Breast Cancer Screening (Imaging)
The American Cancer Society emphasizes that the use of regular mammograms, clinical breast exams, and a women’s awareness of changes in their breasts are an important part of every woman’s breast health plan, and are the best approach to detecting breast cancer early when treatment is most successful and when the range of treatment options is greatest. This combined approach is clearly better than any one examination.
Breast Self Exam (BSE)
Although a mammogram is the most sensitive screening method, a small percentage of breast cancers do not show up on mammograms, but can be felt by a woman or her doctor. To familiarize yourself with the look and feel of your own breasts, a monthly visual and manual examination is recommended. In some cases, this aids in the early detection of changes in a woman’s breasts. Many women have natural lumps and breasts of different sizes.
A physical examination of your breasts by a doctor, nurse practitioner, nurse, or other health professional is known as a Clinical Breast Examination. This is a thorough examination of the entire breast and chest areas, including the areas above and below the collarbone and under each arm. The health care professional can teach you the correct techniques for performing your own breast self-examination.
One type of breast imaging is called mammography. "Screening Mammography" is the term used for the type of images that are taken of a woman’s breasts when she has no breast complaints or symptoms. There is another type of imaging that is used if there is a symptom or complaint. Mammograms are a low dose x-ray examination that is the best test available to detect breast cancer. This examination usually takes about 15-20 minutes and is performed by a skilled technologist. Two pictures are taken of each breast. A radiologist who is a specialist in breast imaging reviews the images. If an abnormality is found on a screening mammography, or if you have a lump or other symptoms, diagnostic imaging may be needed.
The goal of breast self exam is to become familiar enough with your breasts so that you will detect any changes that should be checked by your health care professional. In addition to examining your breasts on a monthly basis, you also should have a clinical breast exam performed by a health care professional who is skilled in this process. A small number of breast cancers are not detected by mammography but can be felt on a physical examination.
Watch for any of the following changes and follow up with your health care provider:
¨ Any new lump or thickening in your breast or armpit that does not shrink after your next period
¨ Any change in the size, shape or symmetry of your breast
¨ A thickening or swelling of the breast
¨ Any dimpling, puckering or indentation of the breast
¨ Skin irritation, dimpling or other change in the breast skin or nipple
¨ Redness or scaliness of the nipple or breast skin
¨ Fluid coming from your nipples that is not breast milk; particularly if the discharge is bloody, clear and sticky, or dark and occurs without squeezing your nipple
¨ Nipple tenderness or pain
¨ Nipple turning or drawing inward or pointing in a new direction
¨ Any other change that concerns you
Breast self examination is an option for women starting in their 20's. Women should be told about the benefits and limitations of BSE. Women should report any breast changes to their health professional right away.
Women who choose to do BSE should have their BSE technique reviewed during their physical exam by a health professional. It is okay for women to choose not to do BSE or not to do it on a regular schedule. However, by doing the exam regularly you get to know how your breasts normally feel and you can more readily detect any signs or symptoms. If a change occurs, you should see your doctor or nurse as soon as possible for evaluation. Remember that most of the time these breast changes do not indicate cancer.
The following link is a very complete guide to Breast Self Exam, including a video demonstration.
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Clinical Breast Examination (CBE)
American Cancer Society Recommendations for Clinical Breast Exam
Women in their 20's and 30's should have a clinical breast exam (CBE) as part of a periodic (regular) health exam by a health professional preferably every three years. After age 40, women should have a breast exam by a health professional every year.
There may be some benefit in having the CBE shortly before a mammogram to manually feel for abnormalities which may then be investigated further during a mammogram. The exam should include instruction so a woman can become familiar with her own breasts. Women should also be given information about the benefits and limitations of CBE and BSE (breast self-exam). Breast cancer risk is very low for women in their 20's and gradually increases with age. Women should be told to promptly report any new breast symptoms to a health professional.
If you have a strong family history of breast cancer, you may be advised to have yearly or more frequent clinical breast exams starting in your 20's.
Disabled women can receive clinical breast exams through our Breast Health Access for Women with Disabilities Program.
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Screening Mammography
The American Cancer Society recommends that women over 40 years of age have this screening every year. Here are some tips from the American Cancer Society on how to have an optimal Mammogram.
Digital Mammography
Alta Bates Summit offers a new technology to the East Bay - Digital Mammography. Women now have access to the best screening and diagnostic tool available for breast cancer detection. Our new General Electric Senographe DS digital mammography system, in conjunction with state-of-the-art ultrasound equipment, offers clearer imaging, faster processing, greater accuracy, and improved patient convenience. This new technology also allows for lower dose radiation exposures than the traditional film mammography.
Clearer imaging is important because:
¨ Radiologists can more easily see through dense breast tissue that may hide suspicious masses or calcifications
¨ The digital system often reduces the need for repeat mammograms because radiologists can manipulate images on the computer in ways that were not possible with traditional x-rays.
¨ Digital mammography is more accurate than film, especially in women under 50 years of age, premenopausal, perimenopausal, and/or women with dense breast tissue.
Digital mammography takes seconds for the images to be viewed by technologists, reducing the patient's exam time. Images can be stored in the hospital's computer, and even burned to a disc allowing the patient and physicians to easily view and share information.
Other benefits:
¨ Patient-friendly design
¨ Ergonomic paddle shapes to the breast for better comfort
¨ Easy positioning
¨ Easy access for women using wheelchairs
¨ Better imaging of very small cancers in pre- or peri-menopausal women
Disabled women can be accommodated through our Breast Health Access for Women with Disabilities Program.
Dedicated Mammographers
It is strongly recommended that your mammogram is evaluated by an expert - in this case a radiologist who specializes in breast imaging. At the Carol Ann Read Breast Health Center, our radiologists review more than 5,000 mammograms each year.
Insurance
Most insurance plans pay for this exam. The California Detection Program, Every Woman Counts pays for mammograms for women who are low income California residents and meet the program’s criteria. Find out more about Every Woman Counts.
Appointments
To make an appointment for a Screening Mammogram, please call the Carol Ann Read Breast Health Center in Oakland at (510) 869-8377 or the Imaging & Mammography Center in Berkeley at (510) 204-1880.
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