A Message from the Heart to the Heart
Prepared by Dr.Mirunalini Arivuchelvan M.D.IMG,Toronto, Canada.
Reviewed By Dr. Abdulwahab Arrazaghi.MBBCH,FDABIM,FRCPC
Specialist of Internal medicine and cardiovascular diseases, Toronto, Canada
Breast Cancer Screening
Why is it important to screen?
In the early stages of breast cancer it is difficult to see or feel the tumour. Screening could help in early diagnosis and better treatment options and thus improve quality of life and cure.
Who has to undergo screening?
- In most provinces of Canada all women aged 50-69. Women aged 40-49 may discuss with their healthcare provider about the risks of developing breast cancer. Women above 70 years may discuss how often they have to undergo screening.
- In Ontario all women aged 50 -74 who are at average risk for breast cancer and all women aged 30-69 who are at high risk for breast cancer are screened.
How would I know whether I have high risk?
- If you or your parent, sibling or child found to have a genetic mutation for breast cancer
- If you have a family history suggesting of hereditary breast cancer syndrome and confirmed by genetic counselling to have 25%
- higher lifetime risk for breast cancer Or If you have undergone radiation to chest for any other cancer before 30 years old (eg: Hodgkin's disease)
How is the screening done?
- In most provinces of Canada women aged 50-69 have mammogram every 2 years.
- In Ontario for women at average risk aged 50-74 mammogram is done every 2-3 years and for women at high risk aged 30-69 mammogram and MRI are done every year.
- In addition your healthcare provider would do a physical examination.
Where do I do the screening?
- Your healthcare provider may refer you for a mammogram or you may wish to approach an organized breast cancer screening programs in your province.
What are the risks of mammogram?
- As most investigations mammogram is also not 100% accurate sometimes leading to false positive and false negative results.
- There is also a small risk of radiation.
- However, it is proven that mammogram is the best method of screening for breast cancer.
How can I perform self breast examination?
- Self breast examination is considered optional though women at high risk may benefit from it. If you are menstruating select a day as soon as your period has ended. It can be performed once a month same day in the cycle. If you are not menstruating it can be carried out once a month.
- First look in the mirror with hands on hips and raised: look for asymmetry, skin changes (e.g.: dimpling, puckering, bulging, distortion, swelling); note the nipples for inversion, changed position and discharges (e.g.: watery, milky, yellowish)
- Second feel the breasts in lying and standing/ sitting positions moving with the right hand for the left breast and vice versa. Movements should be in small circles covering the whole area in vertical lines or radially inwards to outwards from the nipple. Raise the hand on the side of examination. When lying down use a pillow on the side of the procedure. Some prefer to examine in the shower while standing. Please review the diagram below.