It is sad but true that the medical profession does not know the “cause” of cancer, nor other major diseases such as diabetes or heart disease. In a society the uses the principle of cause and effect to solve problems, the medical profession is handicapped to dealing with the symptoms or “effects” of a disease, without knowing the “cause.”
When it comes to cancer, we know that it starts with a single, malfunctioning cell that then multiplies rapidly. Here again, we face another roadblock. No one can tell why the rapid cell production spreads quickly in one person and not another. In some persons, the cancer is contained, while in another it spreads to other parts of the body, keeps multiplying and eventually results in death. Gross studies have been made but the results are rather meaningless when it comes to a single woman who may have breast cancer.
The earliest technical diagnosis of breast cancer was the introduction of mammography. Started in the 1920s, it became a test of choice in the 1960s. Mammography is an X-Ray technique. We know that X-Rays work well on hard tissue like bone, however, they have proven unreliable when it comes to breast cancer detection, especially in young women. Young women have dense breast tissue, making it difficult for X-Ray technology to accurately diagnose the presence cancer cells. Hence, mammography is not recommended for women under age 50.
NHS has conducted a study of the reliability of mammography in women ages 50 to 70. Here are the findings for a screening of 1.6 million women.
- Estimates are that 1,300 lives were saved through the screening.
- 1 in 20 women were called back for further tests.
- Of those called back, 1 in 6 had breast cancer.
- In the UK, on average, 48,000 cases of breast cancer are reported each year. Most are in women over age 50.
Screening for breast cancer can begin with a simple Self Breast Exam (SBE) where a woman examines her breasts to determine any abnormalities such as lumps or changes in size or shape. This can be followed up with a Clinical Breast Exam (CBE) performed by a specialist.
The next formal test would be a mammogram or X-Ray of the breast. Mammography has yielded both “false positives” where the patient was diagnosed with cancer, yet was cancer free and “false negatives” where the patient was ruled not to have cancer, yet was later found that she did have it.
One of the most perplexing situations is to determine if a patient has a benign cyst or a tumor that is spreading rapidly. To gain more precise information, a technique called “Breast Ultrasound” is used. It is a small hand held device (transducer) that is coated with a special gel. The unit is then moved over the breast and sends back sound waves that can be monitored on a screen or print out. The ultrasound screening can detect changes in sound waves and the areas where these waves are not consistent with the rest of the scan are then studied for cancer.
A follow up would then be a biopsy that would determine the presence of cancer. Blood tests then can determine if the cancer is benign or malignant, depending on how long it takes for the cells to multiply.
In the final analysis, the choice of whether or not to adopt a formal screening is an individual choice. In most cases, a woman knows here body best and that should be the guiding principle in breast cancer screening.
Michael Smith is a keen health blogger and has featured on various publications online. He enjoys working with people and helping them deal with various health issues.