It is important to know how to detect breast and ovarian cancer as early as possible—the sooner it’s detected, the greater the chance of survival.
The benefits of early detection include increased survival, increased treatment options and improved quality of life.
There are many ways to screen for breast cancer, including self-examination, clinical breast examination, mammography, ultrasound and Magnetic Resonance Imaging (MRI). You and your doctor will decide on the best options for you. Screening does not reduce the risk of cancer happening but it does offer the best chance of early detection.
As part of the resource Feel Your Boobies, Pink Hope encourages all women to get to know their breasts. Take the time to get to know the normal look and feel of your breasts as part of your daily routine, such as when you shower or look in the mirror. By knowing what is normal for you, you will be able to detect any new or unusual changes if they arise.
By feeling your boobies once a month, you will get to know them and any changes that occur. If you notice a change make an appointment to see your doctor.
If you would like to learn how to conduct a breast check, refer to Feel Your Boobies.
Clinical Breast Examination
Clinical breast exams are physical examinations done by physicians, nurse practitioners and other trained medical staff. The exams involve checking the look and feel of the breasts and underarm for any changes.
The breasts are often checked while a woman is sitting up and lying down.
Remember to seek medical advice if you detect any changes in your breasts.
Mammography is a technique that uses X-rays to provide an image of inside the breast. These images, called mammograms, are used to find potential signs of breast cancer including tumours, small clusters of calcium (micro calcifications) and abnormal changes in the skin. For most women, mammography is the best screening tool available today for breast cancer. Finding breast cancer early can save lives. Even a small cancer, however, still needs surgery, and often other treatments (which may include radiation, chemotherapy and hormonal treatments). For some women at high risk, other forms of screening (see below) may also be considered. This is because young women often have dense breast tissue which can make it harder to see changes on a mammogram.
For women from the age of 40, BreastScreen provides a free mammogram, every two years, if you contact them to request one. You don’t need a referral from a doctor. For some women who have certain risk factors such as particular types of past breast disorders (determined by BreastScreen), annual screening is available. The number to enquire is 13 20 50 or you can go online at www.breastscreen.org.au.
At present, 2D mammography is used by the vast majority of BreastScreen Australia centres for screening purposes and has been considered to be the most effective population primary test for breast cancer in women aged 50–74 years.1 One of the latest methods for diagnostic testing is the 3D MAMMOGRAPHY™ exam. This newer technology helps to eliminate most detection challenges associated with conventional 2D mammography in a diagnostic setting.2,3 This may be performed in conjunction with an Ultrasound and/or MRI exam.
Although all women could potentially benefit from a 3D MAMMOGRAPHY™ exam, the following high-risk groups may be more suited to a diagnostic referral for 3D MAMMOGRAPHY™:
- Those with a strong family history of breast or ovarian cancers
- Women with dense breasts, e.g. those aged <50 years not actively targeted by the national screening program
- Women with any breast changes, signs or symptoms
- Women with a previous diagnosis of breast disease or those requiring further assessment following a 2D exam
Breast ultrasound uses the same high frequency sound technology used to visualize the foetus in a pregnant woman, but is applied to the breast tissue using equipment specific to the breast (high frequency ultrasound probes). The ultrasound examination does not use x-rays. It obtains images that are complementary to mammograms and useful in some situations.
Not all women are recommended to have a breast ultrasound as part of a standard breast cancer screening program. Your doctor can advise whether or not there is any potential benefit to you in having an ultrasound alongside your mammogram.
Magnetic Resonance Imaging (MRI)
MRI is a test that uses magnetic fields to create an image of the breast that can be meticulously examined for abnormalities. MRI is a useful tool for some women at high risk of breast cancer. It can also detect changes on the image that require more investigation (sometimes with ultrasound or a biopsy) but turn out not to be cancer.
The greatest benefit from breast MRI is for women with high risks, for example, women with a gene mutation (change) in certain genes such as BRCA1 or BRCA2. Women aged less than 50 years who have a mutation in a breast risk gene or a very strong family history-based breast risk may be eligible to get a Medicare rebate to cover some or all of the costs of a breast MRI. Your doctor can advise whether you may benefit from breast MRI.
I haven’t made the decision yet on what risk reduction option I will choose. I currently undertake annual mammograms and MRIs and lots of research to give me the information to make the right health decisions for me and my family. – Robyn
Unfortunately, there is no screening test proven to detect early stage ovarian cancer.
A Pap test doesn’t detect ovarian cancer. It’s only used to screen for cervical cancer. You may have heard of a CA125 blood test for ovarian cancer. This test looks for increased levels of the CA125 protein. However, there are many factors that can affect CA125 levels, including menstruation. Large studies have shown the CA125 test is not a reliable test for screening for ovarian cancer and is not recommended for this purpose. Similarly, an ultrasound of the ovaries is not effective in detecting early stage ovarian cancer.
Fortunately most women will never develop ovarian cancer. The lifetime risk for a woman in Australia is 1.2%. However there are some symptoms that can alert you to the presence of ovarian cancer. Through the Pink Hope resource – Know Your Os – you can familiarise yourself with these symptoms.
Although there’s no screening test for ovarian cancer, one thing you can do is know your body and what is normal for you so you can recognise any unusual changes.
Abdominal bloating, abdominal or back pain, appetite loss or feeling full quickly, changes in toilet habits, unexplained weight loss or gain, indigestion or heartburn and fatigue can all be signs of ovarian or other cancers. While these symptoms can be part of everyday life, it’s important to see your doctor if they are unusual for you and they persist.
Click here to refer to the FAQs on Screening.
References: 1. BreastScreen Australia. Available at: http://newsroom.breastscreen.org.au/position-statement-on-the-use-of-tomosynthesis-within-breastscreen-australia-services/. Accessed June 2017. 2. Skaane P et al. Radiology 2013;267:47–56. 3. Rose S et al. AJR Am J Roentgenol 2013;200:1401–8.