The whole process of breast health examination

For the vast majority of ordinary women with no family history or previous breast disease, a complete breast health examination can be completed from self- familiarization at home to specialist screening at the hospital, and a clear conclusion can be obtained in up to 3 days. More than 95% of breast abnormalities can be identified early in this process. The earlier intervention, the better the prognosis. There is no need to panic to the point of insomnia just because you feel a small lump.

Oh, by the way, the attitudes of domestic and foreign guidelines towards "routine breast self-examination" are actually quite different: A few years ago, the American Cancer Society directly canceled the recommendation for routine self-examination for ordinary women. The reason is that people without professional training can easily regard normal glandular tissue as nodules, which will cause unnecessary anxiety and even lead to excessive examinations.； However, many domestic clinicians still recommend that you "touch" more often. This is not to expect ordinary people to detect cancer on their own, but mainly to familiarize you with your body's "baseline" - for example, you know that your breasts will be swollen and have a scattered grainy feeling one week before each period. After the period is over, these tactile sensations will disappear. Then this is normal. If a small bump suddenly appears that you have never touched before, is hard, and does not hurt when you press it, you can immediately realize that something is wrong. That is enough. I accompanied my colleague to the outpatient clinic last month. She felt a small hard ball while taking a shower and rushed to the doctor. It was found to be a 1cm fibroid. She went back to work the same day after the minor surgery in the outpatient clinic. There was no delay at all.

If you really want to go to the hospital, just go to breast surgery or thyroid and breast surgery. If you have had relevant examinations at the physical examination center before, remember to bring the report with you, which can save you a lot of effort in repeated examinations. Don't be shy when you enter the clinic. Just answer whatever the doctor asks, such as the time of your last menstrual period, whether you have a history of breastfeeding, whether you have immediate family members who have had breast cancer, and whether you have been taking estrogen and progesterone drugs for a long time. These are all information to be honest. I once met a girl in her early 20s in the clinic. She was embarrassed to say that she had been taking short-acting contraceptive pills for half a year. At first, the doctor almost regarded her physiological nodules as pathological, which was a waste of worry for several days.

Next, the general doctor will perform palpation. You just need to lie flat and raise your arms above your head as required. There is really no need to fidget. Professional doctors have to palpate dozens of patients a day, and there will be no unnecessary thoughts. If you fidget for a long time, it will only waste time. If a suspicious abnormality is detected, the doctor will directly issue a test order. This is also where everyone has the most quarrel: Should we do breast ultrasound or mammography? Many people say that the mammography target is so crowded that it hurts and they will not do it. Some people say that if the ultrasound cannot be seen clearly, a mammography target must be done. In fact, there is really no unified answer. Women under the age of 35 have relatively dense breast glands, and the penetrating power of mammography is not enough. Generally, ultrasound is enough first, and the shape, boundaries, and blood flow signals of the nodules can basically be seen clearly. ； If the glands slowly atrophy over the age of 35, or if suspicious nodules or abnormal calcifications are detected by ultrasound, it is not too late to undergo mammography. I have a distant aunt who is 42 years old. Last year’s physical examination and ultrasound did not detect any problems. The doctor saw that she had a family history of breast cancer and asked her to have a mammography target. The result was clustered microcalcifications. The puncture revealed that it was very early-stage carcinoma in situ. She did not even need to undergo chemotherapy after the operation. She is now living well. ； But there was also a 30-year-old girl who followed the trend and asked for mammography. She was so squeezed that it hurt for two days, but no abnormalities were found. She was just miserable.

After the ultrasound examination, the report is usually available in half an hour, but the mammography report may take 1 to 2 days. Don’t blindly compare it with Baidu after you get the report. The BI-RADS classification that makes everyone panic is actually Category 1 to 2, which is completely normal, and annual physical examination is enough. ； For Category 3, more than 98% are benign, and a review is enough every six months to one year. ； Only if it reaches Category 4 and above, further needle biopsy is needed to clarify the nature.

Don’t be afraid if you really need to do a puncture. You just inject a small local anesthetic and use a fine needle to take out a little tissue for pathology. The pain is almost the same as getting a COVID-19 vaccine. The whole process takes less than ten minutes. The pathology results are the gold standard for judging benign and malignant, and are usually available in 3 to 7 days. If it is benign, just do what you should do. If the problem is really detected, there is no need to collapse. The treatment methods for breast cancer are now very mature. The five-year survival rate of early-stage patients can reach more than 90%. It is not an incurable disease at all.

One final word, don’t believe in the “breast palpation screening” and “massage to eliminate nodules” offered by beauty salons. They are purely IQ-taxed. I had a patient before who had a breast cyst that was massaged in a beauty salon and caused mastitis. The pain lasted for half a month before he came to the hospital. It cost him several thousand to cure. It was completely unnecessary.