Some time ago, Zhimei received a message from a friend: she has always paid attention to health and annual physical examination, and recently found breast cancer...
Fortunately, the discovery was timely, the operation was done early, and the operation was relatively successful. But she still can't figure it out: Why didn't breast cancer be found in the annual physical examination?
This article will say: can breast cancer be detected by routine physical examination?
Image source: Stand Cool Helo
Early breast cancer is inherently difficult to detect.
The early symptoms of breast cancer are not obvious, do not hurt or itch, and do not affect eating and drinking. Even with regular breast self-examination, early breast cancer may not be able to detect obvious masses [1].
Therefore, the most efficient way to detect breast cancer in time is to standardize the examination.
Can a general physical examination detect breast cancer?
Without a targeted breast cancer screening program, it really isn't necessarily.
For example, the general physical examination generally only examines the routine items, including: general examination (height, weight, blood pressure, pulse, waist circumference), internal and surgical examination, kidney function, blood lipids, blood glucose, blood routine, urine routine, liver function, routine ELECTROCardiogram, chest ortholateral tablets, hepatobiliary, spleen and pancreatic double kidney ultrasound, etc.
That said, if your physical exam is just an ordinary physical examination, it may not include a single screening for breast cancer. It is difficult to detect breast cancer by taking only a positive chest film.
Some special physical examinations for women will include breast ultrasound (ultrasound), which can indeed help check for breast cancer, but for some people, it is not enough to screen for breast cancer through ultrasound.
Therefore, the physical examination is not about "checking diligently", but about "project right". If you want to detect breast cancer early, you have to conduct targeted screening programs.
Currently, "B ultrasound + molybdenum target" is the best combination for breast cancer screening [2,3].
B ultrasound has the advantages of non-invasive, safe and high detection rate.
Molybdenum target examination, will be subject to low-dose X-ray radiation, young women breast dense, so women younger than 39 years old routine physical examination does not advocate molybdenum target examination.
Of course, if the B ultrasound finds a problem, it can be further confirmed by a molybdenum scan. For women older than 45 years, a molybdenum scan can be done every 1 to 2 years.
How to do it, and how often to check it, you can refer to the following figure [2]:
As for some of the physical examination items in the physical examination package that are known as "can detect breast cancer", they are not necessarily reliable. For example, the following 3:
1
"A drop of blood to test cancer"? Easy to mistake, not yet accurate
Many medical examiners claim that early cancer can be detected by taking blood from the fingertips.
Fingertips collect a small amount of blood and contain only a very small amount of tumor information. Moreover, the continuous expansion of trace amounts of gene fragments, amplifying the detection signal, is prone to error, and the gene fragments released by normal cells into the bloodstream may also interfere with the results.
Even if it is positive, it is difficult to determine whether there is really cancer, from which part, and how to intervene. Therefore, this test is not necessarily reliable.
2
CT: insensitive to the mammary glands
Some medical examiners may recommend CT screening for breast cancer.
(Source: Screenshot of a physical examination website)
However, the detection rate of ct to detect breast cancer is not high. Because CT is not sensitive to breast cancer detection, the specificity of the breast is not strong. This check is not supported by mature data and is not necessary at this time.
3
Infrared: low sensitivity, large error
Although many places include "infrared testing" on the list of breast examinations, infrared testing is not the international standard for breast cancer screening.
On the one hand, the performance of the machine is insufficient, the sensitivity is low, the error is large, on the other hand, the doctor's subjective judgment is strong, and now the big hospitals have not used this method to do testing.
The figure below is an image of a breast mammography x-ray of a breast cancer patient
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You may also want to ask: after checking, how do you know your situation?
After you've done your super, you'll receive a report. Even if you can't understand the other content, you can also use the result of "BI-RADS classification" on the ultrasound checklist to make a preliminary judgment that the situation is not serious.
BI-RADS is a taxonomy that assesses the extent of breast lesions through ultrasound, with the aim of allowing ultrasound physicians to standardize the description of the lesions found for better diagnosis.
BI-RADS is divided into 0 to 6 categories, and in general, the higher the category, the greater the likelihood of malignancy of breast lesions [4].
If the results in the report are not "Class 1 or Class 2", please be sure to cooperate with the doctor to do follow-up examinations or review them regularly.
Note that the "class 0" in the report does not mean that everything is normal, but may not be assessed for the time being, and it needs to be judged in conjunction with the results of other tests or previous imaging tests, and it is also necessary to seek help from a doctor in time.
Finally, Zhimei wants to say: as long as active screening and early detection, breast cancer is not so terrible!
In China, the overall five-year survival rate of breast cancer was 80.9% between 2005 and 2009 [5].
The 5-year survival rate has improved significantly due to the increasing proportion of early breast cancers found on screening and the improvement of breast cancer surgical procedures [6].
Therefore, the detection of breast cancer is not equal to the "end of the world", as long as active cooperation with treatment, most breast cancers are completely defeated!
I hope that you who see this article can also share this article with Little Sisters, so that more people can actively screen and stay away from breast cancer.
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
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