Breast Cancer and Digital Mammography

Breast cancer is the number one cancer found in Thai women, and the incidence continues to rise. Detecting cancer at its earliest stage significantly increases the chances of a successful cure.

The Advantages of Digital Mammography

A Digital Mammogram is a specialized X-ray of the breast designed specifically to detect cancer. It uses lower radiation doses than standard X-rays to produce high-resolution, crystal-clear images. This technology allows doctors to see abnormal tissues or tiny calcifications even when a lump is too small to be felt by hand. This leads to early diagnosis—often before any symptoms appear—allowing for faster and more effective treatment.

Risk Factors

• Increasing age.
• History of breast cancer or benign breast tumors.
• Family history of breast cancer (Genetics).
• Early onset of menstruation (before age 12) or late menopause (after age 55).
• Smoking and heavy alcohol consumption.
• Obesity and lack of physical exercise.

Warning Signs of Breast Cancer

1. A lump or thickening in the breast or underarm (axilla).
2. Changes in the shape or size of the breast.
3. Abnormal discharge or fluid from the nipple.
4. Nipple retraction (inverted nipple) or persistent sores on the nipple.
5. Dimpling, puckering, or rashes around the areola.
6. Unusual pain in the breast or underarm area.
7. Changes in skin texture, such as dimpling or "orange peel" skin (peau d'orange).

Diagnosis

1. Digital Mammography: Detects tiny masses or calcifications; usually performed alongside an ultrasound.
2. Breast Ultrasound: Helps distinguish between fluid-filled cysts and solid masses, making treatment planning easier.
3. Biopsy: The most accurate method to confirm if a mass is cancerous and to determine the cancer type.
4. Tumor Markers (Blood Tests):
   • CA 15-3: (Note: The provided text mentions CA125, but CA 15-3 is the primary marker for breast cancer monitoring). Used to monitor treatment and check for recurrence.
   • HE4: When analyzed alongside other markers, it can increase sensitivity in detecting certain epithelial-related changes early on.

Treatment Options

• Surgery: Lumpectomy (removing the tumor) or Mastectomy (removing the breast tissue).
• Radiation Therapy: Using targeted high-energy rays to destroy remaining cancer cells. The approach depends on the cancer stage and patient health.
• Systemic Therapy: Includes chemotherapy, targeted therapy, hormone therapy, and immunotherapy.

Doctors may use a single method or a combination of treatments based on the stage of the disease, age, and physical strength of the patient.

Screening Recommendations

• Monthly: Perform a breast self-examination.
• Yearly: Clinical breast exam by a healthcare professional.
• Age 35+: Baseline mammogram.
• Age 40+: Annual mammogram and ultrasound.
• High Risk: Individuals under 35 with symptoms or a strong family history should consult a doctor immediately.