Breast cancer screening
Breast cancer is still the principal cause of death in women aged between 50 and 69. One woman in 10 can develop breast cancer, and early detection greatly increases the chances of cure and survival.
Detection is achieved in two ways:
-Either by personal screening. This is a breast examination requested by a gynaecologist or general practitioner. It involves an interview, clinical examination and mammogram, and most often an ultrasound, all carried out at a specialist consultation. This examination is recommended for women aged 40 and over, every year until age 50 and then every two years without limit of age.
-Or by the mammotest, a national screening programme free on invitation, given every two years between ages 50 and 69 at an approved centre. It involves a mammogram, interpreted independently by two radiologists (double reading). If these interpretations differ, a third reading is carried out.
We at our centre provide personalised breast examinations at the request of gynaecologists and GPs.
Patients are referred either for screening, surveillance following treatment of breast cancer, examination of an irregularity, or an additional test and a second opinion.
Patients are welcomed at the mammography department by specialist breast examination technicians, who perform the mammogram. This examination requires rigorous techniques and high-performance equipment, which must be regularly examined.
After the mammogram, an experienced breast examination technician will conduct an interview and a physical examination. Most often, an ultrasound follows the mammogram. This will pick up dense tissue lesions that the mammogram may miss. The radiologist uses the most modern ultrasound machinery when conducting the test.
If the clinical examination, mammogram and ultrasound are consistent, a conclusion will be made. The results, usually benign, are sent to the referring doctor following comparison with previous examinations.
If there is an irregularity, additional examinations are performed.
Most often, a simple puncture with a fine needle is enough. It is conducted under ultrasound surveillance, which is rapid and not very painful. It will empty cysts or take cells from inside a nodule. Results are reliable in 90% of cases and can be obtained quickly.
For doubtful lesions, micro or macro biopsies will be taken, either under ultrasound surveillance if the lesion is visible with ultrasound, or using stereotaxis (guided mammogram) with a dedicated table. These will produce a sample of mammary tissue, and the sample can then be analysed histologically.
The only precaution is to stop taking aspirin and Sintrom anticoagulants one week before the procedure.
With ultrasound, samples are taken after a local anaesthetic. The procedure lasts 10-20 minutes and is usually painless.
In stereotaxis, samples relate to lesions not visible with ultrasound, such as micro-calcification seats. The breast examination department at Cliniques Universitaires Saint-Luc purchased a Mammotome, a system that takes samples by suction, a few years ago, and more recently acquired a dedicated stereotaxis table.
Macro biopsies are taken at external consultations, lasting for one hour on average (including installation); the patient can resume normal activity afterwards.
The combination of Mammotome and dedicated stereotaxic table has greatly improved patient care in terms of both diagnosis and comfort. To find out more about this examination, click here (link to “sample taken under stereotaxis”).
La table stéréotaxique dédiée permet :
- Une amélioration importante du confort de la patiente ; celle-ci est allongée sur le ventre, le sein placé dans une fenêtre et l'équipe médicale travaillant sous la table (la patiente ne voit pas la procédure). Une fois placée dans le sein après repérage stéréotaxique, l'aiguille est laissée en place et tourne sur 360°, permettant la réalisation de plusieurs prélèvements dans différentes directions. La durée moyenne du geste est de 20 minutes.
- Une meilleure accessibilité des lésions, une aspiration permettant le contrôle d'un éventuel hématome.
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Table de stéréotaxie dédiée |
 Mammotome |
The third breast imaging technique, after mammogram and ultrasound, is nuclear magnetic resonance or mammary IRM.
Its indications are specific and limited.
Breast examinations allow screening, diagnosis and surveillance of breast pathologies. They are carried out by specialist teams using very high-performance equipment.
