Strategies for Early Detection

We know that the earlier a breast cancer is diagnosed, the more options a woman has for treatment and the better her outcome in general will be. A good breast cancer surveillance program for most woman involves three simple steps:

1) Monthly Self Breast Exam

Women who examine their breasts regularly find cancers at a smaller size than women who don’t – and when it comes to breast cancer, size matters. All women should begin monthly self breast exam in their early twenties when their risk of breast cancer is extremely low. In this way, they become "experts" at their own breasts and are comfortable with what is normal for them. Once normal is familiar, abnormal will be more obvious, allowing earlier evaluation of a potential problem. Breasts should be examined the  week following the end of the menstrual period as they are least stimulated by hormones at that time. Lumps that change in size with the menstrual cycle are likely benign, those that persist through cycles should be evaluated.

2) Annual Mammogram

Every woman should have a screening mammogram annually beginning at age 40. It is helpful to have a baseline mammogram performed sometime in the late 30s in order to have a comparison for the first screen. A mammogram can detect a cancer long before it can be felt and these are the cancers that are most curable.

3) Annual Clinical Breast Exam

A breast exam performed by a woman’s primary physician should accompany her annual mammogram. At that time, the physician will also discuss her particular risk factors for developing breast cancer and evaluate any concerns about the monthly self breast exam or mammogram. A woman’s primary physician is her partner in maintaining good breast health!

For women who are at higher risk, such as those with a strong family history of breast or ovarian cancer, or a previous biopsy finding a high risk lesion, a more aggressive surveillance program may be warranted. This may involve the use of more sensitive imaging studies such as breast MRI, or a shorter screening interval starting at an earlier age. A breast cancer specialist can help determine the right strategy for early diagnosis in high risk women.

Copyright 2008 by Janet Grange, MD