Breast cancer

How to detect breast cancer?

According to WHO, one in 12 women develop breast cancer in their lifetime. According to the French National Cancer Institute, this type of cancer accounts for 33% of female cancer cases in France. The success of breast cancer treatments - which usually combines mastectomy and drug therapy - increases with early detection. Breast cancer can be detected with regular screening and a consultation with a doctor if symptoms are observed.

What are the symptoms of breast cancer?

In most cases, breast cancer is suspected after a mammogram screening showing abnormal results. Swelling can also be discovered during a routine gynecological examination or self-examination. Sometimes, breast cancer is responsible for other suggestive signs. In this case, the first symptoms of breast cancer can be the following:

  • The presence of a mass in the breast
  • A change in the breast shape
  • A change in the appearance of the nipple or areola
  • Abnormal nipple discharge
  • Skin changes
  • Unexplained weight loss

How to detect breast cancer? Clinical examination and diagnosis

Breast lumps are not always a cancer. They can be benign tumors, cysts, fibroadenoma or they can even show an infection. Screening is the only way to detect breast cancer. Early diagnosis reduces the risk of a cancerous tumor progression and spreading to nearby lymph nodes or breast tissue. The treatment of breast cancer is more effective when the cancer is detected at an early stage.

As part of breast cancer screening, a yearly breast examination from the age of 25 is highly recommended. During the consultation, a doctor or a midwife looks for the presence of any abnormalities by performing palpation of the breasts. A follow-up mammogram is recommended every two years for women over 50.

What tests are performed to diagnose breast cancer?

To diagnose breast cancer, several tests are carried out:

The first consultation

If a cancerous lesion is suspected, the first consultation with a gynecologist is important to confirm the diagnosis. It also allows the doctor to identify the characteristics of the tumor mass. This assessment initially includes a palpation of the breasts and the axillary hollows in search of lymph nodes under the armpits.

Image tests

Imaging tests are indicated by the doctor after the first consultation. These usually include mammography and ultrasound of both breasts and lymph nodes, and in some cases a breast MRI. 

Biopsy

A biopsy using a sample of the suspicious lesion must be carried out in order to perform an anatomopathological analysis. This examination helps determine whether the lesion is cancerous or not. A small skin incision is made under local anesthesia in order to introduce a needle into the breast. This little intervention is painless thanks to the anesthesia. Several samples are taken. Tissue analysis helps identify the nature and characteristics of the suspected tumor.
Sentinel lymph node biopsy:

During a sentinel node biopsy, the armpit lymph nodes are identified and removed for analysis. With this technique, axillary dissection is only considered in the event of lymph node invasion by cancer cells. To identify the location of the sentinel lymph node, fluorescence imaging associated with the use of indocyanine green is an innovative and effective method. FLUOBEAM® offers a great visualization of the superficial lymphatic drainage, but also helps detect the sentinel lymph node after incision.

What are the goals of these clinical screening tests?

These tests make it possible to define the type of cancer as well as the extent of the suspicious lesions (infiltrating or invasive cancer, for example). The analysis of the breast also helps detect the presence of HER2 receptors. These cancer cells multiply quickly, which can make the cancer more aggressive. The presence of estrogen and progesterone receptors is also decisive for the choice of breast cancer treatment. Following excision of the sentinel lymph node, a second analysis of breast tissues is usually performed. This technique makes it possible to identify the presence of cancerous cells in the first lymph nodes and, thus, to consider eventually an axillary dissection.

In some cases, a biopsy is not possible. When the tumor is difficult to access, it is necessary to take a sample from the lesion during surgery.

Definition of the type of cancer

Once the diagnosis of breast cancer is confirmed, an additional assessment must be carried out. It includes:

  • A blood test
  • A heart checkup
  • An assessment of the tumor extension including a CT scan, a bone scintigraphy and an abdominopelvic ultrasound.

These medical examinations make it possible to define exactly the type of breast cancer, the size of the tumor and its extent. It also gives more information about the possible presence of metastases in the liver, the lungs or in the bones. The most appropriate treatment will then be offered to the patient according to the stage of the cancer and the type of lesion.  

What are the risk factors for breast cancer?

Breast cancer can affect any woman in a lifetime. Regular screening examinations can detect it at an early stage, which improves the efficiency of breast cancer treatments.
Although it can be difficult to prevent breast cancer, some specific factors can influence its occurrence. Women are thus advised to always keep a healthy lifestyle. 
Women who practice regular physical activity are less at risk of breast cancer. A varied and balanced diet rich in fruits and vegetables reduces the risk of cancer. On the other hand, the consumption of tobacco and alcohol increases the risk of breast cancer. 

The main risk factors of breast cancer are:

  • Age. Women over 50 are more likely to develop breast cancer.
  • Gender. Women are mostly affected by breast cancer as this disease rarely affects men
  • Genetics. According to data collected from the cancer league, 5 to 10% of breast cancers are due to genetic reasons.
  • Family history of breast cancer.

A cancerous tumor can be detected during a palpation of the breasts or during imaging tests (mammography). Therefore, in order to detect breast cancer, regular screening examinations must be carried out from the age of 25. Patients with a family history or predisposition to breast cancer should go for regular medical follow-up.