Cancer screening
The term “cancer screening” is actually misleading. Colonoscopy or X-ray examination of the breast, probably the two best-known “cancer prevention” examinations, cannot prevent cancer from developing in the bowel or breast. A better word is therefore “early cancer detection”.
The aim of these screening measures is to detect breast cancer as early as possible and to prolong the life expectancy of women suffering from breast cancer, or at least to improve their quality of life in the long term. The impression must not be given that early detection of breast cancer is a guarantee that it is curable. The type of cancer, size, location and other factors also have a significant influence on the prognosis.
Nevertheless, the stage at which a malignant tumour is discovered is a decisive prognostic factor for the success of a therapy. Not everyone should always go for early detection at any age. It is obvious to everyone that it makes no sense to subject a 12-year-old girl to an X-ray examination of the breast and thus expose her to considerable radiation exposure.
But what about a 30-year-old woman or a 60-year-old? Ultrasound is the most important additional method for self-examination and mammography. It plays a major role in the early detection of breast cancer and is of great importance.
In contrast to many other imaging procedures, no harmful X-rays are used here. The quality of the examination is strongly dependent on the examiner, it is particularly suitable for the specific clarification of palpable findings or mammography findings. However, because of the time required for the complete examination and the varying applicability to different breast tissues of the whole breast, it is suitable as a screening method.
As a rule, every gynaecologist has an ultrasound unit (sonography device) and can use the transducer and the ultrasound waves it emits to produce an image of the breast tissue. The ultrasound examination is usually carried out directly after the palpation performed by the doctor, if suspicious findings (such as lumps or hardening) can be palpated. The ultrasound image can then be used to differentiate more precisely what the palpation findings are (e.g. cyst, tumour).
However, the exact assessment with regard to benign or malignant tissue changes cannot usually be made with certainty, so that further examinations such as a biopsy (sampling of the suspicious tissue under ultrasound vision) or a mammography are often necessary. An ultrasound image of the breast is taken lying down. The examiner scans the breast with a transducer to which he has previously applied a gel.
The transducer emits sound waves inaudible to the human ear. Due to the different extent to which the sound waves are reflected, depending on the density of the tissue, an image is created on the monitor. If you wish, have your doctor show you the images on the monitor and explain what he sees.
For young women, an ultrasound can also be performed as a sole examination, but for older women it should not be a substitute for a mammography. The ultrasound examination is an important diagnostic tool in modern medicine, which is not associated with side effects or radiation exposure for the patient. However, in contrast to mammography, ultrasound plays a subordinate role in the early detection of breast cancer, as it is considered inferior in the diagnosis of breast cancer.
It is different, however, if a lump in the breast has been tattooed, either by the patient himself or by a doctor, or if suspicious symptoms exist. In this case, the gynaecologist can very easily determine whether it is a benign cyst or a benign fibroadenoma, for example, by means of an ultrasound examination. The latter is very common, especially in young women.
In this case, ultrasound is more meaningful than mammography, as the latter cannot depict the dense glandular tissue of a young breast well. In older women, however, as already mentioned, mammography is clearly superior to ultrasound in terms of its informative value. Mammography is a common imaging procedure for the early detection of breast cancer or for clarifying conspicuous symptoms.
This radiological examination should be performed for the early detection of breast cancer in women over 40 years of age. In this way, precancerous stages and suspicious microcalcifications can be detected before symptoms occur. In young women, on the other hand, mammography makes little sense, as the very dense breast tissue is not imaged very well.
This limits the assessability of the image. Young women should therefore be examined using other imaging procedures, such as ultrasound or MRI. Breast cancer diagnostics in the context of preventive medical check-ups does not usually include blood tests.
If there is any suspicion, blood tests are performed in addition to other diagnostic examinations. In this context, the patients’ blood is tested for so-called tumor markers. These are specific known molecules that are elevated in the blood in the case of a tumor disease or are only detectable in the blood in the case of a disease.
Over the past few years, however, it has become apparent that the common breast cancer tumor markers are only of limited significance. The problem is that tumours show very individual characteristics in different patients. In addition, other tumour types or diseases can also lead to an increase in certain tumour markers. Accordingly, the examination of known tumor markers is not a reliable diagnostic method for every patient.
