According to a comprehensive report of breast cancer statistics in Singapore, 1 in 16 Singaporean women will be diagnosed with breast cancer in their lifetime. In 2020, breast cancer was responsible for 32 per cent of all new cancer cases in Singapore. And 1 in 39 women die from breast cancer each year. However, breast cancers detected in the earliest stages have a 90 per cent survival rate. Here is where mammogram screenings come into play.
What is a Mammogram?
A mammogram is a type of x-ray that allows doctors to observe any abnormalities or changes in breast tissue. Regular mammograms are currently one of the best ways to detect early signs of breast cancer — plus, they can be easy, cheap and safe.
Why is Breast Cancer Screening Important?
Breast cancer is the leading form of cancer amongst Singaporean women — affecting 1 in 16 individuals here. Several factors contribute to your breast cancer risk, some that cannot be changed and some that can.
While leading an active and healthy lifestyle helps to minimise our risk of breast cancer, identifying breast cancer early greatly improves the chances of surviving it.
Here’s where breast cancer screening comes in. Early detection through mammograms and breast self-examinations, along with subsequent intervention, could mean that you’ll less likely need to resort to invasive treatments like surgery or mastectomies (breast removal).
Stage 0 to Stage 1 breast cancer — where cancer is limited to the area where abnormal cells first start to form — is highly treatable and survivable, and may not even require chemotherapy to treat.
Who Should Go for a Mammogram?
The Singapore Health Promotion Board (HPB) recommends that women aged 50 or more get mammograms regularly (once every two years), even if you do not feel like there might be anything wrong.
If you are between the ages of 40 and 49, you should seek your doctor’s advice on whether or not you should get a mammogram done.
Besides age, other factors that could put women at a higher risk of breast cancer include:
- A family history of breast cancer
- A history of ovarian cancer
- Early onset of menstruation
- Late menopause
- Having a first child after the age of 30
- Being on hormone replacement therapy
- Gaining weight after menopause
Mammogram screening for women under the age of 40 is typically not done as pre-menopausal women typically have denser breast tissue, reducing the effectiveness of mammograms in detecting early breast cancer.
If you happen to notice any changes in your breasts — regardless of age — consult a doctor immediately.
What’s the Mammogram Process Like?
First of all, you should try to schedule your appointment a week after your menstruation ends. If you no longer have periods, you can schedule it at any time that is convenient for you.
On the day of your mammogram, avoid applying any deodorant, talcum powder, lotion or ointment to your underarms. As you will have to undress from the waist up, do wear a two-piece outfit if you can as well.
During your mammogram, a trained female technician will lead you to a special low-dose x-ray machine. She will position your breast between two flat plates and compress them slightly for less than two minutes. This will be performed on one breast at a time. The compression is to allow the machine to capture better images of the flattened breast tissue.
The whole mammogram procedure usually lasts about 30 minutes. A radiologist will later examine the resulting images for any abnormalities or signs of cancer. You should receive your results within four weeks by post or at a consultation with the doctor.
If your results are normal, do continue to perform monthly breast self-examinations and go for regular mammogram screenings at the recommended frequency for your age. It is best to stick to the same screening centre.
If you are notified that your results require further investigation, do not panic. 90 per cent of the time, individuals receive normal results after further testing.
Are Mammograms Painful?
As the x-ray machine has to compress your breasts to capture a clear image, mammograms are usually uncomfortable or slightly painful — especially if you have dense breasts.
To reduce the tenderness, you can consider scheduling your mammogram a week or so after your period, to avoid the timeframe where your breasts might be more sensitive than usual.
How Often Should I Go for a Mammogram?
Even though you might be cleared after your first mammogram, breast tissue can still change over time.
As such, women aged 50 and above should get a mammogram once every two years. If you are aged 40 to 49 and have been advised by your doctor to get a mammogram, you should do so once every year.
Pregnant women are not advised to go through mammograms, as the x-rays could pose a risk to the foetus. If you have recently given birth, you should only get your mammogram done at least six months after you stop breastfeeding, for the most accurate results.
Balancing the Risks of Breast Screening
Breast cancer screening can save lives. However, there are still women who feel uncertain about undergoing breast cancer screenings like mammograms due to the perceived risks.
Here are some risks commonly associated with mammograms, along with the reasons why it’s still worth it:
During a mammogram, your breasts are exposed to very small amounts of medical radiation. This radiation is equivalent to about six months of background radiation you are exposed to in daily life and is at a lower dose compared to regular x-rays. Regardless, the benefits of screening and early detection outweigh this small risk of undergoing mammograms.
* Pregnant women are still not advised to undergo a mammogram, as it may pose a risk to the foetus.
2. Callback Distress and False Positives
Mammograms aren’t always accurate — factors such as age and breast density can reduce the accuracy of mammograms. Roughly 10 per cent of mammograms may require additional testing.
Having an abnormal mammogram result does not necessarily mean you have cancer. It just means that an abnormality has been detected in your breast tissue that needs to be investigated further. This would require tests that are only available in the hospital.
Approach the follow-up checks with a calm mind and treat them as you would with any ordinary medical follow-up.
(See also: Telling my Children that I have Cancer)
3. False Negatives
In the same vein, mammograms may not always detect the presence of cancer. Factors that contribute to this include the cancer being too small, being in an area difficult to view via mammogram, or having dense breast tissue that might obscure signs of cancer.
However, this should not deter you from undergoing your regular mammogram screening. In the meantime, continue conducting your own monthly breast examinations (some cancers might be detected by physical examination but not by mammogram), and consult a doctor if you have any concerns.
Be Aware of Your Breasts
The best way to detect anything unusual in your breasts is to be familiar with them from the get-go. Monthly breast self-exams are a great tool to help you understand what is normal for your breasts and when there might be changes to flag out.
The Singapore Cancer Society has an easy 3-step DIY Breast Self-Check that you can do every month:
Standing in front of a mirror, place your hands on your hips. Look out for changes in breast shape and skin surface, as well as any nipple abnormalities. Raise your arms above your head and look for changes (especially dimples) on the underside of your breast.
2. Touch (Breasts)
Using your middle three fingers, gently massage each breast in a circular motion, starting from the outer area near your armpit and ending towards the nipple. Lightly squeeze your nipple to check for any discharge.
3. Touch (Overall)
Did you know that your armpit area is also part of your breast tissue? Do a final check by feeling your entire chest area from underarm to cleavage, looking out for any lumps.
Early Detection Saves Lives
Even though breast cancer research is always advancing and there are several options for effective treatment out there, early detection is still your best bet. More than 90 per cent of women diagnosed with breast cancer at the earliest stage remain disease-free for five years or more, while their chances of living without serious long-term complications become much higher as well.
As the Screen for Life programme puts it, the best time to get a screening is when you still feel fine. Be aware of your body, consult your doctor if ever in doubt, and stay on track with your regular health check-ups.
This article first appeared on Homage, an award-winning personal care solution that provides on-demand holistic home and community-based caregiving and medical services to seniors and adults, allowing them to age and recover with grace, control, and dignity.