Screening for breast cancer using mammography is
Secondary prevention is the identification and treatment of premalignant or subclinical cancers. Screening by means of mammography is a typical example of secondary prevention. Teiary prevention is defined as symptoms control and rehabilitation. Screening for breast cancer There is evidence that screening for breast cancer has a ourable effect on moality from breast cancer. The basic techniques for early detection of breast cancer are : (a} breast self-examination (BSE) by the patient (b) palpation by a physician (c) thermography (d) mammography. All women should be encouraged to perform breast self- examination. Breast cancers are more frequently found by women themselves than by a physician during a routine examination. Although the effectiveness of BSE has not been adequately quantified, it is a useful adjuvant to early case detection. In many countries, BSE will probably be the only feasible approach to wide population coverage for a long time to come. Palpation is unreliable for large fatty breasts. Thermography has the advantage that the patient is not exposed to radiation. Unfounately, it is not a sensitive tool. Mammography is most sensitive and specific in detecting small tumours that are sometimes missed on palpation. The use of mammography has three potential drawbacks: (i) exposure to radiation. This may amount to a dose of 500 milliroentgen compared to a 30-40 milliroentgen dose received in chest X-ray. Therefore, there has been concern about exposure to radiation from repeated mammographies and the risk of breast cancer developing as a result (ii) mammography requires technical equipment of a high standard and radiologists with very considerable experience - these two factors limit its more widespread use for mass screening purposes, and (iii) biopsy from a suspicious lesion may end up in a false-positive in as many as 5-10 cases for each case of cancer detected. Although recent evidence points to the superiority of mammography over clinical examination in terms of sensitivity and specificity, medical opinion is against routine mammography on the very young. Women under 35 years of age should not have X-rays unless they are symptomatic or a family history of early onset of breast cancer Ref : Park 23rd edition Pgno : 387
Primordial prevention
Primary prevention
Secondary prevention
Teiary Prevention
Concept of health and disease