The Importance of Screening
Breast cancer in its early stage is easier to treat and is more likely to be cured. It is important to attend a screening clinic in order to be fully assessed, especially when you find new symptoms or changes in your breast. Early detection often reduces the need for breast amputation (mastectomy) and chemotherapy, with breast conserving treatment more widely available. Almost all women diagnosed with breast cancer at the earliest possible stage survive for at least 5 years after diagnosis and are more likely to be cured compared with 3 in 20 women whose disease is diagnosed at its latest stage.
Screening recommendations for women with an average breast cancer risk*
*Kenyan National Screening Guidelines, Ministry of Health, 2018
Screening Recommendations for Women with a High Breast Cancer Risk
Women in the high-risk population require more intensive screening and/or genetic counselling. Women with the following characteristics are classified as high risk for breast cancer. Women who do not fulfill any of the four criteria should be classified in the average risk group.
- Affected first degree relatives
- Previous abnormal breast biopsy
- Previous chest wall radiation
- Previous breast cancer
The screening recommendations for these are as follows:
1. Women with one or two first degree relatives with invasive breast cancer
- Clinical breast examination from the age of 25 years,
- Annual mammography starting 10 years younger than the youngest case in the family, but no earlier than age 25 and no later than age 40;
-Complementary imaging like ultrasound and MRI in addition to the above where justified.
2. Women with a breast biopsy showing atypical hyperplasia or lobular carcinoma in situ and following surgical management to rule out invasive carcinoma:
- Clinical breast examination every 6-12 months
- Annual mammography
3. Women with a history of chest wall radiation (i.e. mantle radiation for treatment of Hodgkin’s lymphoma) at age 30 or younger:
- Annual mammography and MRI starting 5 years after radiation given, but starting no earlier than age 25 and no later than age 40 - - Annual clinical breast examination
4. Women with previous breast cancer require screening of contralateral breast
- Clinical breast examination every 6-12 months
- Annual mammography
*Kenyan National Screening Guidelines, Ministry of Health, 2018
What to Expect at the Screening Clinic
At the clinic, you will see the Breast Consultant and a nurse. They will ask if you have had any breast problems before and whether you have a family history of cancer. The specialist will examine your breasts and under your arms. They will explain which tests you need. These may include:
Mammogram: uses low-energy X-rays to identify abnormalities in the breast. This is the most important breast screening tool as it identifies early signs of breast cancer, microcalcifications and small lesions. Regular mammograms are the most effective tests for detecting breast cancer early, sometimes up to 3 years before it can be felt as lump.
Breast ultrasound uses high frequency sound waves to assess the size and shape of breast lumps and determine whether they could be tumorous growths or fluid filled cysts
Ultrasound of the lymph nodes in the armpit
Biopsy: to obtain a sample of breast tissue. A biopsy is done when mammograms, other imaging tests, or a physical exam shows a breast change that may be cancer. A biopsy is the only way to know for sure if it’s cancer. the biopsy samples will be sent to a lab where a specialized doctor called a pathologist will look at them. It typically takes a few days for you to find out the results.