The World Health Organization creates awareness of breast cancer in October. First initiated in October 1985, Breast Cancer Month has grown exponentially globally and this year is no exception. <\/p>\n\n\n\n
According to the Cancer Association of South Africa (CANSA), it\u2019s far better to have an early-stage diagnosis, as it results in better breast-cancer treatment and long-term survival. CANSA recommends monthly breast self-examination, annual medical check-ups, and screening. <\/p>\n\n\n\n
Staffers of the SCP Radiologist Practice and Dr Lizanne Langenhoven, who specialises in the treatment of breast cancer, address some concerns with breast-cancer screening.<\/p>\n\n\n\n
If early detection is recommended and provides the best outcome, why are women reluctant to screen for breast cancer? An informal survey among women, who are hesitant to go, even though they have the means to, shows that top reasons include the following:<\/p>\n\n\n\n
\n It\u2019s going to be too painful<\/b>\n<\/p>\n\n\n\n
Many women still rely on their mother\u2019s experience with early mammograms, which were painful. Mammography machines have progressed exponentially since the early days, so the level of discomfort experienced during the procedure is now significantly reduced. Modern technology and digital equipment allow us to use less compression and still obtain quality imaging. Also, the amount of pressure is different for each individual, depending on the breast size and composition. Pressure is often manually adjusted, so speak to your mammographer if you experience any discomfort.<\/p>\n\n\n\n
\n Fear of exposure to radiation <\/b>\n<\/p>\n\n\n\n
A mammogram uses relatively low-dose radiation. The total dose is approximately 0.5 mSv (2D mammogram). To put it into perspective, we are exposed to 3.0 mSv of background radiation from our natural surroundings per year. Radiologists also strictly follow what\u2019s known as the Alara principle \u2013 always to apply radiation \u201cas low as reasonably achievable\u201d. The benefits of mammography so far outweigh the risks from this low-dose radiation.<\/p>\n\n\n\n
\n Fear of finding out you have breast cancer<\/b>\n<\/p>\n\n\n\n
Dr Langehoven said: \u201cThe good news is our understanding of the different subtypes of breast cancer has improved significantly over the past few years! We no longer follow a one-type-fits-all approach, and many women may even safely be spared chemotherapy in a curative setting. <\/p>\n\n\n\n
\u201cAs with everything else in life, it is easier to address a \u2018small\u2019 or \u2018early\u2019 problem than it is to address a much larger problem! I\u2019ve seen breast cancer diagnosed at a size of 2 mm on mammogram \u2013 meaning treatment is tailored to a very low risk situation. In short, the earlier we become aware of an existing problem, the sooner it can be addressed, and with much less invasive treatment.\u201d <\/p>\n\n\n\n
\n I don\u2019t go for mammograms, I go only for thermography<\/b>\n<\/p>\n\n\n\n
At present, thermography cannot substitute mammography, but may be used as complementary screening. Dr Langenhoven cautions that thermography is not all it is cut out to be. For the cancer to give off heat signals, it has to be significant in size. Mammography on the other hand can detect changes in the breast before they progress to cancer. A mammogram therefore picks the disease course up much sooner than thermography.<\/p>\n\n\n\n
\n Why mammography instead of ultrasound, which doesn\u2019t use radiation?<\/b>\n<\/p>\n\n\n\n
Mammography is our workhorse. We look for masses, calcifications, and architectural distortion. Ultrasound is a supplementary investigation used to evaluate morphology, blood flow, consistency of masses and lymph nodes that are abnormal on a mammogram further. Tomosynthesis is also supplementary, used to evaluate architectural distortion seen on a mammogram further. They all work together. With denser breasts mammography is less sensitive, which is when we add the supplementary investigations to improve the sensitivity of detection.<\/p>\n\n\n\n
\n If am diagnosed with breast cancer I am going to die anyway, so I would rather not find out<\/b>\n<\/p>\n\n\n\n
This statement is not true in these current times, when 90% of women with early breast cancer can be cured of their disease, Dr Langenhoven says. \u201cIn the same way we don\u2019t drive cars from the \u201950s our treatment is no longer ancient either!\u201d<\/p>\n\n\n\n
The side-effect profiles of our new drugs are aimed at improving quality of life during treatment, and the fact that we now identify and treat four distinct subtypes of breast cancer means that we can target the specific growth pattern at play and avoid unnecessary treatment. <\/p>\n\n\n\n
Previously, because we didn\u2019t know which women had aggressive breast cancers and who didn\u2019t, all women were treated more or less the same up to a few years ago. This meant that women feared finding out they had breast cancer for fear of the radical and toxic treatment they would be subjected to. This has really changed over the past 10 or 15 years and our approach has changed to be specific and conservative when we advise treatment. It is tailored to the specific characteristics of each women\u2019s disease.<\/p>\n\n\n\n
Surgical outcomes are so much better, and very few women would ever be offered a \u201cflat\u201d mastectomy as part of their treatment plan. We no longer approach breast-cancer surgery without consideration of the cosmetic outcomes and quality of life of the woman behind the cancer.<\/p>\n\n\n\n
The notion that cancer means suffering and death comes from a bygone time and we should do all we can to change this outdated perception.<\/p>\n\n\n\n
The survival rate of breast cancer depends on a number of factors, including the type of cancer, the immune receptors, the grade and speed at which it is growing \u2013 these all determine the survival rate. A big tumour that is slow growing and has a low grade has a more favourable outcome after treatment than a small tumour that is high-grade and fast growing. However, if a cancer is found early and the grade is established earlier then tailored treatment can begin earlier, which may slow down or limit the progress. An early diagnosis will improve treatment outcome.<\/p>\n\n\n\n
\n The advantage of screening is early detection for better treatment outcomes and prognosis.<\/b>\n<\/p>\n\n\n\n
Dr Langenhoven adds that early detection really counts when it comes to treatment-related side-effects and cost of treatment. An early cancer may very well be treated with less invasive surgery, a smaller radiotherapy field given over a shorter period of time with fewer side-effects, and the omission of chemotherapy for many women. <\/p>\n\n\n\n
\n I can\u2019t have a mammogram, I have breast implants<\/b>\n<\/p>\n\n\n\n
Yes, you can, is the short answer. If you have breast implants the compression and positioning are adjusted. The amount of pressure is equivalent to sleeping on your stomach. Modern technology means there is a very low risk of implant rupture or damage. It is usually combined with ultrasound for better evaluation of the implants.<\/p>\n\n\n\n
\n I don\u2019t need a mammogram, I have had a double mastectomy<\/b>\n<\/p>\n\n\n\n
Once a patient has had breast cancer it becomes a diagnostic mammogram and not a screening mammogram. The normal rules for screening do not apply. Follow-up is according to the informed discretion of the referring physician as each cancer is different and therefore treatment and rate of recurrence differs, depending on the cancer subtype, surgical and oncological treatment received. Having a double mastectomy does not unequivocally mean you cannot have a recurrence in your breasts.<\/p>\n\n\n\n
\n I don\u2019t have time . . . <\/b>\n<\/p>\n\n\n\n
\n It takes longer to have a manicure and pedicure than a mammogram and we find time to do them at least once every two months. A mammogram is only once a year.<\/b><\/p>\n","protected":false},"excerpt":{"rendered":"
The World Health Organization creates awareness of breast cancer in October. 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