Breast cancer is one of the most common cancers among women. It occurs when the cells in the breast start to grow uncontrollably, leading to a tumour. The symptoms usually include lumps, skin dimpling, breast or nipple pain, inward appearance of the nipples, and nipple discharge. However, in most cases, the disease remains asymptomatic, which makes it difficult to detect the condition, increasing the risk of complications. There are various tools to diagnose breast cancer, including ultrasound, mammogram, and MRI. In this article, we try to find out the safest and most effective diagnostic tool. Dr Uma Dangi, Consultant Medical Oncology, Fortis Hospital, Mulund and Hiranandani Hospital, Vashi, shares insights and helps us with the same.
Also Read: Breast Cancer Vs. Breast Cysts: How To Distinguish Between The Lumps?
Breast Cancer Prevalence
Globally, breast cancer accounted for 20.3 lakh cases and 6.8 lakh deaths in 2020, says the World Health Organization (WHO), adding that almost half of all breast cancer cases occur in women with no specific risk factors other than sex and age.
In India, breast cancer accounted for 13.5% of all cancer cases and 10.6% of all deaths with a cumulative risk of 2.81, as per the Globocan data 2020.
Up until 1990, the cervix was the primary site of cancer in India, followed by breast cancer. However, the scenario has shifted and breast has overtaken as the leading site of cancer, according to the National Cancer Registry Programme.
Early Diagnosis Is Key
According to the American Cancer Society (ACS), the 5-year relative survival rate of breast cancer, when detected early and at a localised stage, is 99%.
The WHO says, "Early diagnosis of cancer focuses on detecting symptomatic patients as early as possible so they have the best chance for successful treatment. When cancer care is delayed or inaccessible there is a lower chance of survival, greater problems associated with treatment and higher costs of care. Early diagnosis improves cancer outcomes by providing care at the earliest possible stage and is therefore an important public health strategy in all settings."
Dr Dangi says, "The most critical key for ensuring cure and successful treatment is early detection, as stage I and II breast cancers have cure rates of over 90%. Although the self-breast examination is an essential method of early detection, imaging studies like mammography, Magnetic Resonance Imaging (MRI), and Ultrasonography (USG) help determine the presence of abnormalities, especially in asymptomatic women.”
Mammography Versus Ultrasound: Which Is Better?
Mammography (MMG) is nothing but an X-ray picture of the breast, says Dr Dangi, explaining, “The breast is compressed between two plates, causing the person to feel slight pressure and discomfort during the test. However, it is valuable in obtaining breast images and can detect tiny abnormalities, including micro-calcifications, which are signs of early breast cancer.”
On the other hand, USG or ultrasound uses sound waves to detect abnormalities in any organ, and does not involve radiation exposure.
“Although it helps determine the type of lump, solid, or cystic, it has its limitations for cancer detection," says Dr Dangi. According to her, it is mainly used as a supplementary tool with MMG as USG cannot image the whole breast at once and is operator-dependent.
“It may not accurately capture abnormalities that are too deep. Micro-calcifications also cannot be seen on USG,” the doctor adds.
All in all, Dr Dangi says, “Women below the age of 40 years are usually subjected to USG to avoid radiation exposure. In younger women with dense breasts, MRI of the breast is the investigation of choice. However, it is not widely available and has a learning curve. Therefore, mammography remains the investigation of choice for the detection of breast cancer.”
Bottomline
Early cancer detection is key in managing disease progression and determining successful outcomes. Regular self-breast examination is said to be an effective way to detect breast cancer. In fact, a study published in the Journal Cureus found that there was no significant difference in identifying cancer or positive ultrasound finding between clinical breast examination and breast self-examinations. However, it is best to visit a healthcare professional and get yourself examined with a diagnostic tool so that you get an accurate picture.