Benefits of early detection include increased survival, increased treatment options and improved quality of life. Methods of early detection of breast cancer include:17
- breast awareness – awareness by the woman of the normal look and feel of her breasts
- screening mammography – use of mammography in asymptomatic women to detect breast cancer at an early stage
- clinical breast examination – physical examination of an asymptomatic woman’s breast by a medical or allied health professional.
Being aware of the normal look and feel of one's breasts is important for early detection, as more than half of breast cancers are diagnosed after investigation of a breast change found by the woman or by her doctor. However, while there is evidence that women can find breast changes due to early breast cancer, there is no evidence to promote the use of any one self-examination technique over another.10
BreastScreen Australia is the national program of screening mammography in Australia. The program aims to reduce mortality and morbidity from breast cancer by actively recruiting and screening women aged 50–69 years every two years, using mammography for early detection of the disease. Women aged 40–49 years and 70 years or over may also be screened.11
It is estimated that screening 10,000 women aged 50–69 years will prevent about 10–20 deaths from breast cancer over 10 years, with similar results for women aged between 65-74 years who do not have other diseases or conditions affecting their survival.10 Screening mammography is less beneficial for younger women, due to the reduced accuracy of mammography resulting in a higher risk of false positive and false negative results.10
In the 2009-2010 two-year period, the participation rate was 55% for women in the target age group of 50-69.4 Participation rates in screening mammography vary, with significantly lower rates found in populations of Aboriginal and Torres Strait Islander women (36%)4 and women whose main language spoken at home was not English.11
Clinical breast examination
For women who are not participating in regular mammographic screening, regular clinical breast examination may offer some benefit.10
Screening programs may appear to be a routine part of health checks for women. However, social and cultural meanings of breast cancer can mean that mammographic screening can cause distress for some women. In particular, women who perceive themselves at greater risk, or who have experienced a false negative or false positive diagnosis may be at greater risk of experiencing psychological distress.18
- Justify why breast cancer meets the criteria for a population screening program.
- Debate whether, with increasing life expectancy, the value of screening women over 70 years should be investigated.
Using available evidence, justify the advice you would give women in the following age groups about how to detect breast cancer early:
- younger than 40 years
- 40-49 years
- 50-69 years
- 70 years or over.
Discuss the advice you would give a woman on how she should check her breasts and what breast changes would warrant further review by a health professional.
Access BreastScreen Australia Program20 website and:
- Review the major aims of the BreastScreen Australia program Identify strategies that an SCN could use to promote achievement of the aims of the BreastScreen Australia program.
Identify reasons for lower mammographic screening rates among Aboriginal and Torres Strait Islander women, and women from non-English speaking backgrounds.