Breast screening refers to the examination of a woman’s breast to facilitate the detection of breast problems such as diseases or breast malignancies.
When regularly done, breast screening forms an early entry point for the diagnosis, care and treatment of disease conditions affecting a woman and further preventing complications that may arise from them. In some countries, breast screening is done individually to the woman seeking the services while in others; it involves the running of organized programs. These invite the women for breast cancer screening, reminding them about the services, notifying the participants of their results, tracing them to avoid defaulters, and checking the quality of the service provided to these participants. This paper discusses the various breast screening programs; the imaging modalities utilized in the diagnosis and their advantages, as well as their limitations. It also explains the multidisciplinary approach to the breast cancer screening, diagnosis as well and the role of the stakeholders.
Breast screening programs:
Currently, the NHS runs a breast cancer screening program that provides breast screening at an interval of three years for women aged fifty (50) years and above. The program provides screening for free, although with both invitations and personal appointments, with an age extension of 47 to 73 years. According to NHS (2014), this program has contributed to a reduction in deaths of women aged 55 to 69 years. The Ontario breast screening program is run by the Ontario cancer care that screens women at risk of breast cancer of the age extension 50 to 74 years. It also screens the women at high risk of breast cancer, especially those aged between 30 to 69 years. Through this program, the women receive quality mammograms and breast MRIs. They are also referred to the necessary facilities for continued care, and, for care for those who are diagnosed with breast cancer, arrangements are made for follow-ups (Cancer Care Ontario, 2014). In Canada, the Nova Scotia breast screening program carries out a cost effective breast screening to Nova Scotia women at the age extensions between 50 and 69 years. It promotes the guidelines for the policies of decentralized breast screening services in Scotia, and it also provides clinical services (Nova Scotia Breast screening Program, 2014). In the British Columbia, the BC Cancer Agency runs a breast screening program with the goal of reducing breast cancer through early detection. It also ensures that screening policies are up to date and carries out regular screening mammograms to women aged 40 years. According to its statistics, about 7% of the women require further tests to confirm breast problems (BC Cancer Agency, 2014). The Saskatchewan Cancer Agency carries out a screening program for women aged between 50 to 69 years. The centers for disease control and prevention has come up with a program called “the national breast and cervical cancer early detection,” which provides screening for underinsured women of low income aged between 40 to 64 years.
Triple assessment in breast cancer screening and diagnosis:
The screening process involves the use of varied methods, ranging from simple to advanced. The procedures are done in a systematic manner, leading to a continuum of investigations that build on one another, building a pool of clinical data available about cancer, and helps in easier diagnosis and management (Heusner et al., 2011). As commonly referred to as triple assessment, it involves a set of screening tests, which are done to people who are with the aim of detecting malignant breast cancer cells as early as possible for early initiation of management. These include techniques such as self-breast examination and clinical breast examinations (CBE), done through inspection of the breast that allows for the visualization of breast changes such as color of the breast skin, as well as the difference in sizes of the two breasts. Palpation is another commonly used screening procedure which helps in the detection of the presence of breast lumps (Heusner et al., 2011). Although it may outline the breast masses, it is limited to the provision of in-depth explanation of their nature in terms of composition, extend of other tissue and organ involvement, as well as the stage of the breast cancer. Mammograms remain a key screening test for women. When done regularly, or at a given interval, a present breast cancer can be managed early. This is because mammography provides a high definition of the breast condition and more detailed and reliable information compared to the other screening methods (Heusner et al., 2011)
Breast imaging modalities, their advantages and disadvantages:
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