What is breast cancer screening ?
Breast self-examination is a first way to detect breast cancer. It allows a woman to note any changes in her breasts as soon as they appear.
In France, breast self-examination is recommended every month from the age of 20. If a change occurs, such as the development of a lump or swelling in the breast or under the armpit, irritation or irregularity of the skin, pain or retraction of the nipple, redness or flakes peeling off on the skin of the breast or nipple, discharge other than milk, you should consult your doctor as soon as possible.
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The best time to perform breast self-examination is approximately one week after the end of menstruation when the breasts are no longer swollen.
If the menstrual cycle is regular, it is preferable to examine them on the same day of each cycle.
To perform breast self-examination, it is necessary to press firmly enough to feel the breast tissue well. The examination should be done lying down and then standing up. The latter position facilitates the examination of the upper and outer parts of the breasts (towards the armpits), where almost half of breast cancers are detected (source: arcagy.org).
Breast self-examination
Clinical breast examination by a specialist doctor (gynecologist) is a second method of screening. It is recommended every 3 years between the ages of 20 and 39, and then every 2 years between 40 and 50.
Mammography constitutes a third method of screening.
In France, screening by mammography is organized nationally for women aged 50 to 74. This screening follows a rule called "the rule of 2": women in this age group receive free mammography screening every two years and a clinical examination performed by a radiologist.
Two images per breast are taken, followed by an additional image if necessary. Moreover, a second reading of the images by another radiologist must be systematically done in case of a normal examination. An ultrasound may also be performed.
This screening method by mammography detects many cases of breast cancer: in 2015-2016, nearly 39,000 cases of breast cancer were detected. However, French women's participation in this screening program remains insufficient and varies by region. Participation rates range from 35% in Corsica to 57% in Centre-Val de Loire, whereas a rate of over 70% would be necessary to significantly reduce breast cancer mortality.
Outside the age range of 50-74 years, women under 50 who are at risk should also undergo mammography every year or every 2 years.
This is particularly the case for women who have an increased risk of breast cancer due to a hereditary genetic mutation. These at-risk women may also benefit from an ultrasound or MRI (Magnetic Resonance Imaging).
For women over 74, regular mammography at intervals is still recommended.
Interview with Professor Elise Deluche
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Article updated on 10 sept. 2024
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