When a woman is diagnosed with breast cancer it affects not just her, but those around her. Women who know her will hopefully look at themselves and ask, “Could that happen to me?”
Breast cancer in someone close to you, whilst causing you fear and uncertainty, will hopefully encourage you to start self-examining your breasts and going for screening.
Regular screening helps pick up cancers early so that they can be better treated at a smaller stage.
Screening guidelines used to be similar for all women, irrespective of the woman’s risk factors. Because we now know that some women are more at risk than others, we suggest a different pattern of screening, individualised to each patient and their risk of cancer.
So, what is your risk, and when and how often you should be screened?
What is my risk?
You are at average risk of cancer if:
- You have no symptoms
- You have never had breast cancer
- You have never been diagnosed with atypical hyperplasia (or any other type of benign breast disease) or lobular carcinoma-in-situ
- There is no family history of breast cancer in first generation (sisters or parents or daughter) or suggestions of hereditary forms of cancer
- No history of mantle radiation for lymphoma (a type of upper body radiation given for lymph gland cancer).
You are at above average risk if:
- There is a close family history of breast cancer. This means that a parent, grandparent, sibling or child has had breast cancer. It also may include your aunts, cousins and other relatives if there are many in the family who have had breast cancer, all from the same side of the family.
- You have had a diagnosis of atypia from a breast biopsy. This is a form of benign breast disease but can be associated with an increased risk of later cancer
- You had mantle radiation before the age of 32.
- There is no test or method that prevents cancer from developing in the breast, but picking it up as early as possible ensures the best outcomes.
Screening guidelines are intended to increase the chance of picking up a cancer, or worrying area of cells, once they have developed in your breast.
Average risk patients
- Examine your own breasts each month and get to know what is normal for you
- After the age of 40 see your doctor, or breast specialist, every six months for a clinical breast examination
- After the age of 40 get a mammogram and sonar at least every two years
- After the age of 50 get a mammogram and sonar every year.
Above average risk patients
- Examine your own breasts each month and get to know what is normal for you so it is easier to spot something abnormal if it happens
- See your doctor, or breast specialist, every three to six months for a clinical breast examination, starting when you are ten years younger than the youngest age at which breast cancer was diagnosed in your family (but not earlier than 25 years or later than 40)
- Go for an annual mammogram and sonar starting no later than ten years before the youngest age at which breast cancer was diagnosed in your family
- If you have atypia diagnosed, you should start annual mammograms irrespective of age, and see your doctor for a clinical breast examination every three months
- You may want to consider an MRI scan, which helps with the differentiation of normal and abnormal breast tissue in some difficult to diagnose patients.
Simple measures can reap great rewards. Getting to know your breasts, and getting into the habit of checking them regularly, is important.
Consider booking your next mammogram and sonar for the week after your birthday – that way you will be reminded every year that it is time for a check-up!
Written by Dr Sarah Rayne