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Screening for Breast cancer

Breast cancer is the most common cancer among women in South Africa. It is estimated that one in every twenty-nine South African women will develop breast cancer in their lifetime. 1

Studies have shown that it is possible to reduce the number of women dying from breast cancer by 45% using very simple measures. 2 These include understanding your risk of having breast cancer based on your personal and family history and being screened regularly for breast cancer. 2

Breast Self-examination

Breast cancer often is found by a woman herself. 3 This happens in almost one half of all cases of breast cancer in women aged 50 years and older. 3 It is important to do a monthly breast self-examination, 2 so that you have a sense of what is normal for your breasts and you can then tell if there are changes—even minor changes—and report them to your doctor. 3,4

The best time to do a monthly breast self-examination is about 3 to 5 days after your period starts. 5 Your breasts are not as tender or lumpy at this time in your monthly cycle. If you have gone through menopause, plan to do your exam on the same day every month. 5

Monthly breast self-examination should always include: 6

  • visual inspection in a mirror to note any changes in shape, contour, texture or colour; and
  • manual inspection in standing and reclining positions to note any unusual lumps or thicknesses

Watch this video to find out more information on doing a breast self-examination.

chart: breast self examination

Investigations used for Breast cancer screening

Mammograms

Mammography is an examination of the breast using a low-dose of X-rays to look at any abnormalities. 2 The images created are called a mammogram. 3

What to expect during a mammogram 3

You will need to completely undress from the waist up and put on a gown. You will be asked to stand in front of an X-ray machine. One of your breasts will be placed between two flat plastic plates. You will feel firm pressure on your breast. The plates will flatten your breast as much as possible so that the most amount of tissue can be viewed. These steps will be repeated to take a side view of the breast. The test then is done on the other breast.

The pressure of the plates often makes the breasts ache. This discomfort is brief. If you are still having menstrual periods, you may want to have the test done in the week right after your period as breasts are usually less tender after your period.

Ultrasound (breast sonar)

Ultrasound is another imaging method to look inside the breasts. It uses high-frequency sound waves to echo back a picture of the structures inside the breast.It can be used to evaluate abnormalities found on clinical examination & mammography. It is particularly good for looking at breasts of younger women. 2

When should I start screening for breast cancer?

If you are at an average risk of breast cancer, it is recommended that you: 2

  • Examine your own breasts each month and get to know what is normal for you
  • After the age of 40 see your doctor every six to 12 months for a clinical breast examination
  • After the age of 40 get a mammogram and sonar at least every two years
  • After the age of 50 get a mammogram and sonar every year

If you would like to better understand your risk of breast cancer, speak to your Medicare Pharmacy healthcare professional about our doctor video consultations.

References: 1. National Institute of Occupational Health. Breast Cancer – Let’s Prevent Together! [Online] 2012 Oct 3 [cited 2018 July 11]. Available from URL: http://www.nioh.ac.za/breast-cancer-lets-prevent-together. 2. Breast Cancer Foundation. How can I check for Breast Cancer? [Online] 2017 [cited 2018 Jun 28]. Available from URL: http://www.mybreast.org.za/breast-health/breast-cancer/how-can-i-check-for-breast-cancer. 3. American College of Obstetricians and Gynecologists. Mammography and Other Screening Tests for Breast Problems. [Online] 2017 Sept [cited 2018 Jun 28] Available from URL: https://www.acog.org/Patients/FAQs/Mammography-and-Other-Screening-Tests-for-Breast-Problems. 4. Mayo Clinic. Breast self-exam for breast awareness [Online] 2018 July 3 [cited 2018 July 11]. Available from URL: https://www.mayoclinic.org/tests-procedures/breast-exam/about/pac-20393237. 5. National Institutes of Health (NIH). Medline Plus. Breast self-exam. [online] 2018 Jul 9 [cited 2018 Jul 11]. Available from: URL: https: //medlineplus.gov/ency/article/001993.htm. 6. Breast Cancer Organisation. How to Do a Breast Self-Exam: The Five Steps. [online] 2018 Feb 19 [cited 2018 Jul 11]. Available from: URL: https://www.breastcancer.org/symptoms/testing/types/self_exam/bse_steps.

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