Breast cancer is the most common cancer affecting women, with some 2m cases worldwide at any one time. 10-15% of women will have a form of breast cancer in their lifetimes. Although 5-year survival approaches 90% with early diagnosis and good modern care, breast cancer is most certainly a dread, and dreaded, disease.

Screening is all about early detection. If the cancer is found early, before aggressive spread, treatment is much easier and the outlook much more positive. This is the simple but powerful logic behind medical screening (and check-ups in general). It is often said that “you cannot manage what you do not know about” and this could be a slogan for preventive healthcare and proactive health screening.

The main options for breast cancer screening are:

  • Understand your own risk profile. Family history, genetics (the infamous BRCA genes) age, obesity, lack of exercise, alcohol, not having children (or having children at an older age) can all increase your risk profile, so this is something to discuss carefully with your own doctor.
  • Genetic testing – if you have a strong or suggestive family history of breast cancer, you may want to undergo gene testing to see if you carry the BRCA1 or BRCA2 genes (which increase breast cancer risk significantly). This can be a tricky decision because the real question becomes what to do in the event of a positive genetic test (preventive mastectomy is sometimes considered) – again, a matter to discuss with your doctor.
  • Self-examination – every woman should examine her own breasts at least once each month. Learn how to do it. Then do it. Every month.
  • Clinical examination – your doctor can examine your breasts looking for any suspicious or worrying signs.
  • Mammogram – this specialised type of x-ray looks at breast tissue and can detect lumps, thickenings, etc.
  • Biopsy – this is where a tissue sample is removed and examined in a laboratory (under microscope etc.). A biopsy can be done at doctor’s rooms, as a minor outpatient procedure, or as part of a more major operation in an operating theatre (all these details vary case-by-case). A biopsy or “tissue diagnosis” is the gold-standard and really the only way a proper diagnosis of breast cancer can be reached.
    Guidelines vary around the world and guidelines change as new research emerges and best practice evolves. In general terms though:
  • Personal risk assessment and regular self-examination are vital for all women of all ages.
  • Most women should have a clinical examination once a year.
  • Most women over 50 should have a mammogram every second year or so.
  • Higher risk women should consider earlier (younger age) and or more frequent screening.

Breast cancer is the archetypal dread disease but as serious as it most certainly is, we are not powerless. A well-considered personal screening plan is one key step towards beating this one.