Breast cancer: screening and prevention

doi:10.1017/CBO9780511545672.016

16 - Breast cancer: screening and prevention

from Part IV - Cancer prevention

Published online by Cambridge University Press: 21 August 2009

Jo Ann Rosenfeld

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Jo Ann Rosenfeld

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Jo Ann Rosenfeld: Affiliation:
East State Tennessee University
Jo Ann Rosenfeld: Affiliation:
The Johns Hopkins University

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Summary

Introduction

Breast cancer has the highest incidence and the third highest death rate for cancer in women in the USA. More than 200 000 women annually develop breast cancer in the USA. The incidence of breast cancer increased between 1973 and 1998 by 40%, perhaps caused by an increase in early-stage breast cancer detection. A woman in the USA has approximately a one in eight risk of developing breast cancer in her lifetime. The incidence of breast cancer increases with age, making screening more important in middle-aged women.

Unlike with lung cancer, screening programs and early detection for breast cancer have reduced its mortality. No studies have found a method to prevent breast cancer. Thus, early detection to reduce mortality is essential. The fact that early detection with mammography reduces mortality in women aged 50–69 years has been accepted and established. However, controversies about the efficacy of screening with different methods and in different populations have occurred; newer studies may be reported in the near future that may reduce or increase these disputes. Evaluation of previous investigations is, thus, important.

Presentation

The most common presentation of breast cancer is no symptoms. The first symptom is often a small, painless nodule or pain. Other symptoms include skin changes, dimpling, and nipple discharge.

Case: a 48-year-old woman comes to the office for an episode of acute bronchitis. After history and examination, you notice that there is no note of any breast cancer screening, including mammography, on her chart. You suggest a mammogram, but she says, “Hasn't that proven lately not to be accurate?”

Keywords

breast cancer clinical breast examination CT scanning mammography randomized controlled trials MRI self-breast examination mortality ultrasonography

Type: Chapter
Information: Women's Health in Mid-Life
A Primary Care Guide
, pp. 275 - 286

DOI: https://doi.org/10.1017/CBO9780511545672.016 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2004

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References

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Book contents

16 - Breast cancer: screening and prevention

Summary

Keywords

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