Breast cancer is a prevalent health concern that affects millions of women worldwide. As the leading cancer in women, its impact is undeniable yet it’s a disease that can be managed more effectively when caught early. Early detection of breast cancer depends on awareness, screening, and diagnosis.
Awareness starts with understanding your breast anatomy so that you notice any changes while performing self-examinations. Regular mammogram screenings play an increasingly important role in early detection as they can reveal changes in breast tissue prior to noticeable physical changes. Upon discovering any abnormalities, early diagnosis can be hastened through breast MRI (magnetic resonance imaging) and biopsy.
Here, we’ll discuss breast health in a straightforward way, investigate the difference that early detection of breast cancer makes on survival rates, and explain the role of breast examinations, screening mammograms, and other types of breast imaging that enhance detection rates.
Early detection plays a critical role in effectively managing breast cancer and improving patient outcomes. Regular screening tests are essential for identifying breast cancer at its earliest stages when treatment options are typically more successful.
From self-exams to mammography and genetic testing, these tests offer valuable insights and play a vital role in the early detection of breast cancer, empowering individuals to make informed decisions about their health and facilitating timely intervention when needed.
The importance of breast self-exams can’t be overstated. Being familiar with the shape, texture, and feel of your breasts can help you notice anything unusual. Be aware of the symptoms of breast cancer and examine yourself for lumps, skin dimpling, nipple discharge, nipple inversion, or changes in texture or breast size. Reporting these changes to your healthcare provider is integral to early diagnosis of breast cancer and better cancer treatment options.
A CBE may help detect abnormalities in the breasts. During the examination, your healthcare provider will carefully feel the breasts and underarm area to check for any lumps or other suspicious signs.
Conventional mammograms, also called 2D mammograms, are the most common imaging technique to screen for breast cancer. They use X-rays to take images of the breast from different angles. To get the clearest images, breast tissue is gently compressed between two metal plates. 2D mammography has been proven effective in detecting many cases of breast cancer. However, it does have limitations. For instance, it may be more challenging to detect early breast cancer changes in dense breast tissue.
Technological advancements in screening tests have proven vital in the pursuit of early detection. One example is the 3D mammogram, which provides a more detailed view of breasts. A 2023 study found that 3D mammograms find more cancers than traditional screening mammograms. This is because 3D takes three-dimensional pictures by capturing low-dose images of the breast from varying angles.
As a result, the radiologist can see up to 300 pictures compared to just four from a regular 2D mammogram. This prevents cancers from being hidden by dense breast tissue. A mammogram can show how dense your breasts are. If you have dense breasts, talk with your doctor about how it may impact your risk of breast cancer. There are many other factors to consider, including family history and hereditary risks.
Ultrasounds use high-frequency sound waves to create detailed images of your breast tissue. Ultrasound is particularly beneficial in examining dense breast tissue or as a complement to other imaging methods.
For example, it can help to determine whether lumps in breast tissue are fluid-filled cysts or solid lesions. In contrast to mammograms, ultrasounds do not use ionizing radiation. However, they are not intended to replace mammograms as a screening test for the entire breast.
Magnetic resonance imaging with contrast is a specialized technique for early breast cancer detection. It involves the use of a contrast agent administered intravenously.
A breast MRI with contrast offers several advantages such as in the case of dense breast tissue and for finding early changes in women who have a high risk of developing breast cancer. The gadolinium-based dye enhances the visibility of breast tissues and highlights areas of increased blood flow.
A needle biopsy involves extracting tissue samples from suspicious breast tissue for further examination under a microscope. There are two main types of needle biopsy: core needle biopsy and fine needle aspiration biopsy.
Core needle biopsy employs a larger needle to extract small cores of tissue while fine needle aspiration biopsy uses a smaller needle to collect cell samples. By obtaining these samples, pathologists can accurately determine whether the breast lesion is cancerous or benign, providing crucial information for appropriate treatment planning.
Needle biopsy is a relatively quick and safe procedure that can be performed in an outpatient setting, minimizing patient discomfort and enabling efficient diagnosis of breast cancer while minimizing unnecessary surgeries or interventions.
Genetic testing plays a crucial role in the early detection of breast cancer, particularly through the assessment of specific genes such as BRCA1, BRCA2, and more broadly through a 21-gene panel like Oncotype DX.
By analyzing your genetic makeup, these tests can identify inherited mutations that significantly increase the risk of developing breast cancer. For instance, mutations in the BRCA1 and BRCA2 genes are associated with a higher lifetime risk of breast and ovarian cancers. Additionally, the 21-gene panel test examines multiple genes to assess the likelihood of cancer recurrence and guide treatment decisions for early-stage breast cancer.
Genetic testing empowers individuals and their healthcare providers with valuable information, enabling personalized screening and prevention strategies to mitigate the risk or implement timely interventions for early detection of breast cancer.
Your breasts are composed of three types of tissue. First, there’s glandular tissue that includes lobules (the glands that produce milk) and structures called ducts that transport milk from the lobules to the nipple.
Your breasts also consist of a fatty layer of fibrous connective tissue that holds the structures in place. Finally, there are lymphatic vessels that help your immune system eliminate waste and toxins.
Most breast cancers fall into the category of carcinomas. This means that they originate from epithelial cells of glandular tissue. Often, breast cancers start in the milk ducts or in the milk-producing lobules.
Breast cancer can be categorized based on invasiveness. Oncology doctors who specialize in cancer treatment will classify breast cancer into two main categories: “in situ” and “invasive.”
Breast cancer in situ is one that has not spread, such as ductal carcinoma in situ (DCIS). Breast cancers in situ are also known as pre-invasive tumors. However, if left untreated or not caught in the early stage, in situ cancers can develop into invasive tumors.
Invasive cancers have already infiltrated the adjacent tissues. There are two main classifications: invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC). According to the American Cancer Society (ACS), IDC accounts for 70-80% of all breast cancer cases.
Some types of invasive cancers have unique features that affect treatment approaches. Although these types of cancer are less common, they pose more serious risks and are often harder to treat, making early detection of breast cancer even more important.
For example, inflammatory breast cancer, which occurs only 1-5% of the time but is more likely to lead to poor survival rates if not detected early.
Another rare breast cancer referred to as “triple-negative” resists hormonal treatments and certain medications. You see, most breast cancer cells have estrogen, progesterone, and human epidermal growth factor 2 (Her2) receptors. Most cancer treatments work by effectively targeting these receptors. In triple-negative breast cancer, the cells do not have these receptors which makes it more challenging to treat compared to other breast cancer types.
The American Cancer Society estimates that roughly 13% of women in the U.S. will get breast cancer in their lifetime. Determining if you have above average risk of developing breast cancer hinges on the following factors.
Women are at a higher risk of getting breast cancer than men. According to a study published by the European Journal of Cancer Prevention, transgender women might have an increased risk of breast cancer compared to cisgender men.
The increased risk appears to be lower than that of cisgender women, though it depends largely on whether they are using hormones like estrogen or progesterone. Transgender men who haven’t had a mastectomy still have a risk of breast cancer. Those on testosterone therapy might experience changes that could make cancer detection more difficult. It’s important for transgender women and men to discuss risks and screening with their healthcare professional.
According to the Centers for Disease Control, cancer detection and death rates increase as you age. Most women diagnosed with breast cancer are 50 or older. While strides have been made in screening technologies and awareness, the statistics regarding the median age at diagnosis and the relatively small number of cases in younger women highlight the need for continued efforts in early detection initiatives.
There’s a crucial need to reach and educate women of all ages about the importance of regular screenings, especially those who may be at higher risk due to family history or genetic factors.
Breast cancer incidence and survival rates exhibit disparities across different racial and ethnic groups. Non-Hispanic white women have a higher incidence rate of breast cancer compared to Black women. However, the impact of breast cancer is more severe for Black women who face higher mortality rates, are often diagnosed at later stages when the cancer has progressed, and tend to develop breast cancer at a younger age.
According to a report by the New England Journal of Medicine, these disparities due to health inequities, such as access to healthcare, shed light on the need for targeted interventions and support systems to address the specific challenges faced by Black women in the battle against breast cancer.
Dense breasts have a lot of fibrous or glandular tissue and little fat. Women with dense breasts are at a higher risk of breast cancer. This might be because having dense breast tissue makes images from screening mammography harder to interpret. If you have dense breast tissue, your healthcare provider may suggest you follow up with a breast ultrasound or an MRI.
Heredity plays a significant role in a subset of breast cancer cases, accounting for approximately 5-10% of diagnoses. This association stems from specific inherited mutations in the BRCA1 and BRCA2 genes, which are directly linked to the development of cancer. Normally, these genes play a crucial role in DNA repair processes, but when mutations occur, it can disrupt this function, leading to abnormal cell growth and the eventual onset of breast cancer.
Women who carry one or both of these mutations are at an increased risk of developing breast cancer, with the elevated risk potentially reaching as high as 72%. The presence of BRCA1 and BRCA2 mutations highlights the importance of genetic factors in understanding and assessing an individual's susceptibility to breast cancer.Genetic testing can check for mutations. The test is simple and usually done with a blood sample, though saliva or tissue can also be tested.
Even if your test results indicate that you haven’t inherited a gene mutation, a strong family history of breast cancer may also indicate a higher risk level. This is especially true if your mother, sister, or daughter has been diagnosed with breast cancer. Your risk increases the more close relatives you have with a current or previous breast cancer diagnosis.
The United States Preventive Services Task Force (USPSTF) recently lowered the age to start routine screening from 50 to 40 for women who value the benefits of early screening over any potential risks. If you’re in your 40s and haven’t started screening yet, discuss your options with your healthcare provider.
You are considered high-risk for getting breast cancer if you meet any of the following criteria and the American College of Radiology advises yearly mammograms starting at age 40 or even earlier:
Early detection of breast cancer means a better chance of effective treatment since smaller cancer lesions are easier to treat. When an abnormality is detected, swift medical intervention is imperative. Follow-up radiological tests such as a breast MRI or even a biopsy may be necessary.
If breast cancer is confined to the breast only, the 5-year survival rate is around 99%. However, if the cancer has spread to the regional lymph nodes or other distant parts of the body, the 5-year relative survival rates drop to 86% and 30%, respectively.
Enhanced breast cancer detection (EBCD) represents a new horizon in the forefront of the early detection of breast cancer. Mammography with EBCD is an advanced approach to breast cancer screening that incorporates artificial intelligence (AI) technology. By using AI via machine learning algorithms with highly sophisticated mammography systems, radiologists can find and differentiate subtle abnormalities.
Ezra, in Partnership with RadNet, is on the cusp of AI, in the form of Saige-Dx, to help to identify abnormal areas of soft tissue or tiny deposits of calcium that might suggest cancer.
Saige-Dx is like an extra set of eyes for the doctor. It looks at the mammogram pictures, points out anything that might be cancer, and gives a sense of how likely it is that the finding could be cancer. This helps the doctor make better decisions when interpreting your mammogram results.
Knowing your risk factors and understanding the signs of breast cancer are essential to determining when to get checked.
Regular screenings like self-breast exams, clinical breast exams, ultrasounds, and mammograms play vital roles in early breast cancer diagnosis. Coupled with prompt medical diagnosis and cancer care and treatment, these measures can significantly improve your outcomes.
EBCD mammography promises to be a breakthrough in early breast cancer detection. AI technology and enhanced screening methods can improve your radiologist’s accuracy and efficiency.
If you have a higher risk for breast cancer due to family history, genetic factors, or other causes, adhering to an early screening mammogram or breast MRI schedule can drastically improve your prognosis and treatment. Remember that early detection of breast cancer can save lives — and it starts with taking action.
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