Dr Inder Singh
In 1993 President Clinton when informed about increasing incidence of breast cancer and the usefulness of mammography for its early detection and treatment, he named October as breast cancer awareness month and third Friday in October as National Mammography Day in USA. India also accepted this slogan.
Mammography is a specific type of breast imaging that uses low dose of xrays to detect cancer or other breast diseases early before women feel the symptoms. Mammogram is an xray picture of the breast.
Diseases of the breast are quite common in females and benign tumours and tumors like conditions are more frequent than the cancer of the breast. All these entities have a common presentation of pain and lump in the breast which create lot of confusion and fear in the mind of the patient of it’s being cancer. It is a terrible situation and great psychological trauma for the patient. Here comes the role of Mammography and FNAC (Fine Needle Aspiration Cytology) to differentiate benign conditions from cancer of breast which need to be done at the earliest. Hence the reassurance that a mammogram gives is of enormous values to remove fear of malignancy from the mind of the patient.
The key to fighting breast cancer is early detection and key to early detection is screening mammograms i.e. looking for cancer in women who have no symptoms of disease and the best available tool is a screening Mammogram/Mammography.
Breast cancer, the second most common after uterine cancer, is leading cause of mortality among women. The life time risk for a woman having been diagnosed with the breast cancer has steadily increased over the years. 75000 new cases of breast cancer are detected among the Indian women every year and incidence of the breast cancer in India is as high as 51.3 per 1000 women.
The cause of breast cancer remains obscure. There is yet no known way to prevent breast cancer and once the disease is disseminated it’s cure remains elusive. At present mammography is the only imaging modality with proved efficacy for screening and early detection of breast cancer.
Early detection and awareness saves lives. Therefore every women has a significant role to contribute to turn the tide against this dreaded disease of breast cancer and help bring back health, dignity and life to women fold.
Breast cancer is common in women above 50 yrs of age but for the last few years women in lesser age group have also been detected suffering from breast cancer. Exact reason is not known. Some increase may be due to facilities for better detection, results of changes in life style like having no children or having child after 30 years of age, prolonged use of oral contraceptive or taking replacement harmones, eating high fatty food resulting in obesity, lack of exercise and drinking alcohol.
Most of the breast lumps are found by the women themselves. Periodic examination of the breast is very important for every women above the age 35 yrs to know the normal feel of the breast and to find out the changes as soon as these happen. See your doctor whenever a lump or change is noticed in the breast that worries you. The change may be in size or shape of breast, nipple discharge, pulling back of nipple, flattening or pulling in of the skin, development of pain or redness of the skin. These may not be due to cancer but need to be checked by a doctor and then by mammography to be sure that it is not a cancer.
Above the age of 30 years every women should have a base line mammogram for future reference. Then after the age of 40 yrs. Screening mammograms are recommended for all women once in a year. Mammogram is also required for any lump in the breast, for symptoms like pain, tenderness fullness of breast, nipple discharge of various kinds, nipple retraction and for skin changes such as thickening, redness, flattening or retraction.
There is another group of women termed as high risk categories who need regular check up and Mammography for early detection of breast cancer. These includes:
a) Women with positive family history i.e. a close relative like sister/mother/daughter/aunt having breast cancer.
b) Early age of starting periods i.e. before 13 yrs or late menopause i.e. continuation of periods after 50 yrs.
c) Women who are not married, have no children or having first pregnancy after the age of 30 years.
d) Women who have taken birth control pills or harmones for prolonged periods.
e) Obesity with lack of exercise and high intake of animals fats are also grouped under high risk category.
f) Women who had cancer of opposite breast.
Breast cancer generally causes no symptoms in the beginning and if you detect early enough, it can be removed without having spread to the rest of your body, thus increasing the chances of survival.
Do self examination regularly at least once in a month and go for Mammography whenever you have any problem with the breast. After age of 40 years even if you have no symptoms get screening Mammography done every year. Mammography is unchallenged for early detection of breast cancer. No other imaging technique matches it’s ability to find small cancers. This is quick and easy way to detect breast cancer early when the treatment is more effective and survival is high.
Early detection and awareness saves lives. Do it for yourself and for your family.
(The author is formerly Professor and Head Deptt. of Radio-Diagnosis and Imaging Govt. Medical College, Jammu.)
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