Friday, Dec 14, 2018
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Doctors stress early diagnosis crucial in the breast cancer fight


An early breast cancer diagnosis not only increases the chance of a cure, but also decreases the incidence of morbidity and the side effects of various aspects of treatment, according to Dr. Osama Kellini, medical director and clinical oncologist specialist at the Cancer Centre.

With breast cancer the most commonly occurring cancer in women, and the second most common cancer overall, and over two million new cases in 2018, Kellini said the good news is that women are living in a time when they are surviving the disease, and the population of survivors is expected to grow. But he cautions that women still need to be vigilant and take measures to protect themselves.

“The recommendation that women who are at average risk for breast cancer start getting mammograms yearly at age 40; women 55 and older should switch to mammograms every two years or continue yearly screening.”

The clinical oncologist specialist warned that mammograms do not detect every breast cancer, and that women at every age should be familiar with how their breasts normally look and feel, as well as be familiar with signs and symptoms of breast cancer.

“Although there are differing opinions about the benefits of breast self-exams, it is important… starting in their late teens and early 20s, for patients to know the proper technique, what to look for, and what is their normal,” he said. “For example, if one breast has always been smaller, of if one nipple has always turned inward.”

The most common symptom of breast cancer, he said, is a new lump or mass in the breast.

“A painless, hard mass that has uneven edges is more likely to be cancer; but breast cancers can be tender, soft or rounded. For this reason, it is important to have any new breast mass, lump or change in the breast checked by a health care professional.”

Other possible symptoms of breast cancer, he said, can include the swelling of all or part of a breast, even if no distinct lump is felt; skin irritation or dimpling of the skin; breast or nipple pain; nipple retraction or turning inward; redness, scaling or thickening of the nipple or breast skin; and nipple discharge other than breast milk.

He said the comprehensive guidance on risk assessment, genetic testing, screenings and prevention strategies will give a multi-disciplinary approach to cancer care, which then provides an individualized recommendation regarding diagnosis, treatment, surgery and recovery.

Dr. Amaresh Hombal, consultant radiologist, the Breast Center at Medical Pavilion, said the five-year survival rate of breast cancer is over 90 percent if detected early. During October’s breast cancer awareness month where the highlight is on education, prevention and cure, he said prevention offers the most cost-effective long-term strategy for controlling breast cancer.

Prevention of breast cancer mainly involves two things – lifestyle changes to reduce the cancer risk, regular screening tests in women over 40 years, or earlier in those with high risk.

According to Hombal, lifestyle changes include staying physically active with regular exercise, eating healthy, watching your weight, limiting alcohol intake and avoiding smoking.

“Screening for breast cancer with medical imaging has been shown to significantly decrease mortality, and mammography is the mainstay of screening for clinically hidden disease. Other diagnostic exams like ultrasound and magnetic resonance imaging have been used as adjunctive screening tools, especially for women who are at increased risk.”

Hombal said a mammogram is used to aid in the early detection and diagnosis of breast diseases in women. Two pictures of each breast are taken – one from the side and one from above; a screening mammogram usually takes about 15 to 20 minutes from start to finish.

There are two types of mammograms.

“Mammograms are most often used to look for breast cancer that is too small to be felt in women who have no breast complaints or symptoms – these are called screening mammograms. Mammograms are also used in women who have breast symptoms, such as a lump, nipple discharge, pain, or who have a suspicious finding on a screening mammogram – these are called diagnostic mammograms.”

With advantages of digital mammography over conventional, the radiologist said digital mammography takes less time than traditional film-based exams which translates into less discomfort, and less compression application.

“Radiologists can zoom in and out of the breast images and contrast can be adjusted. Through an inverting feature, physicians can detect micro-calcifications more efficiently. Digital images give better visibility of the breast, particularly near the skin line, chest wall and in women with dense breast tissue. Digital images are easily stored and retrieved. Physicians can electronically send digital images anywhere to be viewed on a workstation by another physician.”

Hombal said screening mammograms have been proven to significantly decrease deaths from breast cancer.

Simply put, early detection of breast cancer using mammograms saves lives. The risk of getting cancer from the mammogram itself is negligible, and the benefits far outweigh the risk.

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