Symptoms of breast cancer should be taken more seriously

Women with breast symptoms have an increased probability of breast cancer diagnosed before the next scheduled visit. These women should have an easier access to further assessment and biopsy and possibly a shorter screening interval. Improvement in the awareness of breast symptoms in women, in general, while visiting a doctor is important.

A recent study by the Finnish Cancer Registry assessed the risk of interval breast cancers in women who reported these symptoms. The study found that women with a lump had a three-fold increased risk of cancer diagnosed during the interval before the next scheduled screening visit when compared with women who had no symptoms. Women with nipple discharge had two-fold risk and those with nipple retraction had a 1.5-fold risk.

This means that women with a breast symptom such as lump should undergo further assessment easier than nowadays, irrespective of mammography findings. In addition, a biopsy should be taken in them more frequently than nowadays. “As mammography doesn’t detect all breast tumors, women with symptoms, especially with a lump, should be invited at shorter intervals, before the normal scheduled date”, adds Ahti Anttila Director of Research at the Finnish Cancer Registry. Also increasing awareness of breast symptoms and on importance to seek for diagnostic service already prior invitation to screening is very important.

“Even though women were more likely to be recalled for further investigations after their mammogram if they had breast symptoms, cancer could still be missed in a significant number of these women, and they were more likely to have cancer diagnosed either before the next standard screening visit”, says Deependra Singh, a researcher at the Finnish Cancer Registry.

A significant proportion of breast cancers are detected outside mammography screening programme

The Finnish mammography-screening programme invites women every two year mainly between the age of 50 and 69 irrespective of any personal history. Previous studies conducted in Finland reported that women who report these symptoms have higher changes of being diagnosed with a breast cancer than those with no reported symptoms at the screening visit. Still, about one third of breast cancers in screening attendees are detected outside the mammography screening programme.

About three  percent of the attended women report breast symptoms such as a lump, retraction or nipple discharge. “There is room for improvement in the capability of mammography to detect cancer for women who have breast symptoms.” Our study put forward one of the best possible way to monitor these women by offering shorter screening intervals between screening mammograms so that breast cancer is detected in its early stages”, concludes Mr. Singh.

The full report of the evaluation is published online in a scientific journal, British Journal of Cancer, on November 8. Full-text link, https://www.nature.com/articles/s41416-018-0308-2

For further information:

Deependra Singh, Mass Screening Registry, Finnish Cancer Registry, at +358-449887191 or deependra.singh@cancer.fi (in English)

Ahti Anttila, Mass Screening Registry, Finnish Cancer Registry, at +358-503809514 or ahti.anttila@cancer.fi

References:

Singh D, Malila N, Pokhrel A, Anttila A.Association of symptoms and breast cancer in population‐based mammography screening in Finland. Int J Cancer 2015;136:E630-E637. doi:10.1002/ijc.29170

Singh D, Pitkäniemi J, Malila N et al. Cumulative risk of false positive test in relation to breast symptoms in mammography screening: a historical prospective cohort study. Breast Cancer Res Treat 2016;159:305. https://doi.org/10.1007/s10549-016-3931-8