In recent decades, the incidence of cancer has risen significantly in all developed countries around the world. Breast cancer is one of the leading cause of cancer related deaths among women in most developed countries, and a major public health problem due to the incidence and high mortality of the disease.
After lung cancer, malignant breast cancer is the second leading cause of death in Hungary: more than 2,000 women die every year and nearly 9,000 new cases are diagnosed. Cancer development is a multi-stage process that takes years, during which time it is possible to detect the symptoms before they would appear (screening).
Breast cancer initially causes no symptoms. Later, an unusual lump is formed in the breast, which women can discover themselves through regular self-examination. The sooner breast cancer is recognized and treated, the better the chances of recovery are.
The aim of breast screening
The primary goal of organized screening is to reduce the mortality of the target disease. In addition, an important goal is to improve the quality of life, to detect the precancerous condition or the disease as early as possible, and to treat the target disease earlier than it would be possible without screening.
Breast cancer belongs to the type of tumors that can be easily screened. Organized breast screening (mammography) for women aged 45-65 exists since 2002 in Hungary. Women at risk who are eligible for screening will receive an invitation with the exact time and place of the screening during the two-year screening cycle.
Eligibility for organized breast screening
All women with valid social insurance between the age of 45-65 who have not had a breast screening or diagnostic breast examination in the last two years (exactly 22 months) and who do not have diagnosed breast cancer can be invited for breast screening (mammography).
A significant proportion of deaths caused by malignant breast tumors could be prevented by regular participation in screening.
Locations of organized breast screening
Organized breast screening can only be performed by Complex Mammography Centers (KMK) and Mammography Screening Centers (MSZÁ) designated by the healthcare authority in 2001, which cover the entire country.
Organized breast screening is currently performed by 39 KMKs suitable for both mammographic screening and clinical follow-up, as well as 10 MSZÁs that perform only screening examinations and have the capacity to examine the entire population at risk based on their age. The locations of mammography centers are available HERE.
The process of breast screening
At check-in at the breast screening center, the patient is questioned about her illnesses as well as any tumors that may occur in the family. The screening then consists of a physical examination - palpation of the breasts - and a mammography. Mammography is a two-way x-ray examination of the breasts using soft X-rays, which means low radiation exposure. The examination is not painful and takes up to 20 minutes including the time spent in the locker room and administration.
The mammogram is evaluated independently by two radiologists according to the so-called “four-eye principle”. In the case of a non-negative result, i.e. if any changes in the mammogram are detected by the two radiologists, additional examination (s) is required, for which the screening center will recall the patient.
Possible results of breast screening:
Negative result: The doctors evaluating the mammogram did not find any changes in the breasts, in which case no further action is required.
Non-negative result: in this case, the patient is recalled by the breast screening center and additional examination (e.g. ultrasound, biopsy) is performed to clarify the lesion. In the event of a recall, it is absolutely important to appear at the examination for your own health. It is important to know that the patient can be also called back to the breast screening center if the mammogram cannot be evaluated due to technical errors.
Breast self-exam
It is common experience that benign or malignant lesions that grow in the breasts are most often recognized by women or their partners. One possible method of early detection is self-exam at home. However, regular self-examination cannot substitute attending the screening test, it only allows you to notice some of the changes. Mammography, on the other hand, can detect non-palpable lesions and provide information on the nature of the lesion. If you notice an unusual change during self-exam, contact your gynecologist or GP as soon as possible.
The self-exam must be carried out in accordance with the following instructions:
- Face the mirror, lower your arms and shoulders. Observe the shape of your breasts and look for skin changes, discoloration, swelling, or unusual deformities (such as nipple retraction). Raise both arms above your head and repeat the observations!
- Palpate your breasts by taking one breast and then the other between your palms and slide your palms along the breast vertically and then horizontally. With closed fingers of your right hand, palpate one breast, then the other in a circular motion heading from the inside to the outside using light pressure.
- Lying comfortably on your back, place one hand under your head and place a small pillow under your shoulder, also palpate one breast then the other in a circular motion; palpate your armpit with the tip of your fingers too! Then, place your arm next to your body, and repeat the palpation on one side and then on the other side.
- Press lightly your nipples and watch for discharge.
If you notice any unusual lumps in your breast, the thickening of your skin, or discharge, contact your doctor immediately.
