Please note, we have shifted the entire early detection pages onto the site of The Pink Initiative. You will find a lot of information on all forms of breast symptoms (lumps, nipple discharge, skin changes, etc.) on that website - The Pink Initiative: Early Detection of Breast Cancer . We have summarized it in brief for you, in this present section, especially the Guidelines page, but we would definitely urge you to visit the link of 'The Pink Initiative: Early Detection of Breast Cancer' page highlighted above.
EARLY DETECTION OF BREAST CANCER
What is 'screening'?
Screening is a systematic evaluation of a 'normal' individual to see if there is any underlying cancer. A 'normal' individual implies one who does not have any symptoms or signs of cancer, and one who is living a normal life.
What is the importance or the necessity of screening?
Many cancers go through a stage wise manner. A cancer begins in a single cell, which slowly multiplies to form microscopic 'tumour' which keeps on enlarging, and ultimately produces some symptom, depending on the organ system it involves. It is usually seen that most tumours tend to produce symptoms when they are fairly big. As a 'cancer' grows, its 'invasiveness' increases. So if we were to catch a cancer much before it produces any symptoms, we will be able to treat it with minumum number of modalities, decreasing the trauma, and at the same time, increasing the survival of the patient. And we definitely do it for several cancers, like breast cancer, cancer of cervix etc. By regular check ups and by being alert, we can catch the cancer in its initial stage. To note here, as the stage of a cancer increases, the survival becomes less and less. So it is essential to detect cancers early. We CANNOT PREVENT a cancer, but we CAN definitely DETECT it EARLY!
How does screening help?
Screening enables us to detect a cancer much before it produces symptoms. This cancer will be in its initial stages, and adequate treatment of this initial stage will lead to a longer life.
Can screening be done for all cancers?
Screening protocols are laid down for particluar cancers, which include breast and gynecological cancers in females. But a thorough history and evaluation by a doctor, and assessment of any underlying 'routine' symptoms (symptoms for which you would routinely take some over counter preps and may not consult doctor) can also guide to particular investigations, which may lead us to an underlying cancer. As for breast cancer and cancer of the cervix, implementing screening protocols, and generating awareness in general population has led to a shift in the number of patients coming in advanced stages to more numbers of patients coming now in early stages, and this enhances survival. By screening for cancer cervix, in some countries, the rate of cervical cancer has become around 1 or 2 per 1 lakh population, and this is a sign of victory.
At what age should screening begin?
When discussing screening, cancer of breast and cancer of cervix go hand in hand.
For breast cancer, screening involves the following:
Breast Self Examination: This includes regular and systematic palpation of the breast by a woman herself to assess for any abnormality. You can find the details here. After age of 20 years, a woman must regularly do a BSE, and must be evaluated by a clinician, atleast once every few years. Up to the age of 40, this is all that is needed.
Mammography: Mammography will be advised by a clinician yearly, after a woman crosses 40 years of age. If mammography is normal, screening continues every year.
Who should be involved in screening?
For screening of breast cancer, a qualified medical personnel, preferably who is well versed and up to date with diseases of the breast and who is involved in the treatment of breast cancer, should be involved in screening. The reason is, all lumps in the breast are not cancerous, and sometimes, there is just nodularity and nothing else, all of which may be 'benign' (non cancerous) and may not need any treatment. So if the doctor involved in screening is not an expert in breast diseases, it may cause unnecessary apprehension in many normal people if some positive finding turns up.