New Delhi: Breast cancer has overtime become one of the most common forms of the condition affecting women in urban India. Although the incidence is to low, breast cancer can develop in men as well. However, with evolving incidence, the treatment and diagnosis techniques for breast cancer also witnessed a major evolution thereby making a potentially fatal yet treatable condition. And to spread awareness about the same, October is globally celebrated as Breast Cancer Awareness Month. This year, we aim at strengthening the knowledge base of every individual with respect to breast cancer diagnosis.

For a long time, experts have relied on mammograms for breast cancer diagnosis. A mammogram is an X-ray picture of the breast to diagnose early signs of breast cancer. These are considered to be the best test for timely diagnosis as it can spot the tumour early, sometimes even three years before the signs start to appear externally. However, over the years, breast cancer diagnosis techniques have evolved a great deal, and to learn about the same, Times Now Digital connected with oncologists for more insights on the pros, cons and types of techniques currently in use.

Dr. Shubham Jain, HOD & Consultant of Oncology at HCMCT Manipal Hospitals spoke about a triple assessment technique which helps them in being absolutely certain about the diagnosis given the amount of distress a patient can go through.

“The diagnosis of breast cancer can be devastating for patients. Therefore, we ensure that before giving any patient that diagnosis, we are absolutely certain about the condition. For this purpose, we follow a triple assessment technique – first, an oncologist or a surgeon who examines the patient’s therapy, determines a possibility of evasion being cancerous or not. Secondly, the patient is subjected to a form of imaging. Lastly, depending on the risk of the patient and medical history, we opt for a test could be either a mammogram, which has been there conventionally, or it could be an ultrasound or MRI of the breast,” he explained

Dr Jain went on to explain how the MRI and ultrasound work for breast cancer diagnosis. He went on to recommend the three modalities to patients who have a breast lump. Additionally, he stressed on the importance of a combination of tests for breast cancer diagnosis.

“MRI is a very sensitive tool that is used in patients who may be at higher risk of cancer based on genetic history. Ultrasound, on the other hand, is another modality that can be used to evaluate breast cancer risk in younger patients, because the breasts are dense, and that is why it’s not visible very clearly on a mammogram. If there is any suspicious reading found based on the imaging, the patient is then subjected to a pathology test, which could either be a site of pathology that is an efficacy or a biopsy, which is done through a fine needle. And when we assimilate the results of the clinical examination, the imaging and the pathological tests, that is when we are able to determine with reasonable certainty of whether a patient is diagnosed or detected with breast cancer or not,” he concluded.

Dr Meghal Sanghvi, Surgical Oncologist at Wockhardt Hospital, also stressed on the triple assessment for breast diagnosis. However, she first explained how a mammogram works and explained how simple clinical breast examinations can also offer hope for patients.

“Mammography has been a time tested method for diagnosing breast cancer. Previously, it used to include only an x-ray mammogram with recent advances USG of the breasts or sonomammography has increased the sensitivity and specificity in diagnosing breast cancers. Newer modalities like MRI provide more details when used for screening, especially in high risk population. Vacuum-assisted biopsy is also a new scar-less technique for diagnosis in patients with breast lumps. Triple Assessment is still the most important technique for diagnosing breast cancer as it includes mammography, clinical breast examination and core biopsy of the breast lesion,” Dr Sanghvi explained.

Dr Garvit Chitkara, Senior Consultant of Surgical Oncology (Breast) at Nanavati Max Super Speciality Hospital spoke about ultrasonography, MRI imaging and diagnostic imaging as the newest and most effective techniques for breast cancer diagnosis. He went on to describe how these new and evolved techniques have supported breast conservation by surgeons.

“Diagnostic imaging for breast cancer has evolved extensively from a standard, two-dimensional, X-ray mammogram. The advanced mammogram machines allow a three-dimensional view of the breast’s anatomy. Additionally, ultrasonography (USG) of the breast is being used more often as a complementary imaging technique to mammography especially for women in younger age groups and dense breasts,” Dr Chitkara explained.

“MRI of the breasts is also a dynamic imaging tool which helps the doctor decide the nature and extent of the disease in the breast. MRI is used to rule out multiple tumours in the breast, especially in some particular disease types which are known to have multiple tumours at same time like Lobular carcinoma of the breast. It is because of these latest imaging techniques that breast conservation is being done by surgeons with more confidence about not leaving any disease behind in the conserved breast,” he added.

Dr Niti Raizada, Director of Medical Oncology & Hemato Oncology at Fortis Hospital, revealed the age at which ultrasound procedure would work best for breast cancer diagnosis. She also spoke about tomosynthesis and other diagnosis techniques that could help patients.

“Mammography, which is like an x-ray of the breast, has been used for many decades. However, we have new versions of the same in the form of digital image which is easier to interpret by enlarging the suspicious area. Ultrasound, on the other hand, is the recommended procedure for younger than 40 women because of high breast density. Besides that, tomosynthesis is a new technique in which breast images are acquired as 3-D mammography and allows the breast to be viewed in 1-millimeter, 3-D slices. MR mammography is an MRI of the breast done for women with high suspicion of malignancy, especially when there is hereditary breast cancer suspicion,” Dr Raizada concluded.

Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a professional healthcare provider if you have any specific questions about any medical matter.