MAMMOGRAPHY

mammogram

Breast Cancer has the unique and dangerous property of not being painful .It is known to be present for many years before it become palpable by hand. Being a hormone driven disease it grows faster in young women with higher estrogens levels but still grows for about 5-7 yrs before a palpable lump is felt. In older women with lower estrogen levels it can take 7-10 yeast before women or her doctor feels a lump.

For these reasons mammography was invented to enable us to detect Br.Ca. At an earlier stage.

TABAR from Sweden did extensive studies and trials that showed (L SEE TRIALS TABAR)

1) Mammography detects Br.Ca much earlier than the hand.

2) The sooner the cancer is detected, the better the prognoses. National screening programs in Sweden managed to reduce Br.Ca mortality by 40% in the last 25 yrs.

2) Small cancers are less likely to have spread outside the breast to glands and other structures.

3) Small cancers tend to be less aggressive than bigger ones.

4) Cancers in young women grow faster and therefore mammography should be done at more frequent intervals than in the older women i.e. annually.

5) Mammography is able to detect a type of cancer that, although small, has an aggressive growth pattern. This is another good reason for having a mammogram in all cancers that is already clinically palpable. Many other reasons for this action exist.

TECHNIQUE:

The breast is placed between 2 plastic plates, slightly compressed and a low dose X-Ray beam is used to create a picture on a sensitive film. Or, a digital picture can be used using a photon sensitive plate which is re-usable.

Digital mammography was developed over the years and is now almost as detailed as film mammogram. It is however still very expensive (about 3 times the cost of conventional film mammography. At the same fee, the Radiologist using digital, must triple his through-put of patients to make his machine profitable, or must charge a higher fee.

Trials – comparing digital with film mammography have shown that experienced radiologists find no difference in detecting cancers between the two methods. It is however easier for inexperienced radiologists to detect cancers with digital making use of the computer assisted facility on digital machines.

Compression of the breasts used in both these methods should not be painful. If it is painful it usually reflects on the radiographer’s inexperience and insensitivity, or wrong compression limits on her machine. Women finding mammography to be a bad experience should go to another breast care centre as we do not want women to be put off from going for her annual check.

Mammography is pointed out as the best method for early detection of Br.Ca. By many trials (See trials on mammography and TABAR) it is cheep, non-invasive and readily available and show a high degree of reliability compared to another methods (eg. MRI) which could give false positive or false negative (Thermograph) results.

Mammography, (not surgery or chemotherapy) has made the greatest advance in the treatment of breast cancer and that is due to its ability to detect cancer in a pre-metastatic phase.

It must be stressed however that it is the experience of the Radiologist evaluating the mammogram together with other modalities (e.g.ultrasound and biopsies) and not the machine, that make the diagnoses at the earliest stage.

Having a mammogram

Make an appointment with the Eastleigh Breast Care Centre tel; +27129930512

Remember to bring all your previous mammogram films for comparison.

On your arrival for your mammogram you will be given a form to complete, you are required to fill in your personal and contact details, medical aid, etc

The Receptionist will take you through to the changing room.  You will be given a gown, and asked to remove your upper clothing.  Panties / jeans / skirts may be left on.

When you are ready you will be accompanied to the mammogram machine by the radiographer who will ask you to assume different poses whilst she takes the mammograms (X-rays).  There may be some discomfort at times, but no pain.

You will be asked to wait whilst the mammograms are looked at to ensure that they are all in order, and that no additional ones need to be taken.

You get dressed, pay your account, which you can claim back from medical aid, and leave the centre, with your mammogram.  You will need to bring this with you for your next visit in 12 months.

I have a lump – now what?

Your GP or gynaecolologist will refer you to a specialist, you can request The Eastleigh Breast Care Centre, or if you have found the lump during your own examination, then don’t wait, make an appointment.

You will need to have a mammogram (see section on Mammograms).

The radiologist will see the lump on the x-ray, and you will be advised about the next course of action.  Usually more detailed x-rays will be taken, as well as sonar.

If the lump is benign (non-cancerous) you will be advised to book for a follow-up in 3 months.

I have breast cancer – what’s next?

Your type of cancer will be discussed with you by our team of specialist. The treatment appropriate to your case will be proposed to you and you will then be given time to consider it and perhaps seek more opinions. This should be international expert opinions which can be found on renowned websites.

When having a mammogram, women should keep the following facts in mind:

  • The procedure should not be painful.
  • The quality of the study depends on the experience of the breast radiologist and the expertise of the Centres staff. as well as the equipment and processing quality used.
  • The diagnoses are not made by any machine.
  • The dedication of the personnel at the centre is of utmost importance, Listen to your women friends and do not go to a centre because it is the nearest or the cheapest.
  • Accuracy of the diagnoses depends heavily on the experience of the people working at the centre and has nothing to do with the Hospital Group where the centre is located.
  • Every woman has the choice where she wants to go for her mammogram, and no Medical insurer or referring doctor should force her to go to a specific centre where she is not comfortable.
  • The sensitivity of mammography to detect cancers early is influenced by various factors. The breast density, age of the women and parity are fixed, but there are factors that can be influenced by the women’s own decisions.

She and her physician should be aware that the use of HRT reduces the accuracy and sensitivity of the mammogram and this is of great concern to us Radiologists whose mission is the early detection of BR CA.  Please read this under TRIALS—HRT AND SENSITIVITY OF MAMMOGRAMS.