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Mammogram and Breast Cancer Screening
Cancer screening
The term screening is commonly used for a test that is used for
evaluation of a person for possible disease without the person ever
having any symptoms or signs of the disease. Screening tests are
usually undertaken in a target population, which has significantly
high risk of developing the disease. Mammogram is a screening
technique used for breast cancer, and the target population for
mammogram is women who are aged 40 and above. PSA testing is a
screening test for prostate cancer and the target population is men
over 50 years of age. Screening tests cannot be employed in all
diseases. In some cases a useful screening test may not be
available, and in some other cases it may not be worth screening
for a disease because screening and finding out the disease early
may not change the natural history of disease. The later is
probably true in case of screening of lung cancer. From the studies
so far published, there is no clear evidence to suggest that
screening for lung cancer in high-risk population (smokers) would
improve survival.
Breast cancer screening
Unlike lung cancer, breast cancer can be screened using available
techniques with beneficial results. Mammogram is the only accepted
screening test for breast cancer. Mammogram till this date may have
saved lives of thousands of women, by detecting the disease at a
very early stage, when it is mostly curable. Screening for
mammogram does not prevent the occurrence of breast cancer, but
instead it provides a very simple and useful technique to detect
breast cancer at a very early stage. Mammogram is capable of
detecting breast cancer at a stage prior to infiltration of the
tumor to the surrounding structures, called stage 0 breast cancer
or carcinoma in situ. Recommendations for breast cancer screening
vary from country to country and within the same country according
to the views of different organizations who recommend the
screening. American Cancer Society recommends that "women age 40
and older should have a screening mammogram every year and should
continue to do so for as long as they are in good health."
What is a mammogram?
Mammogram is just an X-ray photograph of your breast, and works in
principle the same way as your chest X-ray. The breast tissue is
compressed between two plates and an X-ray picture is taken.
Doctors would look at the X-ray and determine if there are any
abnormalities in the picture. Breast cancer usually appears in the
form of calcifications, architectural distortions, or abnormal
densities. Since mammogram uses X-rays, there may be slight risk
associated with exposure to radiation in women who get mammograms.
However the amount of radiation associated with mammogram
examination is very small and is strictly controlled by regulatory
agencies like National Department of Health and Human Services.
Very strict regulations are enforced by this agency to make sure
that mammography equipment is safe and uses the lowest dose of
radiation possible. The dose of radiation used by the modern
mammogram machines does not significantly increase the risk of
breast cancer.
Digital mammography
Digital mammograms are similar to conventional X-ray film
mammograms except that the pictures are produced in the digital
media in a computer. Digital pictures have the advantages of
manipulation of light and contrast and hence would be more useful
for the studying the mammography picture. It was claimed in the
past that digital mammogram is superior to conventional mammograms
in terms of accuracy, however a recent study has shown that
digital mammography no better than regular mammography.
Computer Aided Detection (CAD)
CAD is sophisticated computer program that can compare areas of the
digital mammography picture and aid the physician to more easily
detect breast cancer. Studies have shown that CAD system improved
diagnostic accuracy by about 20 percent.
Clinical breast examination and self breast
examination
An article on breast cancer screening will not be complete without
mentioning clinical breast examination and (CBE) and self breast
examination (SBE). CBE and SBE are useful adjuvant to mammogram for
detection of breast cancer. It is also to be mentioned that about
10 percent of all tumors that can be felt by the physicians may not
be seen in a mammogram, hence if the physician feels a tumor, the
absence of abnormality in the mammogram does not ensure absence of
a breast tumor. Such patients should be evaluated by biopsy.
Self-breast examination as the name implies denotes examination
of breast by women, without the help of a physician. This can be
undertaken in the privacy of their home. Probably the best time to
do a self-breast examination is while taking showers. Women can ask
their physicians to teach them the technique of self-breast
examination. American Cancer Society recommends "women in 20s and
30s should have a clinical breast examination (CBE) as part of a
periodic (regular) health exam by a health professional preferably
every 3 years. After age 40, women should have a breast exam by a
health professional every year." Regarding self-breast examination,
American Cancer Society gives the following recommendations: "BSE
is an option for women starting in their 20s. Women should be told
about the benefits and limitations of BSE. Women should report any
breast changes to their health professional right away."
The author is the webmaster for http://medicineworld.org which
features many useful articles and news items related to cancer. You
can find more information on breast cancer, breast
cancer news, and breast cancer treatment in author's breast
cancer page of the website.
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