Screening refers to the detection of a common disease in the society with simple tests or examinations before any complaints develop. The purpose of screening for breast cancer is to detect cancer at an early stage and prevent cancer-related deaths. In addition, by detecting breast cancer at an early stage through screening, it is possible to protect the breast without having to remove the entire breast and the need for chemotherapy decreases.
Screening for breast cancer;
-
breast self-examination,
-
clinical breast examination performed by a doctor
-
imaging with mammography.
Screening in People with Normal Risk;
Self-Examination
It is recommended for every woman after the age of twenty to perform the examination;
-
If she is menstruating, the 5th-7th day after menstruation. between days,
-
on a fixed calendar day of each month after menopause,
-
once a month after breastfeeding in breastfeeding women, after the milk in the breasts is emptied .
This examination method can be applied in front of a mirror, lying down or in the shower. The aim here is to get to know one's own breast tissue better and to detect any changes that may occur in the breasts early.
Visual examination: In front of a mirror. should be done. After the arms are lifted up, first while both arms are behind the head, and secondly, while pressing the hands on the hip bones; By slightly removing the shoulders and leaning forward, both breasts and armpits should be examined separately from the front and side. In the meantime, the size and symmetry of the breasts, the color and shape of the skin, the nipples, the sub-breast areas and the armpit should be examined. Attention should be paid to whether there is shrinkage of the breast skin, orange peel appearance on the skin, redness, abnormal growth in one of the breasts, collapse of the nipples and peeling or crusting-like lesions around them. Recurrent, persistent peeling or crusting on the nipples accompanied by skin changes may be a very early sign of cancer.
Manual Examination: Standing in front of a mirror or lying down It can be done in two ways: The breast itself, nipples and armpits should be examined manually.
In outpatient examination; The examination should be started by making small circular movements with the inner surface of the three middle fingers of the hand. For the right breast, the left hand should be examined, and for the left breast, the right hand should be used to examine the breast by pressing first lightly and then a little more.
The same movements should be repeated for the other breast.
Manual examination can be done with three movements on the breast; The first is circular lines on the breast tissue that gradually intertwine in a clockwise direction, the second is by drawing parallel vertical lines to each other by sliding the fingers without lifting the hand, and the third is linear arrows ending at the nipple. It can be done in the shape of /strong> from the outer edge of the breast towards the nipple.
Lying down, manual examination; It is done lying on your back. A small pillow or a folded towel is placed under the shoulder on the side to be examined, allowing the breast to come forward and thus be examined more easily. The arm on the side where the breast to be examined is placed over the head, and the examination begins by making circular movements with the middle inner parts of the 3 middle fingers of the other hand. Then, the arm is placed to the side and the armpit area is examined with the other hand. The same movements should be repeated on the other opposite breast.
Clinical Breast Examination; It is a breast examination performed by a doctor. Depending on the person's risk status, it should be performed every 1-3 years between the ages of 20-40, and once a year after the age of 40.
Mammographic Screening
What is Mammography?
Mammography is a breast X-ray film taken with low dose x-rays and aims to detect early lesions in the breast that are too small to be detected by examination. It is drawn with . Screening mammography can detect breast cancer 1.5 to 4 years before it appears clinically, that is, before it is detected by manual examination. For people who do not have any high risk factors, mammographic screening is performed annually after the age of 40, there is no upper age limit. However, risk factors and family history Depending on the history of breast cancer, this screening can be started earlier.
What are the Screening Recommendations for Women at High Risk?
Normally A woman's lifetime risk of breast cancer is 12%. Various calculation models (such as gail model, claus model) are used to calculate the risk ratio. In these models, parameters such as menstrual and menopausal age and family history are used. If the risk rate is above 20%, this individual falls into the high-risk patient group. Annual mammography and occasional breast MRI scans are recommended for these individuals starting from the age of 30. Some high-risk individuals include:
-
People with a known BRCA1-2 gene mutation and their first-degree relatives,
-
Childhood or People who received radiotherapy to the chest area for therapeutic purposes in their youth, people with certain syndromes and having a first-degree relative with these syndromes (such as Li-Fraumeni syndrome, Cowden syndrome).
Apart from these, mammography is also used in individuals with slightly lower risks; It can be combined with ultrasonography or MRI. These individuals are people with breast cancer in the other breast or biopsy diagnoses such as ductal/lobular carcinoma in situ, atypical ductal hyperplasia and atypical lobular hyperplasia, and people with mammographically extremely dense breast structure.
How is a Mammogram Taken?
The device used for mammography can be found in a clinic or a specially designed mobile screening vehicle. During imaging, the breasts are placed between the plates in the mammography device, slightly compressed, and x-rayed from different directions. The purpose of compressing the breasts is to prevent the images of the tissues from overlapping and creating a false image.
Is Mammography Harmful?
Mammography is based on x-rays. There are many misconceptions in the society about the harms of the radiation it emits due to the shooting. During a mammogram, the breasts are exposed to a very small amount of radiation; This is similar to the radiation a person receives naturally. To give other examples, every intercontinental airline travel We are exposed to the same amount of radiation when we travel by car or by car for 5000 km. The annual radiation exposure in smokers is 25 times higher than the amount of radiation received by mammography. Considering the rate that mammographic screening reduces deaths, this radiation dose is negligible.
The pressure applied to the breasts during mammography does not cause any harm. The pain caused by this situation will be felt less if the individual prepares himself psychologically. However, most of the pain disappears in the first half hour.
Read: 0
