Is Screening Right For You?

Population based screening with a "one size fits all" mentality is not appropriate for all women.

Each of us has unique circumstances. Planning appropriate breast surveillance is a bit like shopping for clothes. We need to find something that is sensible and fits you comfortably.

This starts with a detailed medical history including:

Family history of breast and ovarian cancer

Previous breast problems and biopsies

Hormonal exposure: age at menarche, age of first pregnancy, breastfeeding, use and duration of oral contraceptives, age at menopause, use and duration of HRT.

Then a clinical examination: Looking at size, and lumpiness of breasts. Some womens' breasts are very lumpy and difficult to examine. Ultrasound can be very helpful in this situation.

Then a review of imaging options: How dense is breast tissue on mammogram. If the tissue is very dense mammographic screening is less sensitive and ultrasound can be used to improve sensitivity of screening.

Now we can plan a scheme that fits your circumstances:

• Assess baseline risk
• Modify lifestyle factors to reduce risk
• Discuss screening options:
• breast self-awareness,
• annual medical clinical exam
• mammogram
• ultrasound
• MRI - for some high risk situations

Breast screening should be part of a health plan that encompasses other major health issues such as obesity, smoking and diabetes and that promotes general wellbeing.