All About Breast cancer ( breast cancer treatment )
All About Breast cancer ( breast cancer treatment )
Breast cancer is the most common cancer of women in world. Often the diagnosis for those affected is a shock at first. Early recognized, however, the healing prospects are usually good.
In order to detect breast cancer early, especially early detection examinations at the gynecologist play an important role. These are available to every woman once a year from the age of 30 for free. In addition, women should scan their breasts once a month for themselves .
What is breast cancer?
Breast cancer (also called breast cancer) is a malignant tumor of the mammary gland , which can occur mostly in women, in rare cases but also in men.
Breast cancer: causes unclear
In breast cancer (breast cancer), the exact causes are not fully understood. The overwhelming majority of those affected fall ill spontaneously , that is, without physicians can identify safe causes. However, there are now various risk factors
Risk factors for breast cancer
Risk factors for breast cancer include:
- advanced age
- Long-term use of female sex hormones (eg hormone replacement therapy
- long period of natural hormone fluctuations in women, that is
- Onset of menstruation at a very young age and
- late onset of menopause
- Overweight after menopause
- Lack of exercise after menopause
- regular consumption of larger amounts of alcohol
- advanced mastopathy (ie an initially benign multiplication of the glandular lobes and the connective tissue of the mammary glands )
- Childlessness or a late first pregnancy (after the age of 30)
- hereditary influences
Risk factor age
The risk of developing breast cancer increases with age. The majority of women are at the time of breast cancer diagnosis over 65 years
Risk factor hormone replacement therapy during menopause
A hormone replacement therapy for menopausal symptoms may increase the likelihood of breast cancer. The longer a woman takes hormones, the greater the risk. Therefore, professionals recommend that women should only take hormones as short as possible to treat their menopausal symptoms. According to current knowledge, combined preparations that contain estrogen and progesterone as hormones increase the risk more so pure estrogen preparations. Five years after receiving hormone replacement therapy, the risk of breast cancer resembles that of a woman who has not received hormone replacement therapy.
Although the contraceptive pill also contains female sex hormones, it only slightly increases the risk of breast cancer.
Risk factor genetic predisposition
In 25 percent of women with breast cancer (about every fourth person affected) there are several cases of breast cancer in the family, such as the mother or sister. Genetic causes seem to play a role here. But only in about 5 to 10 percent of the women affected is a genetic predisposition actually responsible for the development of breast cancer.
BRCA-1 and BRCA-2 increase the risk
It has been proven that the two “tumor genes” BRCA-1 and BRCA-2 are associated with breast cancer. BRCA stands for Br east Ca ncer (English for breast cancer). Statistically, in about 50 to 80 percent of women who have the tumor genes BRCA-1 or BRCA-2 a genetic mutation (mutation), before the age of 70 developed a breast cancer – usually at the age of 40 years. The risk of breast cancer increases about 10-fold in the affected women.
The altered BRCA genes also increase the risk of other cancers, such as ovarian cancer (ovarian cancer ). In men, a mutant BRCA gene also increases the likelihood of breast cancer, although not to the same extent as women.
Studies also indicate that alterations in other genes may play a role in the development of breast cancer (eg in the genes RAD51C or PALB2), albeit to a lesser extent.
When is a genetic test useful?
For women who meet one of the following criteria , a genetic test is useful:
- At least three women in the family have breast cancer
- two women in the family with breast cancer, at least one of them ill before the age of 51
- at least one relative with breast cancer and one with ovarian cancer (ovarian carcinoma)
- at least one relative with breast cancer and ovarian cancer
- at least two women in the family with ovarian cancer
- at least one relative with bilateral breast cancer who is ill at the age of 50 or older
- at least one relatives who got breast cancer at age 35 or younger
- a male relative with breast cancer and a female relative with breast cancer or ovarian cancer
However, there is currently no special therapy for carriers of such mutations. A possible treatment in such cases is, for example, to remove the breast tissue in an operation without an existing tumor and to rebuild the breasts with an implant, for example.
Women who belong to this risk group who, from the age of 25 are entitled to a biannual screening examination at the gynecologist and from the age of 30 to aMammography at intervals of one to two years.
Breast cancer: initially hardly symptoms – cancer symptoms
Initially, breast cancer (breast cancer) usually causes no symptoms such as pain . However, there are signs that may indicate a tumor in the breast. Women who regularly palpate their breasts and are alert to outward-looking changes will sooner or later detect any breast cancer symptoms.
Possible signs of breast cancer:
- Knots or indurations in the chest that could not be felt in the past
- Retraction of the skin or withdrawal of a nipple
- Size difference of the breasts, which did not exist before
- different appearance of the breasts when raising the arms
- Secretions from a nipple (eg watery, bloody or purulent)
- other changes of the breast or nipple, eg a sudden strong redness
- palpable lymph nodes in the armpit, which did not exist before and are not caused by another disease (eg inflamed pimple in the area of the armpit)
These signs do not necessarily mean that it is breast cancer. However, to determine the exact cause of the symptoms, you should have the breast examined by a doctor.
If breast cancer is detected early – for example as part of a screening test – and treated successfully, it usually does not even go so far that symptoms appear. However, if breast cancer has already reached an advanced stage , breast cancer can cause symptoms such as:
- Performance kink , fatigue
- unwanted weight loss
- Pain due to secondary tumors ( metastases ) in the bones, eg back pain, body aches
Breast cancer is more common in some areas of the breast
If you think about the female breast a cross with the nipple as the center, so you can make a spatial frequency distribution of breast cancer in four quadrants. Most commonly, the upper outer quadrant is infested, as it also contains most of the mammary gland.
Breast cancer: A female breast on which individual sections are marked with percentages of the prevalent cancer incidence.
How common is breast cancer?
Breast cancer is the most common form of cancer in women in the western industrialized countries . Every year around 70,000 women in Germany suffer from it. In men , breast cancer occurs much less frequently : each year, there are about 620 new cases in men. That means only about one in every hundred breast cancer illnesses affects a man. On average, men are older when breast cancer is diagnosed.
Breast cancer: diagnosis
Any suspicion of breast cancer (breast cancer) should be clarified by a doctor, because an early diagnosis significantly increases the chances of success of the therapy. At the doctor’s visit, the doctor first asks for the medical history and then begins the physical examination. He carefully scans both breasts as well as the armpits and the keyhole pits.
If a suspicion arises , a mammogram , ie an x-ray examination of the breast, and in some cases, in case of unclear findings, an ultrasound examination of the breast (mammosonography) will be carried out in women over 40 years old . In women under the age of 40, ultrasound examination is the first method of examination.
With the help of mammography, benign ones can largely be distinguished from malignant changes , size and number of changes can be determined. In addition, this method allows it, so-calledTo recognize micro-lime :
- Microcalcium accumulates in the ducts of mammary tissue.
- Microcalcemia occurs in both benign and malignant changes of the breast and may indicate a very small tumor.
- The shape, size and arrangement of the micro-lime will tell the doctor if it is more of a benign or malignant cause.
An ultrasound examination in combination with mammography increases the safety of breast cancer diagnosis. To definitively say if the changes are benign or malignant, the examining doctor takes oneTissue sample (biopsy). Possible methods here are:
- Punch biopsy: Taking a tissue sample using a hollow needle punch under ultrasound view
- Vacuum biopsy: Taking a tissue sample under image monitoring, eg during an x-ray examination (“mammographic”), with a hollow needle about three millimeters thin, in which a tiny high-speed knife is located
- Fine needle biopsy: single cell extraction using very thin needles; is no longer recommended as the default method.
- Excess biopsy:In exceptional cases, a conspicuous change is completely excised by a cut in the skin (excision = excision).
Subsequently, an expert examines the tissue under the microscope and checks whether there are benign or malignant changes. If breast cancer is present, it also receives information about the tumor type and the degree of its aggressiveness (so-called grading).
In individual cases, the doctor also uses magnetic resonance imaging (MRI) for breast cancer diagnosis .
Patients with advanced breast cancer and a high risk of metastases, for example in the lungs, liver and bone, are being investigated with other methods , such as:
- X-ray examination of the lung
- Nuclear medical examination of bones ( bone scintigraphy )
- Ultrasound examination of the liver
So-called tumor markers such as the body’s own substances CEA and CA 15-3 play no role in the actual diagnosis of breast cancer . They are more suitable for aftercare when it comes to detecting relapses early.
Classification of the tumor
The results of all investigations allow the tumor in the so-called TNM scheme – T umorgröße, lymph node involvement (Engl. N ode = nodes), M etastasenbildung – classified, from which in turn results in a division into stages. On the one hand, this staging, together with the tissue examination, determines the prognosis of the cancer, and on the other, it determines the treatment strategy.
Tumors of the breast can be roughly divided into:
- Ductal carcinoma (ductal carcinoma): They grow in the milk transitions.
- Läppchenkarzinome (lobular carcinoma): They grow in the milk glands.
Ductal carcinoma in situ (DCIS)
If the doctor diagnoses a so-called ductal carcinoma in situ (DCIS) as a diagnosis, it means that there is a breast cancer precursor in the ducts or a very early form of breast cancer. The breast tumor is still confined to the milk ducts during this phase and does not grow into other tissue. At this early stage, the breast cancer can not yet form secondary tumors ( metastases ).
The doctor uses mammography to find evidence of a DCIS . On the mammogram, he detects minute calcifications ( microcalcifications ) if a DCIS is present. Microcalcification can also occur with benign changes. The doctor takes some tissue ( biopsy ) to find out the exact cause.
Lobular carcinoma in situ (LCIS)
Also in the mammary glands , precursors of breast cancer or early forms of breast cancer can occur. Physicians then speak of a lobular carcinoma in situ (LCIS). The LCIS diagnosis is performed in the same way as in ductal carcinoma in situ via mammography and biopsy.
A special form of breast cancer is the inflammatory (inflammatory) carcinoma: In the process, tumor cells break into the lymph channels located below the skin and cause a lymph congestion. As a result, extended skin areas swell and it forms a lymphedema . The surface of the skin is similar in structure to an orange (“orange peel”) or shows an inflammation-like redness.
Breast cancer: therapy
In breast cancer (breast cancer), the doctor individually aligns the therapy to the patient and their cancer. Which therapy or treatment combination is most suitable depends on various factors, such as:
- the tumor size,
- whether the cancer has already spread, that is metastases ,
- the tissue properties of the tumor,
- the hormone receptor status, ie whether the tumor has receptors for female sex hormones and
- if the woman is already in menopause .
- The most important treatment measure is in most cases an operative removal of the tumor tissue. Following is often aRadiotherapy .
In addition, breast cancer has also established chemotherapy and anti-hormone therapy . The treatment of breast cancer in men is not significantly different from that in women.
Breast conserving surgery
Today, with the use of radiation and / or chemotherapy , surgeons are often able to perform breast- conserving surgery in early stages of breast cancer . This is often the case for so-called non-invasive breast cancer, such as ductal carcinoma in situ (DCIS).
The risk of the tumor recurring after a breast-conserving surgery would be increased compared to a complete breast removal (radical surgery). However, it can be lowered significantly by the subsequent irradiation of the remaining breast tissue. Therefore, a breast conserving surgery is usually followed by radiation.
In some cases, however, doctors recommend the removal of the entire breast even in the case of early forms of breast cancer (radical surgery):
- The patient is younger than 45 years.
- The tumor could not be removed with sufficient safety margin to the adjacent tissue.
- The tumor has certain tissue properties.
- Because studies have shown that in these circumstances more often comes to a recurrence, ie a recurrence of breast cancer.
Which procedure is best suited, the doctor will discuss with the patient. Radiation therapy should always be followed.
A radical operation, ie the removal of the entire breast (mastectomy), was once the common therapy for breast cancer. Today it is known that – as far as the likelihood that the tumor recurs – comparable results can be achieved if a breast conserving operation is performed and an irradiation follows. Therefore, the radical operation is now used much less often. In certain circumstances, however, it is inevitable for breast cancer:
- There are strong calcifications (calcification) in the chest.
- The tumor could not be removed completely surgically.
- There are several cancers in one breast.
- There is an unfavorable relationship between tumor size and healthy breast tissue.
- Irradiation is not possible.
- It is an inflammatory (inflammatory) breast cancer.
- The surgical result is not cosmetically satisfactory.
- The person wishes a complete removal of the breast.
- lymph node removal
For breast cancer therapy, it is also crucial if the cancer already in lymph nodes of the armpit (axillary lymph nodes) spread has. To determine this, two approaches are possible:
- During breast surgery , the physician either directly extracts and examines several lymph nodes and examines them.
- Or he chooses the so-called sentinel lymph node biopsy .
In a sentinel lymph node biopsy, the doctor injects the patient with a radiolabeled substance (radionuclide) close to the tumor tissue before surgery. He then checks with a measuring device whether the radioactive substance has accumulated in a lymph node. The first lymph node storing the radionuclide is called the sentinel lymph node (or Sentinel-Node ). The doctor removes the lymph node and has it examined immediately. Only if he is affected by cancer cells, he also removes the other lymph nodes.
At very early stages (so-called non-invasive breast cancer such as the DCIS) sometimes no examination of the lymph nodes takes place .
Follow-up therapy after surgery
Follow-up therapy (so-called adjuvant therapy) takes place after the actual treatment , usually after surgery. Its goal is to destroy any remaining cancer cells in the body so that breast cancer does not recur. Follow -up therapy may consist of anti-hormone therapy or chemotherapy , or a combination of both.
Which form of follow-up therapy is the right one for breast cancer depends first and foremost on the size and type of the tumor and on whether the cancer has already spread to the lymph nodes . Further criteria are the hormone sensitivity of the tumor as well as the so-called menopausal status of the patient – ie whether she already had her last menstruation (menopause) or not.
Often radiotherapy is an important part of breast cancer treatment. It is suitable as a follow-up therapy after a breast-conserving operation and if it can not be ruled out that there are still tumor residues in the breast. Radiation therapy is designed to kill any remaining cancer cells after surgery and can reduce the risk of breast cancer recurring. Without radiotherapy after a breast-conserving surgery, the risk of a relapse (recurrence) is about 30 percent. With radiation therapy, the risk drops to about 5 to 10 percent.
After a complete removal of the breast , which today usually takes place as so-called “modified radical mastectomy”, the treating physician individually checks whether radiotherapy is necessary. Among other things, it is useful if the tumor was very large or if the cancer has affected the breast muscle or the skin.
Radiation treatment for breast cancer usually takes several weeks . Patients are irradiated for four to five days a week. The single irradiation only takes a few minutes and can usually be done on an outpatient basis. Radiation therapy in breast cancer is not painful , but it can irritate the skin and cause redness. At the end of radiation treatment, patients are often exhausted and feel tired . Permanent changes, such as discoloration of the skin or small, spider-like dilated blood vessels in the irradiated area, are rare.
Depending on the findings of the tissue examination, the doctor treating each breast cancer patient individually decides whether it is necessary to irradiate in addition to the radiation of the chest and the chest wall also other parts of the body , for example, the lymphatic drainage of the armpit and Schlüsselbeingrube.
In addition to radiation therapy from the outside, some tumor remnants are also irradiated from the inside : For this, the doctor inserts a small radiation source directly after the operation at the point where the tumor previously sat. This site is then irradiated with a very high radiation dose – a so-called “boost”. When the surgical wounds have healed, radiotherapy follows from the outside.
The chemotherapy in breast cancer is done with so-called cytotoxic drugs , so drugs that inhibit the growth of cancer cells. Depending on the active substance, the doctor administers the medication via a vein (infusion) or the patient takes it in tablet form. According to the guideline, all patients whose tumors have no receptor for certain hormones (so-called receptor-negative tumors) should receive chemotherapy after the actual treatment.
For the chemotherapy of breast cancer are mainly drugs from the group of anthracyclines and from the group of taxanes in question. Anthracyclines, such as the active substance doxorubicin, destroy the genetic information of a cancer cell and damage the cell membrane so that the cancer cell can no longer divide. Also taxanes , for example, the active ingredients docetaxel or paclitaxel , inhibit cell division.
However, chemotherapeutic drugs also affect healthy cells , especially in fast-growing tissues such as the skin, bone marrow, gastric and intestinal mucosa, and hair roots. Therefore, they can cause side effects , such as:
- hair loss
- Gastrointestinal complaints , such as nausea , vomiting
- susceptibility to infection
With modern drugs, however, many side effects of chemotherapy can be relieved relatively well.
Chemotherapy takes place in so-called cycles . This means that each treatment appointment is followed by a therapy-free period of one to three weeks. This procedure has the advantage that the body can regularly recover from any side effects.
Anti-hormone therapy (endocrine therapy)
About two thirds of breast cancer tumors are hormone dependent . That is, certain endogenous hormones stimulate the growth of cancer cells. The most important is the female sex hormone estrogen . Conversely, this means that the growth of the tumor can be slowed down by substances that suppress the action of the hormones . If chemotherapy is necessary, anti-hormone therapy should not start until chemotherapy is complete.
If the tumor is hormone-positive – ie reacts to hormones -, an anti-hormone therapy (also called endocrine therapy) takes place. For anti-hormone therapy of breast cancer, various substances are available that differ in their mode of action. A commonly used ingredient is the antiestrogen tamoxifen . Tamoxifen occupies the estrogen receptors on the cells, thereby preventing estrogens from “docking”. This principle is called competitive inhibition . Tamoxifen is considered the treatment of choice for women who are not yet menopausal .
Tamoxifen antihormone therapy is around five years and is generally well tolerated. Potential side effects of tamoxifen include, for example
- Hot flashes,
- as well as an increased risk that blood vessels form clots ( thromboses ),
- to emboli develop and
- Cervical cancer ( endometrial carcinoma ) develops.
Another treatment for hormone-positive breast cancer is the treatment with so-called aromatase inhibitors such as the drug letrozole . Aromatase inhibitors are substances that inhibit the body’s own enzyme aromatase , which is important for the formation of estrogen outside the ovaries . Active substances from this group are particularly suitable for women who are suffering from breast cancer and no longer have a menstrual period.
Depending on the findings, anti-hormone therapy may take a different amount of time and may be either with a single active ingredient or combined differently. Possible variants of the anti-hormone therapy are, for example:
- 5 years tamoxifen
- 5 years aromatase inhibitor
- 2 to 3 years Tamoxifen followed by aromatase inhibitors up to a total therapy duration of 5 years
- 2 to 3 years aromatase inhibitor followed by tamoxifen for a total therapy duration of 5 years
- Tamoxifen for 5 years followed by 5 years of aromatase inhibitors
Estrogen is mainly produced in the ovaries. Therefore, another treatment option for hormone positive breast cancer is to medically eliminate the production of estrogen and progesterone in the ovaries . It is also possible to irradiate the ovaries or to surgically remove them.
Immunotherapy (antibody therapy)
Immunotherapy – also known as antibody therapy – uses artificially produced immune system antibodies to destroy cancer cells. In about one in four women with breast cancer, breast tumors carry special docking sites – called HER2 receptors – on the cell surface. If this is the case, immunotherapy with antibodies such as trastuzumab may be a treatment option. This special antibody binds to the HER2 receptors and thus inhibits the further growth of the tumor. The immune system is activated and can attack the tumor cells.
Since the antibody is targeted against cancer cells with HER2 characteristic , most sufferers well tolerate immunotherapy. At the beginning of the treatment flu-like symptoms sometimes occur. However, the heart may also be affected. It is therefore important to have cardiac function regularly checked during treatment.
Doctors usually use immunotherapy for advanced breast cancer – usually in combination with chemotherapy . The treatment may be useful in breast cancer that has the HER2 receptor, but may also be considered adjunctive treatment after the main therapy.
Therapy of metastatic breast cancer
A metastatic breast cancer (breast cancer) is when secondary tumors ( metastases ) in other organs, such as the liver , the bone or the brain , have formed. Cytostatic agents are substances that prevent or delay cell growth – especially cell division. With these substances, an anti-hormone therapy and possibly an additional radiotherapy , it is possible to alleviate the discomfort of metastases and often also to stem their growth.
Bisphosphonates in bone metastases
Daughter tumors often affect the bones in breast cancer . The metastases disturb the natural balance between bone buildup and disassembly and the bone loses stability. Spontaneous fractures, ie those without external influence and recognizable cause, can be the result.
There is also another problem: If a lot of bone substance is broken down, a lot of calcium gets into the blood. A high concentration of this mineral in the blood can adversely affect the whole metabolism, for example on the function of the heart and kidneys.
Certain medications, the bisphosphonates , reduce the breakdown of the bone . Women with breast cancer and bone metastases receive bisphosphonates as tablets or as infusions via a vein.
For tumor cells to share, they need nutrients and oxygen. Both are obtained from the blood. If the blood supply is insufficient, the tumor itself forms new blood vessels . Physicians also call this process Angioneogenesis . For this, the tumor cells release the growth factor VEGF ( Vascular Endothelial Growth Factor ). Special drugs, the so-called angiogenesis inhibitors , block the growth factor VEGF, so that the tumor can no longer form blood vessels and is underserved in the long term – it “starves” to a certain extent.
In metastatic breast cancer , bevacizumab is approved for chemotherapy in combination with taxanes. Patients receive bevacizumab as an infusion every three weeks concomitant with chemotherapy. Possible side effects may include high blood pressure (hypertension) and an increased risk of thrombosis .
tyrosine kinase inhibitor
Cancer cells usually multiply very quickly and uncontrollably. One reason for this is a malfunction of the enzymes responsible for cell growth, including tyrosine kinases . A modern approach in cancer therapy are drugs that specifically inhibit tyrosine kinases and thus block cell growth.
In advanced breast cancer , the tyrosine kinase inhibitor lapatinib is used. It is given in tablet form. As side effects, diarrhea and rash may occur.
Breast cancer: course
Reconstruction of the breast
A reconstruction of the breast, ie a breast reconstruction , is, for example, after an extended procedure such as the radical operation (removal of the entire breast, so-called mastectomy). Reconstruction is also possible after a breast conserving surgery.
The reconstruction can be carried out immediately after the operation as well as months or years later . The timing of the reconstruction and the choice of the method depend essentially on the circumstances of the post-treatment as well as the desire of the patient.
There are basically two ways to rebuild the breast:
- Reconstruction of the breast with the body’s own tissue , such as muscle tissue or tissue from the abdominal wall
- Reconstruction with implants (plastic cushions filled with silicone or with saline) or with so-called breast prostheses, which can be inserted into the brassiere, for example
In both methods of breast restoration, the cosmetic result is already good shortly after the operation. The implants have the disadvantage that in some cases women sometimes perceive them as a foreign body in the breast.
After breast cancer therapy, regular follow-up visits are important. They usually first take place every three months , later the distances become larger. In addition, the person should undergo a mammogram of healthy breast once a year . After breast-conserving surgery, the surgeon also mammographs the operated breast every six to twelve months. If there is a suspicion that the breast cancer has recurred (so-called recurrence), further examinations, for example an ultrasound examination or a magnetic resonance tomography ( MRI ) , may be necessary .
After a breast cancer illness, the social and psychological support is important in addition to the medical care . Conversations with the doctor as well as with relatives and friends, possibly also with a psychologist or psychotherapist, can be helpful here. Support is also provided by numerous self-help groups where you can interact with other people who have or had a breast cancer.
The tumor markers CEA and CA 15-3 are endogenous substances that increasingly occur in the blood in connection with breast cancer . This determines the doctor, especially after the breast cancer therapy regularly from a blood test . The values may indicate whether the breast cancer may have recurred.
Each woman recovers individually differently from breast cancer. Physiotherapy exercises for the arm and shoulder of the affected side help restore strength and freedom of movement after breast cancer treatment more quickly. It also prevents neck and back problems .
After removal of the lymph nodes from the armpit, the arm may swell on the operated side because the fluid from the lymphatic system, the lymph, can not drain. The result is lymphedema . Physiotherapy and lymphatic drainage ensure that the lymph flows out again and the arm becomes more mobile again.
Assistance with professional and social rehabilitation, offers for cures and further support for breast cancer can be obtained from psychosocial counseling centers and the health insurance companies .
Breast cancer can be prevented only to a limited extent by avoiding certain risk factors . Excessive consumption of alcohol, for example, may favor the development of breast cancer. After menopause , overweight and lack of exercise increase the risk of breast cancer.
Breast cancer sign
Those who take hormones to relieve menopausal symptoms should do so for as short a time as possible. Affected women are best advised to consult with the attending physician in order to weigh up the pros and cons of hormone therapy .
Early detection measures
One of the early measures of breast cancer also is one of breast self-examination . Ideally, women should examine their breasts once a month and also look at and feel the skin of the chest and armpit. Abnormalities should be clarified by a doctor, such as:
- not healing wounds,
- Retractions of the skin,
- Swelling of the lymph nodes or
- fluid leaving the mammary gland.
Regular self-examination of the breast is important for early detection and treatment of breast changes. Our video shows you how it works!
However, one has to make it clear: breast cancer can not be detected at an early stage, but only at later stages, through breast self-examination. In the true sense, therefore, the scanning of one’s own breast is not an early detection measure. Nevertheless, self-examination of the breast plays an important role, especially in women who do not regularly participate in early detection examinations at the doctor.
To detect breast cancer as early as possible and thus increase the chance of recovery, the medical examination is therefore of greater importance. Once a year, women over the age of 30 in Germany have a statutory right to a free early detection examination at the gynecologist.
For all women between the ages of 50 and 70, biennial mammography (X-ray examination of the breast) is one of the common screening tests in Germany. The health insurance companies cover the costs of breast cancer screening.
For high-risk patients , for example, women with frequent cancers in the family or with a benign change in the breast (proliferative mastopathy ), recommended from the age of 30 regular mammograms.