Debunking misconceptions on mammogram screening
IN conjunction with Breast Cancer Awareness Month, various activities are being held across the world to highlight the seriousness of this disease and importance of early detection.
Among women, breast cancer is the most prevalent form of cancer and causes the greatest number of cancer-related deaths. In some cases, early detection of breast cancer is a matter of life or death.
Women can easily perform breast examinations at home and clinical breast examinations are widely available, but mammogram remains the main test for detection of breast cancer.
It is recommended that women above the age of 45 get mammograms regularly or as advised by their respective doctors.
Despite the extensive clinical use of mammogram machines the world over, there are countless articles circulating online that claim these machines emit harmful radiation, working against their intended purpose as detection tools. Furthermore, there are other speculative articles that suggest mammogram machines provide a high probability of misdiagnosis.
Such articles, though inaccurate, discourage women from getting screened, some even avoiding mammogram screenings out of fear of being exposed to radiation.
Should women proceed with regular mammogram screenings? What should be the right course of action to detect breast cancer early?
A baseless concern
According to Dr Kiran Kaur Amer Singh, consultant general surgeon with special interest in breast surgery at Columbia Asia Hospital – Klang, women must continue to undergo regular mammogram screenings.
She stresses that mammogram is still the recommended procedure for early detection of breast cancer, and studies have proven that its benefits outweigh its risks. She also says that radiation emitted by mammogram machines is quite low compared to other devices such as computed tomography scanners.
Emeritus Prof Datuk Dr Yip Cheng Har, consultant breast surgeon at Subang Jaya Medical Centre, supports this view, saying that humans are exposed to radiation in other scenarios such as when flying in aeroplanes.
“The radiation dose for a mammogram screening is very low. It is equivalent to you taking a flight from Kuala Lumpur to London because you are also exposed to radiation up in the air.
“The radiation emitted by mammogram machines does not cause cancer and the American Cancer Society recommends undergoing mammogram screenings once every two years,” says Dr Yip.
Besides the fear of radiation, there is also the misconception that mammograms are inaccurate, hence not worth the risk.
Dr Kiran debunks this misconception, saying, “No test has 100% specificity. However, mammography has been proven to be sensitive enough and that is why it is recommended worldwide.
“There may be drawbacks to mammograms, especially for women who have dense breasts as images from their mammograms will appear opaque (white). This can be confusing because calcifications and tumours appear white as well.
“This can be resolved by performing adjunct ultrasound screenings with increased sensitivity for young women who generally have denser breasts. Mammogram is still the main recommendation for women above 45 years old who have less dense breast tissue.”
Maintain the commitment
As for women who are breast cancer survivors, annual follow-up screenings become all the more crucial as the risk of recurrence is never null.
Annual mammogram and ultrasound tests must be done as there is a 5% chance of cancer developing in the other breast.
Dr Yip stresses, “If patients have a lumpectomy (where the breast is not removed), yearly screenings for both breasts are recommended as 10 out of 100 cancer survivors tend to relapse.”
She also highlights that breast cancer survivors must be aware of changes to their bodies as there may be warning signs.
“A relapse could happen in between screenings. Backaches, coughing, difficulty breathing, poor appetite or weight loss could be signs of a relapse, so breast cancer survivors may need to check in earlier than their scheduled yearly examinations.”
Granted, undergoing a mammogram can get a little uncomfortable, but when weighed against the possibility of only detecting the disease when it is already in an advanced stage, a little discomfort is a small price to pay for the gift of life.
The radiation emitted by mammogram machines does not cause cancer and the American Cancer Society recommends undergoing mammogram screenings once every two years. Emeritus Prof Datuk Dr Yip Cheng Har