Breast lumps screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]

Overview

Screening for breast lumps is recommended by breast examination, ultrasound, mammography, magnetic resonance imaging.

Screening

The Screening methods of breast lesions:[1]

  • Breast examination
    • Self breast examination
      • Although this is controversial, most clinicians recommend women to perform self examination monthly.
    • Clinical breast examination
      • Women with age> 40 years is recommended to have clinical breast examination, annually.
  • Ultrasound
  • Mammography[3]
    • Gold standard test of screening
    • Early detection of non-palpabale masses
    • According to 2013 NCCN guidelines
      • Annual screening in average risk women aged ≥ 40 years
      • Annual screening in high risk women from age of 25 years
    • Sensitivity of 0.33-0.39 and specificity of 0.95
  • Magnetic resonance imaging[3][4]
    • Significant method for detection, assessment, and management of breast cancer
    • Sensitivity of 0.77-0.79 and specificity of 0.86-0.89
    • According on 2013 NCCN guidelines
      • Annual MRI for individuals with > 20% risk of developing breast cancer in lifetime starting at age of 25 years
    • Beneficial modality for screening in high risk individuals
    • Valuable screening method in individuals with equivocal results from other screening tests
    • Usable for individuals with ineffective mammography results due to breast augmentation

References

  1. Shah R, Rosso K, Nathanson SD (2014). "Pathogenesis, prevention, diagnosis and treatment of breast cancer". World J Clin Oncol. 5 (3): 283–98. doi:10.5306/wjco.v5.i3.283. PMC 4127601. PMID 25114845.
  2. Kelly KM, Dean J, Comulada WS, Lee SJ (2010). "Breast cancer detection using automated whole breast ultrasound and mammography in radiographically dense breasts". Eur Radiol. 20 (3): 734–42. doi:10.1007/s00330-009-1588-y. PMC 2822222. PMID 19727744.
  3. 3.0 3.1 Kriege M, Brekelmans CT, Boetes C, Besnard PE, Zonderland HM, Obdeijn IM; et al. (2004). "Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition". N Engl J Med. 351 (5): 427–37. doi:10.1056/NEJMoa031759. PMID 15282350. Review in: ACP J Club. 2005 Jan-Feb;142(1):23
  4. Warner E, Messersmith H, Causer P, Eisen A, Shumak R, Plewes D (2008). "Systematic review: using magnetic resonance imaging to screen women at high risk for breast cancer". Ann Intern Med. 148 (9): 671–9. PMID 18458280.


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