breast cancer when diagnosed at a younger age tends to be more aggressive. Early detection means simpler and more effective treatment options as well as increased survival.
There are risk factors that can increase the likelihood of developing breast cancer, including simply being female, age, family history, carrying the BRCA1 or BRAC2 gene mutation, higher breast density and some lifestyle factors.
“A common myth about breast cancer is that people believe breast cancers occur more often in those with family history. The truth is that the vast majority of women do not have a family history of breast cancer. In fact, 8 out of 9 women who develop breast cancer do not have a first degree relative who has had breast cancer” says Dr Katelyn Lee from PRP Imaging.
Women under 40
While mammograms aren’t routinely recommended for women under 40, they are performed on women who have a worrying symptom or strong risk factors (known gene mutations or strong family history).
Generally, for women with no symptoms, screening mammograms can be performed every two years. Additionally, women should be checking their own breasts regularly, as well as ensuring their GP is examining their breasts as part of their overall health plan.
Screening mammograms should be undertaken every two years, while remaining attentive with regular self-breast checks and breast checks with their GP. Women with a personal history of breast cancer or those with strong risk factors should undergo yearly mammograms.
There are many ways women can check their breasts – in the shower, in front of the mirror or lying down.
Visually inspect your breasts, while looking in the mirror and raising your arms overhead, looking for areas of dimpling or redness.
Use flattened fingers to examine the breasts. The most important thing is to cover the whole breast, whether that be by using your fingers to run circular motions around the breast from outside to inside or by running the fingers up and down the breast checking each quadrant at a time.
“Having breasts that feel lumpy is common. The important thing is to become familiar with your breasts so that you recognise any change” says Dr Katelyn Lee.
A mammogram examines the breast tissue using a very small dose of Xray and detects cancers that are too small to be felt. “Mammograms are the most effective tool we have to detect breast cancer in the initial stages. There is strong evidence based on thorough research that mammograms save lives,” says Dr Katelyn Lee from PRP Imaging.
3D breast Tomosynthesis
With 3D breast tomosynthesis, multiple images of each breast are taken from different angles using the latest digital technology. A state-of-the-art software program then produces multiple, fine 1mm slices of each breast. This provides a 3D view, allowing the radiologist to ‘scroll’ through each breast image, one layer at a time.
“This significantly reduces the effect of overlapping breast tissue that is seen on a standard 2D breast screening mammogram, allowing for greater clarity in dense breasts, greater accuracy in characterising abnormalities and an increased chance of detecting breast cancer in the early stages,” explains Dr Katelyn Lee.
Ultrasound images are obtained using a probe that is moved over the breast. It uses soundwaves to obtain information. There is no radiation. It is a very useful adjunct to mammography and tomosynthesis and helps to characterise mammographic findings. It also increases the detection rate of breast cancers and is particularly useful for women with dense breasts.
MRI uses a magnetic field to create thousands images of the breast tissue. There is no radiation involved. It is a powerful and very sensitive tool often used for screening in women with strong risk factors (BRCA1 and 2 gene mutation carriers, strong family history); to assess the extent of breast cancer; surveillance post treatment; and for the assessment of suspected breast implant rupture. It is also used for tricky cases where there are concerning symptoms but the mammogram and ultrasound have been negative.
Ultimately women of all ages should be familiar with the usual look, size and feel of their breasts, with any changes to be discussed with their GP. Changes ranging from lumps, swelling/redness, a change in the size and shape of the breast, skin dimpling, new nipple inversion and discharge from the nipple, should be investigated further.
Dr Katelyn Lee MBBS BSC (HONS) from PRP Imaging
Katelyn graduated medicine from the University of New South Wales with honours. She undertook radiology training at Concord Hospital and then completed a fellowship in breast imaging at Royal North Shore Hospital and BreastScreen.
Katelyn is a general radiologist with special interests in breast, body and oncology imaging.