Specialised Units

Patients area

24-hour Emergency Cancer Care

Consultants

#Breast Cancer Screening Guidelines

Breast cancer almost always occurs in women, however it is also possible for men to develop it.

It is the most commonly occurring tumour in Western women. Around 25,000 new cases of breast cancer are diagnosed in Spain each year.

Breast cancer screening tests refer to the regular breast checks recommended by doctors to detect breast cancer before any symptoms appear. The objective of breast screening is to detect breast cancer in its earliest and most treatable stages.

What is breast cancer?

Breast cancer begins when cells in the breast start to grow in an uncontrolled fashion. These cells normally form a tumour which can be often be identified on an X-ray or which can be felt as a lump. The tumour is classed as malignant (cancer) if the cells can grow and penetrate (invade) surrounding tissue and spread (metastasise) to distant areas of the body.

 

The type of breast cancer is determined by the appearance of the cells when seen through the microscope, following biopsy or the surgical removal of the tumour. Breast cancer is also classified according to: its sensitivity to female hormones (oestrogen and progesterone), levels of certain proteins which play an important role in the growth of breast cancer (such as HER2), genetic composition and other characteristics. This classification helps doctors to predict how a cancer will respond to specific treatments, and also enables individualised treatment to be given.

How does it usually start?

Breast cancer usually originates in the cells of the lobules (milk producing glands), or in the ducts which carry milk from the lobules to the nipple. Less frequently breast cancer may originate in the fatty and fibrous connective tissues of the breast.

 

Over time, cancer cells can invade healthy surrounding tissue and reach the lymph nodes (small organs which remove foreign substances from the body) in the axilla. If cancerous cells reach the lymph nodes, they have found the gateway to other parts of the body. The stages of breast cancer refer to how far the cancer cells have managed to spread from the tumour.

 

85-90% of breast cancer cases have their origin in genetic abnormalities related to the ageing process and life’s “natural wear and tear”.

 

However only 5-10% of cases are caused by an abnormality inherited from a parent.

What are the risk factors?

According the Centres for Disease Control and Prevention (CDC) the majority of cancers are diagnosed in women over the age of 55. With increasing numbers of older women, we can also expect the number of cases of newly diagnosed of breast cancer to increase.

 

The following factors seem to slightly increase the risk of developing breast cancer:

 

• Age
• Personal and/or family history of breast cancer
• Hereditary mutation of some genes such as BRCA and PALB2
• Early onset of menstruation, or late onset of menopause
• Late first pregnancy
• Benign breast disease
• Hormone replacement therapy
• Combined contraceptive pill
• Being overweight or obese
• Exposure to radiation

What methods are used for screening?

Our breast cancer experts have developed guidelines based on their experience in treating patients at HC Marbella. We recommend a series of guidelines for women with the following levels of risk:

 

For women with an average risk of developing breast cancer

 

Doctors at HC recommend the following for women with an average* risk:

• Women between the ages of 25 and 40 require a clinical breast examination at their yearly gynaecological check-up.
• Women aged 40 and over should have yearly mammography plus clinical breast examination.
• Ultrasound may be recommended for women with dense breast tissue.
• All women should perform breast self-examination on a monthly basis from the age of 20 and familiarise themselves with their breasts to be able to identify any changes more easily.

 
 

For women with a higher than average risk of breast cancer

 

Experts at HC have developed the following guidelines for women who have a greater than average risk of breast cancer due to one of the following reasons:

• Family history of breast cancer in a first degree family member (mother, sister or daughter).
• History of atypical hyperplasia (a form of benign breast disease).
• History of carcinoma in situ (abnormal cells which are confined to the milk duct or lobule).
• History of extended field radiotherapy (mantle radiation), a type of radiation used to treat Hodgkin’s disease (and some other conditions) before the age of 32.
• Genetic predisposition to breast cancer (for example, women with BRCA mutation).

 
 

If you have an above average risk of breast cancer for the reasons described above, doctors at HC recommend you follow these guidelines:

 

Women with a family history of breast cancer:

• Clinical breast examination every six months, starting ten years before the age at which the youngest family member was first diagnosed with the condition (but not before the age of 25 or after the age of 40).
• Annual mammography starting at least ten years before the age at which the youngest family member was first diagnosed with the condition (but not before the age of 25 or after the age of 40).
• Possible additional imaging (for example ultrasound) for women with dense breast tissue.
• Possibly alternating between breast MRI and mammography every six months, as decided by the doctor.

 

For women with a genetic predisposition to breast cancer:

• Clinical breast examination every six months
• Yearly mammography starting at the age of 25
• Possible annual breast MRI

 

 

For women who have had extended field radiotherapy (mantle radiation)

• Clinical breast examination every six months starting at the time of radiation treatment
• Yearly mammography starting 8 years after radiation treatment
• Possible annual breast MRI

 
 

All women with a higher than average risk of breast cancer should talk to their doctor about additional screening tests, carry out monthly breast examination, and familiarise themselves with their breasts to be able to detect any changes easily.

HC Marbella International Hospital

HC Marbella offers a comprehensive programme for women at high risk of breast cancer which includes regular breast examination and imaging. The objective of breast screening is to detect breast cancer in its earliest and most treatable stages.

 

At HC Marbella we understand the importance of evaluating cancer risk as well as detecting disease at an early stage when there is a higher possibility of a full recovery.

If you have a history of cancer in your family we can provide you with information on genetics and hereditary cancer. Our Oncology Department has genetic counsellors and specialist doctors who can analyse ways of minimising cancer risk as much as possible.

 

Detection is an essential part of prevention and care in cancer. Our doctors have developed screening guidelines for the most common cancers: breast, cervical, colorectal, head and neck, ovarian, prostate and skin, in line with their experience in the treatment of patients at HC Marbella.