According to the World Health Organization (WHO), cancer is a leading cause of death worldwide, accounting for 8.2 million deaths in 2012. Breast cancer alone accounted for 521,000 of these deaths. It is one of the leading causes of cancer death among women.
However, research has proven that most of these deaths are preventable through early detection of tumours in breast by undergoing diagnosis – mammography or self – examination.
Mammography is an X-ray examination of the breast and is used to detect and diagnose breast cancer in women. Breast cancer originates from breast tissue, most commonly from the inner lining of milk ducts or the lobes that supply ducts with milk.
Cancer, known medically as malignant neoplasm is a broad group of diseases involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumours, and invading nearby parts of the body. Many spread to other parts of the body through the bloodstream. Even though not all tumours are cancerous, how many women find it necessary to test for breast cancer?
Women should ensure to take care of their breast for quite a number of reasons, part of which is maintaining sound health, being careful, our family, and because our body has a right over us.
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| Mammography Machine |
Addressing the fear of Mammography
A mammography is a form of medical treatment and people are expected to seek medical treatment in illness.
Benefits of Mammography
Mammography does not prevent breast cancer, but they can save lives by finding breast cancer as early as possible, for example, mammography has been shown to lower the risk of dying from breast cancer by 35% in women over the age of 50. In women between ages 40 and 50, the risk reduction seems to be somewhat less. Finding breast cancer early with mammography has also meant that many more women being treated for breast cancer are able to keep their breasts.
If detected early, localized cancer can be removed without resorting to breast removal (mastectomy). Mammography is also encouraged in order to reduce detection of breast cancer in the late stage, which could lead to death.
Over diagnosis
Women should be well informed not only about the potential benefits of mammography, but also its potential harm which includes mental distress; biopsies, surgeries, chemotherapy and hormone treatments for diseases that would never have caused symptoms. Radiologists have been trained to find even the smallest of tumours in a bid to detect as many cancers as possible to be able to cure breast cancer.
However, this practice has caused a problem for women – diagnosis of breast cancer that would not cause symptoms or death. Skepticism on the efficacy of breast cancer has caused more concern for public health officials about the after-effects of mammography and its potential over-diagnosis.
Studies have shown that between 15-25% of breast cancer cases are overdiagnosed. One study in the United states of 2500 women who involved in diagnosis revealed that only one death from breast cancer will be prevented, 2470-2474 will never be diagnosed, 6-10 will be over-diagnosed, treated with surgery, radiation therapy and possibly chemotherapy without any benefits.
When and how often should Women undergo Mammography?
Mammography is the most effective breast cancer-screening tool. Most major health organisations recommend women 50-69 years to have mammography every year but studies that are more recent have come to prove that 2 years offered almost as much benefit as annual mammography while cutting the risk in half.
Mammography in women ages 40-49 may save lives, but the benefit for younger women may be less than for older women. Younger women tend to have dense breast tissue, which can make abnormal findings hard to see with current mammography technology. In women age, 40-50 the risk reduction appears to be somewhat less. There is no scientific evidence of any benefits of mammography in pre-menopausal women.
Mammography and Public Health
About 5% of screening mammograms are positive or suspicious and of these, 80-93% are false positives that cause much unnecessary anxiety and further procedures including surgery. Between 10-15% false appearances manifest within a year.
Cost per life saved is $1.2 million. Since the benefits achieved are marginal, the harm caused is substantial, and the costs incurred are enormous, this should come to prove that health policy on a proposed mass population intervention must be based on critical analysis.
Myths about Mammography
Some women wonder about the risks of radioactive exposure due to mammography. Modern day mammography only involves a tiny amount of radiation, even less than a standard chest X-ray.
Mammography Procedure
The entire procedure takes less than 20 minutes. A technologist will position the breast in the mammography unit and use a paddle to gently compress the breast. The breast is compressed to spread the tissue apart and allow the maximum amount of tissue to be imaged and to reduce radiation dose.
The compression lasts just a few seconds. Once the breast is positioned appropriately, the radiologist will step behind a screen and take the X-ray images. The X-ray images are examined before the patient leaves the facility to ensure that the quality and positioning are acceptable.
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| Mammography in action |
Compressing the breast is necessary to obtain the best image. Compression thins and evens the breast tissue so that a lower X-ray dose can be used. It prevents the breast from moving during the procedure, thus reducing or eliminating blurred images. Breast compression is uncomfortable but should not be painful. It only lasts for a few seconds. Mammopads are used to achieve more comfort.
Self-Examination
Adult women of all ages are encouraged to perform breast self-exam at least once a month. John Hopkins Medical Centre states that 40% diagnosed by women who feel for a lump, so establishing a regular self-exam is very important. While mammography can help to detect cancer before you can feel a lump, breast self-exams help you to be familiar with how your breast looks and feel so you can alert your health care provider if there are any changes. Breast self-exams should be performed in front of a mirror, in the shower, and lying down.
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