Breast cancer is one of the most common malignant tumors in women worldwide, with an increasing incidence year by year and a younger trend in recent years. Early detection, early diagnosis, and early treatment are the key to improving the survival rate of breast cancer patients. The 5-year survival rate of early breast cancer can reach more than 90%, while that of advanced breast cancer is only about 20%. Therefore, scientific and standardized examinations are crucial for the early detection, accurate diagnosis, and formulation of treatment plans for breast cancer. The following details the common examination methods for breast cancer, including screening examinations, diagnostic examinations, and auxiliary examinations, to help women understand and take the initiative to carry out breast examinations.
Breast Screening Examinations
Breast screening is the main way to find early breast cancer, especially for women of different age groups. It is suitable for asymptomatic women and aims to detect potential breast lesions early before symptoms appear, so as to improve the cure rate. Common screening methods include breast ultrasound and mammography.
Breast ultrasound is non-invasive, convenient, and low-cost, and is suitable for women of all ages, especially young women under 40 years old. Due to the dense breast tissue of young women, mammography is not easy to show lesions clearly, while breast ultrasound can clearly show the size, shape, boundary, and internal echo of breast masses, and can distinguish between cystic and solid masses, which is of great significance for the preliminary screening of breast lesions. Dr. Emma Wilson, a breast specialist, points out that breast ultrasound can also detect small masses that are not easy to be found by palpation, which is an important part of breast screening.
Mammography is the gold standard for breast cancer screening, which is suitable for women over 40 years old or high-risk groups of breast cancer. It can clearly show microcalcifications (a typical sign of early breast cancer) and small masses, which is conducive to the early detection of breast cancer. However, mammography has a certain radiation, but the radiation dose is within the safe range and will not cause harm to the human body. For women aged 40-69, it is recommended to have a mammography examination every 1-2 years; for women over 70 years old, the screening frequency can be adjusted according to their physical condition and doctor's advice.
Diagnostic Examinations for Breast Cancer
If abnormal lesions are found in breast screening (such as masses, microcalcifications, or structural distortions), further diagnostic examinations are needed to confirm whether they are breast cancer and clarify the pathological type and stage. Common diagnostic examinations include breast ultrasound-guided puncture biopsy, mammography-guided puncture biopsy, and pathological examination.
Breast puncture biopsy is the gold standard for the diagnosis of breast cancer. It takes a small amount of tissue from the suspicious lesion through a puncture needle for pathological examination, which can clearly determine whether the lesion is benign or malignant, and clarify the pathological type (such as invasive ductal carcinoma, invasive lobular carcinoma) and grade. Dr. Michael Brown, a breast oncologist, emphasizes that puncture biopsy is a minimally invasive examination with little trauma and quick recovery. Patients do not need to be hospitalized, and they can return to normal life after the examination.
Pathological examination is the core of breast cancer diagnosis. It mainly includes hematoxylin-eosin (HE) staining and immunohistochemical examination. HE staining can clarify the pathological type and grade of breast cancer, while immunohistochemical examination can detect the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67, which provides an important basis for the formulation of treatment plans. For example, if ER and PR are positive, it indicates that the patient is sensitive to endocrine therapy; if HER2 is positive, targeted therapy can be used; Ki-67 indicates the proliferation activity of tumor cells, and the higher the value, the stronger the malignancy.
Auxiliary Examinations for Breast Cancer
After the diagnosis of breast cancer, auxiliary examinations are needed to clarify the stage of the tumor (whether there is lymph node metastasis and distant metastasis), so as to formulate a more targeted treatment plan. Common auxiliary examinations include chest CT, abdominal ultrasound, bone scan, and positron emission tomography (PET-CT).
Chest CT is used to check whether there is lung metastasis, which is one of the common distant metastasis sites of breast cancer. Abdominal ultrasound checks whether there is metastasis of liver, spleen, and other organs. Bone scan is used to detect bone metastasis, which can find early bone metastasis lesions that are not easy to be found by X-ray. PET-CT can comprehensively check the whole body for distant metastasis, but it is expensive and is generally used for patients with advanced breast cancer or suspected distant metastasis.
Special Examinations for High-Risk Groups
High-risk groups of breast cancer include women with a family history of breast cancer (such as mothers, sisters, or daughters with breast cancer), women with a history of benign breast diseases (such as fibrocystic breast disease, intraductal papilloma), women who have never given birth or given birth at an advanced age, women who have taken estrogen for a long time, and obese women. For high-risk groups, in addition to routine screening, more intensive examination methods can be used.
For women with a family history of breast cancer, especially those with first-degree relatives with breast cancer, it is recommended to start screening 10 years earlier than the age of onset of their relatives. For example, if the mother was diagnosed with breast cancer at 45 years old, the daughter should start breast screening at 35 years old. In addition, breast magnetic resonance imaging (MRI) can be used for screening. Breast MRI has higher sensitivity than mammography and ultrasound, and can detect small lesions that are not easy to be found by other methods, but it has a higher false positive rate and is not suitable for routine screening of the general population.