More breast cancer awareness, less breast cancer

Detection saves lives

We almost all know it: the earlier breast cancer is detected, the greater the chances of survival. Quite logical that detection or screening is so important. Especially when you consider that one in three women still dies of breast cancer. In Belgium, all women between the ages of 50 and 69 receive an invitation for a mammogram every two years. Moreover, the examination is free. Still, too many women ignore this call. A deadly sin, according to Ivo Nagels, medical advisor of the Foundation Against Cancer. "A recent American study showed that mortality from breast cancer can be reduced by 40 percent if women between 50 and 69 get screened every two years. Surely that should be a great incentive to do participate in screening mammography. In addition, the percentage of breast cancers detected thanks to screening mammography is increasing. That's why we're working so hard to raise that awareness."

Did you know this. Mortality from breast cancer can drop by 40% if women between 50 and 69 get screened every two years.

Free screening: do

The women who mainly fail screening are from the lower social classes, according to the consultant. Probably they are unaware of how important detection and early diagnosis is. Or they are afraid that a mammogram hurts. Dr. Ivo Nagels: "It is true that the breast is compressed between two plates and that can be sensitive and even painful. But the examination is very short and can be life-saving. Then again, some people think that the X-rays actually increase their risk of getting cancer. This is a misconception. The examination is done every two years. So that radiation is really very limited. Of course you are free to participate in the study, but I would very strongly recommend that all women take advantage of that free screening."

One mammogram is not the other

By the way, there is a difference between a screening mammogram and a diagnostic mammogram. In the former, you have no symptoms or complaints. You get the examination to check for small lumps or other irregularities. A diagnostic mammogram is done when you do have complaints or symptoms and need further testing to see if something is really wrong. In addition to the mammogram, you can also get an ultrasound and an MRI, among other diagnostic tests. Dr. Ivo Nagels: "But the latter is actually reserved for women with a greatly increased risk of breast cancer, for example if you are burdened with the hereditary BRCA-1 or BRCA-2 gene. It's up to the specialist to judge that, it doesn't happen by default."

Weighing and weighing: the pros and cons

A major advantage of screening mammography is that it finds lumps in women and can detect even small changes. Such as nodules that are smaller than two centimeters and therefore are usually not visible and palpable. This does not necessarily mean you have cancer. For example, it could also be a cyst. But if a lump is malignant, you can catch it very quickly. Treatment is then usually less severe and your chances of recovery are greater. For example, 90 percent of tumors smaller than two centimeters have a 90 percent chance of being cured and the chance of metastasis is much smaller.
There can also be disadvantages. For example, some test results are false positive: something is seen on the mammogram, further tests such as a puncture may follow but it turns out to be nothing in the end. This causes extra stress for women. Sometimes the opposite also happens: a false negative result. The mammogram shows nothing, while after a year you can still have breast cancer. At such a moment, the mammogram gives a false sense of reassurance. Dr. Ivo Nagels: "It can happen that a very small lump is found, treatment also follows, while it might have been a form that you would not have suffered from without treatment."

It is important to know your breasts well and thus notice and report any changes quickly.

And self-examination?

So what about self-examining your breasts, something we have been advised to do for years? In the past it was indeed frequently recommended, but studies show that self-examination does not reduce cure rates or breast cancer mortality. Dr. Ivo Nagels: "It does matter that you look at your breasts regularly and watch for abnormalities such as dimpling, color changes or retraction of the nipple. And that you report those to your doctor." So you should pay particular attention to changes to your breasts. This is also called breast awareness: that you know your breasts and can quickly spot abnormal things. But of course you choose whether you also inspect your breasts regularly yourself.

What can your family doctor do?

Often with a lump or complaints such as pain, fluid loss from the nipple, a "dent" or discoloration on your breast, you will first see your family doctor. There is no set protocol for how your doctor handles your complaints. However, he or she will ask you several questions and examine you. This examination consists of inspection, the thorough examination of your breasts to discover any irregularities, and palpation, the feeling of your breasts and often also your armpits and neck. Based on this, you may or may not be referred for further investigation to a hospital or gynecologist, for example. Depending on your symptoms, you will then be given a mammogram, possibly an ultrasound, in some cases an MRI, and sometimes a puncture or biopsy.

More breast awareness?

Notice these changes in your breasts:

• color changes
• dents
• dimples
• skin like orange peel
• retracted nipple
• fluid or blood from nipple
• red discoloration that is warm to the touch
• paving
• growing vein

Younger than 50?

Then you will not be screened for breast cancer automatically and for free. Some women, especially those who got breast cancer at a younger age, would very much like the age for free testing to go down. Yet that's not in the cards for now. That's because 75 percent of women who get breast cancer are over the age of 50. So that reaches the largest group, policymakers believe. In addition, there is currently no budget for additional screenings. Finally, more consideration is being given to the disadvantages: the younger you start getting mammograms, the more X-rays. A final consideration has to do with the density or density of the breasts. At a young age, your breasts still have very dense glandular tissue which makes the interpretation of any lumps through a mammogram more difficult.

Just do it! Get your breasts checked!

Source: Manon Kluten, courtesy of Dr. Ivo Nagels, medical advisor to Foundation Against Cancer (www.kanker.be)