Breast Cancer Screening in Riyadh

Breast Cancer Screening in Riyadh

Who Is Eligible for Breast Cancer Screening?

The BreastScreen program in Riyadh is designed to offer free mammograms to women aged 50 to 74, with a biennial screening invitation. Women between the ages of 40 and 49 and those over 74 are also eligible for free mammograms but do not receive formal invitations.

Breast Cancer Screening in Riyadh proves highly effective in detecting breast conditions at an early stage.

Risk Factors for Breast Cancer

Several factors increase the risk of breast cancer, including:

1. Increasing age.
2. Family history.
3. Genetic mutations in the BRCA2, BRCA1 genes (more common in Ashkenazi Jewish heritage), and CHEK2.
4. Exposure to female hormones (natural and administered).
5. Early onset of menstruation before the age of 12.
6. Previous breast cancer diagnosis.
7. History of specific non-cancerous breast conditions.

Lifestyle factors that can also slightly elevate the risk of breast cancer include:

1. Being overweight.
2. Lack of physical activity.
3. Alcohol consumption.

There is also a connection between benign breast conditions and prior exposure to radiation.

Breast Cancer Treatment Methods

Mammogram

Mammography employs low-dose X-rays to examine breast tissue. Annual mammograms, also known as screening mammograms, have been shown to significantly reduce breast cancer-related mortality for individuals aged 40 and older. Our screening facilities utilize digital mammography to capture X-ray images as well as computer images that allow for viewing from various angles. We also offer digital breast tomosynthesis, often called three-dimensional mammography, which provides a more comprehensive view of breast tissue.

During a mammogram, you stand in front of the X-ray machine, and a technician positions your breast between two plastic plates to flatten and produce a clear image of the breast tissue. A screening mammogram typically involves taking at least two X-rays of each breast. These X-ray images can reveal both tumors and abnormalities that may suggest the presence of breast cancer.

Mammograms are also utilized for diagnosing breast cancer in individuals with symptoms. Learn more about breast cancer diagnosis.

MRI

Breast MRI, when used to screen for breast cancer, involves the use of radio waves and a strong magnet linked to a computer to create detailed breast images. During a breast MRI, contrast agents are injected to enhance the visibility of breast tissue.

Studies suggest that combining regular mammography with breast MRI may offer certain benefits, especially for individuals at high risk for breast cancer. However, it is not typically recommended for those at average risk of the disease.

Benefits

The primary advantages of mammography screening include a reduction in breast cancer mortality, a decrease in years of life lost due to breast cancer, and a reduction in the severity of breast cancer treatment.

Reduced Mortality

Various statistics demonstrate the impact of breast cancer screening on mortality. All organizations that issue screening guidelines agree that more aggressive screening leads to fewer deaths. Mortality reduction measures the percentage of deaths prevented by a specific screening method compared to an alternative method or no screening at all. As the age range for screening expands and screening frequency increases, total mortality reduction reaches higher levels. Annual screening mammography between ages 40 and 84 results in a 40% reduction in mortality compared to no screening. The specific contribution to mortality reduction from annual screening between ages 40 and 49 is 12% to 29%. The mortality ratio (observed breast cancer death rate divided by the expected death rate) is similar between women aged 40 to 49 initially screened and women over 50. Another common statistic is the number needed to screen (NNS), which indicates how many women must be screened to prevent 1 breast cancer death. Estimates from one systematic review provide an NNS of 753 for women aged 40 to 49, compared to 462 and 355 for women aged 50 to 59 and 60 to 69, respectively.

Reduced Years of Life Lost

The mortality benefits of screening younger women are greater due to their longer life expectancy and often greater family and career responsibilities than older women. An estimated 30% of years of life lost due to breast cancer occurs in women diagnosed in their 40s. Although breast cancer incidence increases with age, the increased rate does not keep pace with reduced life expectancy. One year of life is gained for every 20 women in their 40s who undergo annual screening, whereas 45 women in their 70s need to be screened every two years to gain 1 year of life. Currently, no detailed studies are available to assess the economic impact of life-years gained from preventing breast cancer deaths in younger women compared to older women. However, it is likely that the impact of preventing breast cancer deaths in younger working-age women with families outweighs that of older women who are more likely to be retired from the workforce.

Reduced Treatment Severity

Screening detects breast cancers at an earlier stage. Compared to symptomatic cancers, screen-detected cancers are typically smaller and lack lymph node involvement. This has an impact on prognosis, with 5-year survival rates close to 100% for localized disease, 86% for regional disease (e.g., axillary lymph nodes), and only 27% for distant metastatic disease. The stage also influences treatment options, with larger tumors requiring more aggressive surgery and radiation therapy. Data comparing treatment approaches between screened and unscreened women reflect this. Women aged 40 to 49 who do not undergo screening are 3.4 times more likely to undergo a mastectomy, 4.6 times more likely to have axillary node dissection, and 2.5 times more likely to undergo chemotherapy than screened women. More extensive surgery is associated with increased post-surgical complications, including persistent pain and lymphedema. Therefore, the detection of breast cancer at an earlier stage through screening can significantly reduce the morbidity associated with breast cancer treatment.

Breast Magnetic Resonance Imaging (MRI) is employed for the following purposes:

1. To ascertain the extent of breast cancer before surgery (evaluating size, location, additional involvement, skin and muscle involvement).
2. For breast cancer screening in certain high-risk populations, alongside mammography.
3. As a problem-solving tool, in conjunction with mammography and ultrasound.
4. The primary goal is to identify subtle, hidden breast cancers.
5. To evaluate the effectiveness of preoperative chemotherapy in individuals also undergoing ultrasound.
6. To act as a diagnostic tool for individuals experiencing issues with silicone breast implants, such as rupture or potential contracture.