Breast Cancer Diagnosis
Breast Screening & Oncoplastic Treatments of Breast Diseases
Most frequently asked questions about mammograms
When does a woman go for physical examination?
As a principle for every woman is important to know her breast and in fact every woman knows better her normal breast. (Her own breast)
For women premenopausal and postmenopausal is important at least once a month to check their breast.
For premenopausal women a good time to examine their breast is the week after their periods. If symptoms persist is recommended to have a clinical breast examination by a breast specialist.
If a menopausal woman feels unhappy with her breast and has symptoms is recommended to see her breast specialist have a clinical examination and her screening mammogram up to date.
There are guidelines that can suggest pathways of looking at breast symptoms and their approach. As much as we respect those guideline, is for the breast specialist to decide.
Young women can be missed, with and under the evidence of breast cancer being more frequent to older women.
This now does not apply and same principle applies if she feels unhappy with her breast she should consult a breast Specialist.
The guidelines do not apply but only after assessment and imagine results have been done under a breast specialist care.
Are mammograms effective as a screening test for breast cancer?
Mammograms and screening for breast cancer is very effective. Evidence indicates that screening for breast cancer reduces death significantly up to 30%.
Breast screening can be individualised for certain patients as a dense breast for instance where additional imaging is available and will minimise the possible missing breast cancer with a mammogram only.
There are concerns of possible harm a mammogram can cause to woman.
And more biopsies are done after mammogram shows something and turns to be benign.
Those are downsides with benefits to the patients. Indeed can cause anxiety but the weight is on benefit rather than cost.
At what age should a women start getting mammograms?
We have the ability now to look at a personalised level for each and every woman. Different opinions are out there, in different countries. By starting at 40, or others say 45 or 50 year old. Here now comes a decision, that is personalised on the patient in view of their risk factors, the background of patient and of course on the guidelines base and evidence. Following guidelines a woman who starts the screening at the age of 50, should carry on to the age of 73-75.
How often should women get mammograms?
Based on guidelines there is a monitoring on how often a woman should have mammogram, but having said that, we should look on the personal level of each patient and see whether those guidelines fit to the best benefit of the patient.
In the evidence a woman who starts the mammogram at a young age, example: in her 40’s, she should carry on with annual screening to the age of 50.
A woman, who starts getting mammograms at the age of 50, there is no evidence indicates that annual mammograms work better to a two year mammograms.
But all comes back to personalised medicine, to the patient’s risk factors and to their previous mammogram results.
Base always on guidelines we try to fit the patient into those and not the guidelines to the patient. All is decided for the benefit of the patient, what is best for our patient.
At what age women should stop having mammogram screening?
Following guidelines a woman who starts the screening at the age of 50, should carry on to the age of 73-75.
America’s and most European countries’s recommendation is to the age of 75.
Now what happens after the age of 75? Do we stop getting mammograms?
Of course we don’t and patients are chosen after a clinical assessment where decision is made. Guidelines are not strict on that and since we know now that women live longer and they are healthier, a clinical assessment is important.
Breast cancer is increasing in older women, but at the same time they have other health problems. Breast cancer – most of the time is not their cause of death. An 80-year-old woman symptomatic following a clinical examination a mammogram is still important.
What does it mean dense breast in the report following the results of a mammogram?
This is very commonly written in a result of mammogram. Dense breast is very common and mostly seen in young women. In cases like that, the mammogram even in the hands of an experienced Specialist Radiologist is difficult to be evaluated and they will, most of the time recommend a supplementary test like an ultrasound of the breast, if they have no symptoms. More highly sensitive imagine exist and are used in correlation of patients age, risk factors as well as their symptoms. In over all we do have the tools to get, a more accurate reassuring result for the patient. It may cause anxiety for women as there is no screening in place for a dense breast, and is a risk factor for breast cancer. A woman should know to consult a specialist, if she highly anxious discuss her symptoms if any and her risk factors for breast cancer, and have a clinical examination. Appropriate testing and imaging will be organised for her reassurance.
Many women are thinking they want to choose an image for their test and have MRI of the breast. This is a decision to be made following their specialist advise. Also is important women to know when they are in their screening age 40 y and above, to do an MRI is not a complete assessment of their breast. The MRI of breast and the mammogram both are giving information adding and complete a better result.
Augmented Breast and Screening Mammography.
Many young women having breast augmentation reaching the screening age with fears to do a mammogram or as it may be risk for their implants.
This is wrong thinking. They can absolutely have their mammogram. Their risk of breast cancer is not increased with the implants but they do have same risk as most women do and need to be enrolled and follow their screening mammogram.
It is important to let your radiographer know about your implants if you saw them first before you see your breast specialist.
The mammogram can be done with implants that are under the breast gland or under the muscle. In both cases a technical variation but is very effective.
For the woman with symptoms of breast and implants the approach is more sensitive.
They need to see the Breast specialist for a clinical examination and following that an image will be arranged depending on age of the woman the imagine will be decided but also on suspicion, of more dramatic symptoms with suspicion of rupture of the implant. The most effective imagine will be the MRI of the breast.
Breast Lumps Under the Age of 20
Breast lumps under the age of 20.