Take care: All about breast cancer screening

When it comes to women’s health, breast cancer screening is one of the most important topics. Why? With around 69,700 new cases, breast cancer (mammary carcinoma) is the most common cancer among women in Germany. The average age at diagnosis is 64, but increasingly younger women are affected as well. Even so, it can be said that the risk of developing breast cancer rises significantly from the age of 45.

What are the causes of breast cancer

The exact cause of breast cancer is often unclear. However, scientific research has identified several risk factors. These include, among others, excess weight, too little physical activity, heavy tobacco and alcohol consumption, and a family history of the disease.

What symptoms may occur, and how can I recognize them?

In the early stages of the disease, there may be no pain or other noticeable symptoms. However, the following signs or changes in the breast may indicate cancer and should be checked by a doctor:

• Lumps, hardening, or unexplained changes in the breast
• Fluid leaking from the nipples
• Inverted nipples
• Dimpling of the skin
• Changes in the position, enlargement, or hardening of the entire breast
• Palpable lymph nodes or hardening in the armpits
• Discoloration, for example redness of the breast

How to examine your breasts properly

1. Stand in front of a mirror with your arms relaxed at your sides and look at your breasts:
   Has the size or position changed noticeably?
   Has the color of the nipple changed? Are your breasts, for example, reddened?
   
2. Slowly raise and lower your arms several times and watch how your breasts moves:
   Do your breasts move evenly?
   Are your nipples at the same height?
   What is the texture of your skin like?
   Can you notice any indentations or thickening of the breast?
   
3. Gently press the nipple between your thumb and index finger:
   Does fluid come out of the nipple?
   
4. Palpation at different depths:
   Make circular movements with your fingertips using different levels of pressure.
   Work your way from top to bottom or from the outside toward the nipple.
   Apply light pressure to the upper skin layer, medium pressure for the tissue underneath, and firm pressure to feel deeper layers of tissue.

Regular self-examination and self-observation are very important for noticing changes early. However, they are not a substitute for gynecological screening. Especially in the early stages, abnormal changes in breast tissue may not be palpable, so every woman should attend regular screening examinations from the age of 30. This is because if a tumor is detected early, the chances of recovery are very good. In advanced breast cancer, malignant cells can spread via the lymphatic vessels to the lymph nodes and form secondary tumors (metastases).

What happens next if I notice changes in my breast?

In statutory health insurance, all insured people with breast tissue have the option, from the age of 30, to have an annual early detection examination for breast cancer at a gynecology practice. During the exam, the healthcare professional palpates the breasts thoroughly to detect possible hardening and other nodular changes in the tissue. They will also check whether lymph nodes in the armpits are swollen or hardened. If necessary, they will explain how you can palpate your breasts regularly yourself in order to notice changes early. In addition, a family history will be taken, with a particular focus on cancers that occur in the family.

If suspicious changes are detected during the medical examination, there are various methods for diagnosing tumors:

• Mammography
  This X-ray examination of the breasts can reveal even small changes that are not yet palpable. Mammography screening is a program for the early detection of breast cancer. From the age of 40, it should be carried out every two years.
• Ultrasound (sonography)
  Sonography can be an additional method to mammography for dense breast tissue and is performed while lying on your back with your arms raised.
• Galactography
  This radiological examination using a contrast agent is used to investigate nipple discharge (secretion).
• MRI (magnetic resonance imaging)
  MRI is used for early detection mainly in women with a genetically increased risk of breast cancer.
• Biopsy
  During a biopsy, a needle is used to remove a tissue sample under local anesthesia. The sample is then examined under a microscope (histology).

Trust your body

Screening doesn’t mean worrying, it means taking good care of yourself. If you keep an eye on your breasts regularly and make use of screening options, you can spot changes early and act quickly if needed. Make time for it: your body deserves attention, and you can always seek medical support.