Early detection of breast cancer

What is the "early detection of breast cancer"? 
Early detection enables doctors to identify breast cancer at an early stage. Detected early, tumours will usually be smaller and patients will experience fewer side effects from treatments. What is more, their chances of recovery are higher. 

For women aged 50 and over, a mammogram is the most effective way to detect breast cancer.  

A number of cantons have established a screening programme whereby women aged 50 and over are called for a mammogram every two years. These early screening programmes ensure that fewer women die from breast cancer. Participation is voluntary. 

Even in cantons that do not offer a screening programme, women over 50 are advised to undergo a breast examination every two years.  Talk to your gynaecologist about this. 

What is a mammogram? 
A mammogram is an X-ray picture of the breast.  Doctors use it to check for changes to the breast tissue, which can include benign and malignant changes. 

Having a scan performed involves you going to the X-ray department at a hospital or to a specialist radiology centre. During the scan, the breast is placed between two Plexiglas plates, one horizontal and one vertical. Some women find the pressure exerted by the plates uncomfortable. Talk to the specialist on site if the scan causes you pain.  

Mammograms cannot be carried out on men. In most cases, doctors will perform an ultrasound.  

Who pays for mammograms?

Cantons offering a screening programme 
If you take part in a screening programme for the early detection of breast cancer in the canton where you live, the costs of the mammogram will be covered by your basic health insurance. Your annual deductible (franchise) will not be affected. You will only have to pay the 10 per cent deductible. 

Cantons that do not offer a screening programme 
The costs are not covered by basic health insurance. Check with your health insurance provider to see if it will pay for the mammogram.  

If there is a high incidence of breast cancer in your family, mammograms will be covered by your basic health insurance. The costs of the mammogram will be charged to the annual deductible that you have with the health insurance company. If annual deductible has already been used up, you only have to pay the 10 per cent deductible. 
 
Benefits of screening programmes  

• Fewer women die from breast cancer. 
• The mammograms performed as part of these screening programmes have to meet rigorous quality standards. They are reviewed regularly. 
• The qualified staff working with the programmes have been specially trained. 
• Breast cancer is frequently detected early, which means treating it is less invasive.  As a result, patients have a better quality of life despite a cancer diagnosis.  

What issues may occur? 

• Sometimes the mammogram may indicate a suspicious change. After more tests, it turns out that it is not breast cancer.  
• The exposure to the radiation from a mammogram may be harmful. However, the amount of radiation emitted during a mammogram is minimal. 
• Sometimes, breast cancer is not detected. See your gynaecologist if you experience pain in your breasts or have any other symptoms.  
• Sometimes doctors can detect breast cancer at a very early stage. Treatment for the breast cancer was not necessary. This is what is referred to as "overdiagnosis".   

Stance taken by the Swiss Cancer League (Krebsliga) 
The Swiss Cancer League recommends and supports breast cancer screening programmes. In doing so, it is aligned with the World Health Organisation (WHO). The advantages of screening programmes for the early detection of cancer outweigh the disadvantages.  

What steps can I take to reduce my risk of developing breast cancer? 

• If your canton offers a screening programme, you should take part in it.  
• If not: talk to your gynaecologist about how often you should undergo a breast examination.  
• If there is a high incidence of breast cancer in your family, ask your doctor for personalised advice on how often you should have an examination. More information on genetic predisposition can be found here. 
• You should think about taking the contraceptive pill or hormones during the menopause. Women who take the contraceptive pill or hormones during the menopause have a higher risk of developing breast cancer.  
• If possible, breastfeed your child.  
• Breast self-examination: a straightforward way of detecting any changes in your breasts at an early stage. Find out more on breast self-examination here.  
• Self-examination is not a substitute for a mammogram or other medical examinations. Attend regular check-ups, where possible.