01 October 2014

Early detection key in breast cancer recovery

October is Breast Health Awareness Month and women all over the world are looking at ways to detect breast cancer early and optimise treatment.

The Radiological Society of South Africa (RSSA) and Breast Imaging Society of South Africa (BISSA is a sub group of the RSSA) stress the importance of mammograms and how regular mammograms and breast examination can possibly save your life.

Read: Breast self-examination

“Early diagnosis gives the cancer patient a higher chance of complete cure and less extensive surgery. Early detection is a critically important factor in winning the battle against breast cancer,” explains Dr. Sheldon Godinho, President of RSSA.

1 in 29 SA women diagnosed with breast cancer

Current statistics show that 1 in 29 South African women will be diagnosed with breast cancer in their lifetime. However, this statistic increases alarmingly in more westernised countries where the incidence is as high as 1 in 8.

Of all the cancers, breast cancer is the most common cancer in South African women, constituting more than 50% of all cancer diagnoses.

Mammography reported by radiologists is the foundation of early detection of breast cancer.

Mammography and breast MRI are the only recognised imaging screening tools for breast cancer and multinational, multicentre trials have demonstrated a reduction in the death rate from breast cancer in women regularly screened by mammography, due to the early detection of breast cancer.

Mammography is the mainstay examination, breast MRI is used in special circumstances.

Modern mammography is done with a very small radiation dose and there is no evidence to suggest that mammography itself can produce breast cancer or that the radiation presents any danger to any other part of the body or the thyroid gland.

Read: False alarms raise risk of breast cancer

Women are often persuaded by the fear of radiation risk, which is negligible, to use other ‘imaging techniques’ such as Thermography or the SureTouch system. These are operated by personnel, often with no medical training and no training in conventional breast imaging.

There is no evidence that either of these methods has any value in the screening and detection of breast cancer when compared with mammography. They may do harm by missing breast cancers, leading to delayed diagnosis and limited treatment options, if they are used as a substitute for mammography.

Women encouraged to do mammogram from age 40

“We encourage all women to start regular mammography from the age of 40, regardless of whether they have symptoms or have an abnormality – preventative care is the key objective. We also encourage all women to regularly check their breasts for any irregularities and have a clinical breast examination by a GP or gynaecologist at least once a year. If you notice any abnormality in your breasts regardless of your age, it is essential that you consult a medical professional. Many lumps are harmless but all of them must be checked,” adds Dr. Godinho.

The mammogram is the first imaging method for screening when there are no lumps or symptoms or to provide further information if a lump or abnormality is detected.

Mammography is often followed by ultrasound in both screening and symptomatic examinations.  

“The radiologist’s aim is to detect breast cancer before any of these signs appear. This is why we encourage the South Africa women to have regular mammograms to ensure that if there are any malignant cells, they are caught early and can be treated appropriately,” says Dr Godinho.

Who is at risk?

Every woman is potentially at risk of getting breast cancer. However, there are certain factors that would put women in a higher risk category. The risk factors include:

•    Age – The risk of developing breast cancer increases as you get older. About 1 out of 8 invasive breast cancers are found in women younger than 45, while about 2 of 3 invasive breast cancers are found in women age 55 or older.

•    Family history – Breast cancer risk is higher among women whose close blood relatives have this disease. Having one first-degree relative (mother, sister, or daughter) with breast cancer approximately doubles a woman's risk. Having 2 first-degree relatives increases her risk about three-fold.

•    Personal history – A woman with cancer in one breast has a three to four times increased risk of developing a new cancer in the other breast or in another part of the same breast. This is different from a recurrence (return) of the first cancer.

•    Dense breast tissue – Women with denser breast tissue (as seen on a mammogram) have more glandular tissue and less fatty tissue, and have a higher risk of breast cancer. Unfortunately, dense breast tissue can also make it harder for doctors to spot problems on mammograms.

•    Overweight or obese women – Research has shown that being overweight or obese increases the risk of breast and other cancers. Now, a larger study suggests that overweight and obese women diagnosed with early-stage, hormone-receptor-positive breast cancer have a higher risk of the cancer coming back (recurrence) and are less likely to survive the disease.

•    Lifestyle factors – excessive alcohol use, little to no physical activity, smoking and diets high in saturated fats increase the risk of breast cancer.

Read: Depression may up cancer risk

Women with a higher risk should in addition to mammography consider annual breast MRI studies. Breast MRI is now the ‘Gold Standard‘  in breast imaging and is more sensitive than mammography in the diagnosis of early breast cancer.

Dr. Godinho emphasizes the importance of a dual approach in high-risk women:  “As radiologists, we recommend that women with a higher risk have an annual mammography and breast MRI. This will increase the chance of early detection and treatment of the cancer.”

The RSSA recommends that women aged 40 or older should have a mammogram every 1-2 years. Women between 50 and 75 should have annual mammography.

Women at high risk, usually due to a history of breast cancer in a close family relative, should have annual mammograms and MRI starting at an age five years before the age their family member was diagnosed with breast cancer. High risk is defined as a lifetime risk greater than 15%.

Your doctor will help you calculate this or it can be done online.

In support of Breast Health Awareness Month in SA, the RSSA is highlighting the benefits of good breast health and promoting breast imaging for detecting breast cancer in its early stages. All participating members of the RSSA are offering a 10% discount on mammograms and breast MRI, not paid for by medical aid schemes, during the month of October and first half of November.

For a list of participating members contact the RSSA on their line 011 794 4395, e-mail  or visit their website.

Read More:

10 famous breast cancer survivors
Can your bra really give you breast cancer?
Angelina Jolie inspires rise in breast cancer testing

Image: Woman with pink cancer ribbon from Shutterstock.


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