What are the items in breast health examination

Currently, routine clinical breast health examinations are mainly divided into three categories: home self-examination, clinician physical examination, and imaging examination. Which one should be selected based on age, medical history, and high-risk factors. The more comprehensive, the better. Last week, I accompanied my 32-year-old best friend to have her annual breast screening. She used to think that she didn’t need to check if she couldn’t feel a lump. This time she went there because she couldn’t resist me. The color ultrasound revealed a 1cm Category 3 benign nodule. The doctor said she was lucky to have found it in time, and that she could follow up every six months without any special treatment.

Many people’s first impression of breast examination is home self-examination. It is usually recommended to do it 7-10 days after menstruation, when the glands are at their softest. Look in the mirror to see if there is any asymmetry, skin dimpling, or nipple discharge on both sides of the breast. Then use your fingertips to press flat on the entire breast and armpit area to see if there are any abnormal lumps. However, there are indeed different opinions on the necessity of self-examination in the academic circles. One group believes that the general population's methods are not standard, and it is easy for normal glands to be regarded as masses and cause anxiety, and nodules smaller than 1cm are basically invisible. Self-examination is of little significance for early screening, so some of the latest guidelines South Korea no longer lists it as a mandatory recommended screening item; however, some clinicians believe that self-examination can help everyone build awareness of breast health, and at least detect obvious abnormal signals such as sudden changes in appearance and abnormal discharge in time, so as not to delay seeking medical treatment until the symptoms are severe.

When you actually go to the hospital for treatment, the first thing you do is often a physical examination by a clinician. Professional breast doctors have touched tens of thousands of breasts and can identify abnormal lumps by touch much better than ordinary people. During the physical examination, you will also be asked about your menstrual status, reproductive history, and whether your family has a history of breast malignant tumors, which is equivalent to making a preliminary prediction for the subsequent examination plan. For example, for young people in their twenties with no high-risk factors, a breast ultrasound is usually enough if there is no abnormality in the physical examination. If you are over 40 years old, or have a direct relative who has had breast cancer, the doctor will most likely recommend a mammography examination.

Breast color ultrasound should be the most popular item. It is a bit like an "ultrasound examination" of the breasts. You can clearly see whether there are long nodules in the soft glandular tissue, whether the nodules are cystic or solid, and whether there are abnormal blood flow signals. There is no radiation at all. Pregnant women and lactating women can do it with confidence. It is especially suitable for dense breasts common in young women. The mammography target is equivalent to taking an "X-ray" of the breast. It is best at catching tiny calcifications that cannot be seen through ordinary examinations. For many early cancers that have not yet formed nodules, the first signal that appears is fine sand-like calcifications. The mammography target can identify such lesions. The sensitivity is much higher than that of color ultrasound, but its penetrating power is limited. If the glands of young women are too dense, X-rays cannot pass through them, and the lesions cannot be seen clearly after taking them. Instead, they will suffer from radiation exposure, so it is not routinely prescribed to people under 40 years old without high-risk factors. If the nodule is found to be of poor shape during routine examination, is suspected to be malignant, or the scope of the lesion needs to be clarified before surgery, the doctor will also recommend breast magnetic resonance imaging. This examination is more accurate, but it is also expensive, and the waiting time for an appointment is long, so it will not be used as a routine screening option.

If you have unexplained nipple discharge, especially bloody discharge, the doctor will also prescribe discharge cytology smears and breast ductoscopy to see if there is anything growing in the milk ducts. This type of examination is targeted and does not need to be done routinely by ordinary healthy people. After getting the report last time, my best friend said that she thought she had to do all the examinations before she could rest assured, but now she realizes that choosing the right one that suits her is much more useful than blindly seeking perfection. Now she obediently goes for a color ultrasound check every six months. The nodules have been stable and have not grown, and she is relieved.