Screening for Breast Cancer
Breast cancer screening is performed in the testing of otherwise-healthy individuals for cancer cells within the breast tissue. The primary intention is to make a diagnosis as early on as possible to take preventative action for the best chances of patient recovery. Several screening tests are utilised in the testing for breast cancer, including breast self-examination, genetic screening, and mammograms.
Medical screening: The systematic administration of a test to recognise potential patients at significant risk of a specific disease or disorder. Such tests are carried out to identify those in need of further testing or preventative procedures and actions.
Breast self-examination (BSE)
An individual performs a BSE in an attempt to discover any abnormalities within their breast tissue. This procedure involves close observation of the outer breast and feeling for unusual lumps, swelling, changes in breast size or shape, inverted nipple and distortions. Although recommended to increase attendance to relatively frequent mammograms - a breast self-examination by itself is not enough to detect or diagnose breast cancer. It must be performed alongside regular mammograms and potentially a genetic screening for good measure.
Screening Mammogram
Mammograms use low levels of X-Rays to generate imagery of the breast tissue to search for any early and potential signs of breast cancer. Screening mammograms are performed on individuals to look for evidence of cancer within the breast tissue without having experienced any of the typical signs or symptoms of breast cancer.
During the procedure, the patient is asked to stand in front of the mammogram machine whilst a technologist places their breasts on a plastic plate. A separate plate is then used to fasten and press the breasts onto the plate from above. These plates are utilised to hold the breast tissue still throughout the procedure. All steps are repeated to capture imaging from all views of the tissue (vertically and horizontally).
Fig 3.1
Genetic Screening
Genetic screening is executed through the processing of a blood sample collected from the patient. In the case of breast cancer, geneticists typically look for mutations present within the breast cancer genes, either BRCA1 or BRCA2. If mutations are present within these genes, there is a substantial risk of the patient acquiring breast cancer in their lifetime.
Fig 3.2
Genetic Mutation: a modification within the nucleotide sequence of the genome of an organism.
The BCRA gene test is often recommended to individuals with an increased likelihood of possessing a genetic mutation in the BCRA gene. This is determined through a close examination of the patient's personal and family history relating to breast and ovarian cancer. Nevertheless, positive results only indicate an increased likelihood of developing breast cancer. However, it does not mean that you will unquestionably be diagnosed with breast cancer in your lifetime. Notwithstanding this risk can be managed with the assistance of a physician.
Similarly, a negative result is not a guarantee that a patient will not develop breast cancer in their lifetime. A negative result may have emerged, but it does not excuse the possibility of other mutations present within the genome of the patient. The field of genetics is still widely undiscovered, and consequently, genetic testing isn't always a clear screening indication.
In conclusion, the most accurate form of breast cancer screening is having regular mammograms.
Works Cited
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Ferre, R., et al. “Stereoscopic Digital Mammogram: Usefulness in Daily Practice.” Journal of Gynecology Obstetrics and Human Reproduction, vol. 47, no. 6, June 2018, pp. 231–236, 10.1016/j.jogoh.2018.03.009. Accessed 13 Oct. 2020.
Handel Reynolds. The Big Squeeze: A Social and Political History of the Controversial Mammogram. Cornell University Press.
Rousset-Jablonski, Christine, and Anne Gompel. “Screening for Familial Cancer Risk: Focus on Breast Cancer.” Maturitas, vol. 105, Nov. 2017, pp. 69–77, 10.1016/j.maturitas.2017.08.004. Accessed 9 July 2020.
Smith-Bindman, Rebecca, et al. “Comparing the Performance of Mammography Screening in the USA and the UK.” Journal of Medical Screening, vol. 12, no. 1, Mar. 2005, pp. 50–54, 10.1258/0969141053279130. Accessed 13 Oct. 2020.
Weitzel, Jeffrey N., et al. “Limited Family Structure and BRCA Gene Mutation Status in Single Cases of Breast Cancer.” JAMA, vol. 297, no. 23, 20 June 2007, p. 2587, 10.1001/jama.297.23.2587. Accessed 13 Oct. 2020.