“THE breast screening should be conducted at the ages of 40 to 69 years old. That is the age range where most suspicious abnormalities are usually detected,” said Dr Shyja Abraham, a radiologist at the Jerudong Park Medical Centre (JPMC).
“If you have had a mammogram less than a year back, then you shouldn’t come in for the screening programme at this juncture. Do it after one or two years depending on the age group that you fit into."
Dr Shyja showing the machine used for the mammogram.
But having said this, she advised all women to examine their breasts once a month through self-examination practice and report any suspicious abnormality like a lump or nipple discharge to their doctor even if they have had a recent normal mammogram.
Breast screening is carried out through a mammogram session where the procedure involves two X-rays of each breast. Each X-ray will have a radiation dose of about 18mrem/0.4mSv/.
“The radiation dose is especially low with modern equipment like the one we have in our department – Siemens MAMMOMAT INSPIRATION. So, the total radiation dose will be about 72mrem per mammogram. We compare this to a chest radiograph with a radiation dose of 10mrem/0.1mSV.
“The aim of a screening mammogram programme is to detect cancer in the healthy asymptomatic person at an early stage whereby we can offer more treatment options and restrict the spread of the tumour."
At the same time, the benefits of detecting the cancer at a very early stage will far outweigh the radiation risk associated with mammography.
As for women with physical disability, they too can do breast screening as the machine used also caters for disabled persons if they are able to sit on a wheelchair with extra effort to be taken on the part of the patient and the technician but screening cannot be done for bed-ridden patients.
Most women think the process is painful, actually this is not so, said Dr Shyja. But there will be a little discomfort as the breast will be compressed between two plates, which is done to flatten and spread the breast tissue and modern machines will give optimal compression to the breasts without causing excess pain to the patient.
There are also myths that the pressure from the compression on a malignant tumour will cause it to break open and metastasize. Again, she said this is not so because if proper compression is not given, it may hide the tumour.
Cases of abnormality during mammogram doesn’t necessarily be cancer as chances that abnormality is cancer are very rare as maybe only one person out of every 1,000 persons screened will be positive for cancer.
Most of the abnormalities detected are usually benign in nature and abnormality if detected will need additional investigations like USG, etc.
Risks of having breast cancer are if you have a first degree relative with breast cancer, such as mother, daughter or sister who developed breast cancer before the age of 50, then you are at high risk, said Dr Shyja, advising to start the screening process 10 years before the age of your relative’s diagnosis.
On the other hand, if you have a second degree relative with breast cancer such as maternal grandmother or aunt diagnosed with breast cancer, the risk increases slightly and screening to be started at the usual age.
As for MRI, Dr Shyja pointed out that MRI is not recommended as a screening tool as apart from being time consuming, it is extremely expensive. MRI is used as a problem solving aid to come to a diagnosis whenever there is a dilemma regarding a patient.
“Moreover, MRI cannot detect micro-calcifications which many a time is the presenting feature of breast cancer,” she added.
In highlighting the importance of breast screening for women, JPMC is currently holding a Breast Screening Promotion for two weekends only beginning yesterday and is offered for women age 40 years and above at a price of B$168 that entitled the customer for one doctor consultation and a mammography.
Customer will also get a complimentary self-examination lesson while waiting for their result, which will be given on the same day and customers are advised to make prior appointment at the centre and to come 15 minutes earlier before their appointment.
There will be 16 slots per day from 9am to 5pm and the next promotion will conclude next weekend December 21 and 22, 2013.