Just like a Pap smear test (a screening procedure for cervical cancer) women tend to shun breast cancer exams. Some tend to be unbothered while others, the possibility of receiving bad news keeps them from seeking the services altogether. However, screening for cancer is very important in women’s health, especially those above the age of 40, doctors advise. And one of the tests done for breast cancer is a mammography examination. Mammography is a specific type of breast imaging that uses low-dose x-rays to detect cancer early before women experience symptoms — when it is most treatable. Dr Jean Jacques Nshizirungu, a senior consultant radiologist at Oshen King Faisal Hospital in Kigali, explains that mammography is used in order to detect breast cancer at an early stage. MAMMOGRAPHY EXAMINATION Mammography is the only imaging model that can pick a small lesion or micro-calcification, Dr Nshizirungu explains. It involves taking two x-ray pictures of each breast in order to detect hidden micro-calcifications that cannot be felt by a typical breast exam. Normally, the breast cancer starts by a small lesion with micro-calcifications (small calcium deposits that develop in a woman’s breast tissue) and with this, the mammogram helps us to pick those small classifications at an early stage, he explains. “And as you know, breast cancer is curable. Once you pick it at an early stage, you can treat it and the patient gets cured. “That’s why we advise every woman above the age of 40 to have a mammogram such that if there is any abnormality it is detected early,” he says. The other indication of mammography is for diagnosis. This is used to check for breast cancer in patients who have a lump or other breast symptoms. “If a patient has a breast lump, mammography can characterise it better and show us if the lump has characteristics of a benign lesion or a malignant lesion. A benign lesion is the one which has no cancerous cells whereas the malignant one has cancerous cells,” Dr Nshizirungu says. WHAT TO EXPECT DURING THE EXAM Dr Nshizirungu explains that when one goes for testing, she or he first of all has to be explained to on how the exam will be conducted. The procedure itself is very simple, the doctor explains. The patient undresses from the waist up and wears a gown that is open at the front. The imaging technician then positions the patient’s breast on a plastic tray and then lowers a second tray that will gently compress the breast; all this is done when the arms are raised above the head. And then x-rays will be taken for both breasts. He goes on to explain that the technique of compressing the breast, though a bit uncomfortable, helps to see more details of the breast tissue. The patient will feel pressure on her breasts as they are squeezed by the compression paddles. Some patients with sensitive breasts may experience discomfort. If discomfort is significant, less compression will be used. Always remember compression allows better quality mammograms, he notes. “After the tests, if we discover that there is a lesion which needs to be more characterised by ultrasound, we directly perform the breast ultrasound. And if there is a lesion which is suspicious and needs a tissue biopsy, at Oshen King Faisal, we immediately provide these services and within two days you have the results,” he says. HOW TO PREPARE FOR A MAMMOGRAM The radiologist warns not to schedule your mammogram for the week before your menstrual period if your breasts are usually tender during this time. The best time for a mammogram is one week following your period. Always inform your doctor if there is any possibility that you are pregnant. It is not advisable to wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These can appear on the mammogram as calcium spots, he warns. He also advises to always describe any breast symptoms or problems to the technologist performing the exam. “Obtain your prior mammograms and make them available to the radiologist if they were done from somewhere else. This is needed for comparison with your current exam,” Dr Nshizirungu says. BENEFITS AND RISKS Dr Nshizirungu says that the benefit of having a screening mammogram is that it can help detect small abnormal tissue growths confined to the milk ducts in the breast. These early tumours cannot harm patients if they are removed at an early stage and mammography is an excellent way to detect these tumours. The medic, however, says for patients, who have very dense breasts; they might need to have both the mammogram and ultrasound because there is a possibility of some lesion not being seen on one modality alone. With threats, there is always a slight risk of developing cancer from excessive exposure to radiation, however, since mammography uses low doses of radiation, the risk of this happening is very low. Women above the age of 40 are called to go for screening mammography exams at least every two years. editorial@newtimes.co.rw
