About Mammograms

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Extensive research over decades has proven that mammograms save lives. Annual mammograms allow us to detect breast cancers at the earliest possible stage.

Cancer on mammogram: Small cancer – irregular white spot with spiky margins

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Annual mammograms allow us to detect breast cancers at the earliest possible stage. Unfortunately, some aggressive cancers can exponentially enlarge in even a year which is why we need to do the test every year. In the old days, many breast cancers were only diagnosed when a patient presented with a large tumour which had already metastasized throughout her body. Most of these patients died within months to a year. These days, the majority of breast cancers are found when they are less than 2cm in size. (largely due to mammograms and ultrasound.) The prognosis for those patients is 90% survival at 5 years.

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Interval Cancer ie grown within 10 months!

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Cancer developed in 22 months

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40.  Although breast cancer incidence peaks in the 50s, breast cancer in younger patients is generally faster growing and potentially more devastating. Hence the need to begin at age 40. High risk patients often start earlier.

There is no cut-off age for mammograms. As people are living longer and are healthier at older ages, we are seeing many cancers in patients older than 70. The cancers can usually be successfully treated at any age.

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Breast Cancer by Age

Every year. This means that cancers will be detected at an earlier stage than if mammogram is done only every 2nd or 3rd year. The smaller/less advanced the cancer the easier to treat and better chance of survival. Most breast cancers develop from microscopic individual cells into mammogram detectable lumps in 18 – 24 months. Mammogram intervals longer than a year are therefore not optimal.

The cash price for a mammogram, as linked to most medical aids, is usually between R1550 and R1770. Previously, almost all the medical aids paid the full cost on an annual basis, regardless of your particular plan. Unfortunately, many of the medical aids have cut back on account of financial considerations and are only paying for a mammogram every second year. In order to ensure patients have affordable access to a mammogram every year, many  practices are offering cash discounts for the “intervening” year when the medical aid won’t pay. Discounts of up 10 - 30% can be expected. Some practices may also be amenable to cash discounts on other procedures such as ultrasound, biopsy and MRI

The decision taken to only pay every second year is a financial one, not a medical decision. There is substantial evidence from many years of breast cancer assessment and mammography application, showing unequivocally that yearly screening saves lives. As radiologists we see many cases of breast cancers growing in less than a year. ANNUAL SCREENING SAVES LIVES!

Yes. Although males can get breast cancer, it is very rare. Some males who carry the BRCA gene mutation, may need regular screening but this is only a small minority.

Density in the breasts is generally determined from a mammogram image. The mammogram shows two main types of tissue in every breast – fat and fibroglandular tissue. Fibroglandular tissue refers to the milk glands and the fibrous tissue that forms the surrounding supporting structure. Every women has different proportions of these tissues in her breast. Some women have predominantly fat containing breasts and some women have a high proportion of fibroglandular tissue relative to fat. The breasts with large amounts of fibroglandular tissue are called dense. On the mammogram, the denser the breast, the whiter it is. The opposite, fatty breasts, are mainly black.

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Fatty Breasts: Opposite of dense. Very little breast tissue(white), mainly fat (black) 

X-rays from mammograms are not so good at penetrating dense tissue. As a result, a mammogram is less accurate in women with denser tissue and cancers can be obscured by the overlying fibroglandular tissue

Women with denser breasts are at a higher risk of developing breast cancer.

Dense breasts – more white tissue (fibroglandular) relative to black(fatty). Breast cancers are also white, which makes it sometimes difficult to diffrentiate the cancer from the normal breast tissue.

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Sometimes, looking for a breast cancer in dense tissue is like finding Wally in a Where’s Waldo puzzle

A tomosynthesis mammogram or 3D mammogram is obtained with a special mammogram machine that takes multiple images while moving in an arc around the breast. The resulting compilation of images can be viewed in 3D allowing us to see right through the breast. It makes cancers easier to see and benign lesions more obvious.

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Tomosynthesis – 3D Mammos

There is no additional cost for a 3D mammogram. At our practice all mammograms are now done on the tomosynthesis machine. The breast ultrasound which is routine is also no extra cost when having a mammogram.

Breast augmentation does not increase or decrease your chances of getting a breast cancer. Your risk remains the same. You must have a mammogram prior to getting surgery (or an ultrasound in patients younger than 35) since it would be very unfortunate to be diagnosed immediately after having the surgery. Thereafter annual mammograms are advised like for everyone else.

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Breast Implants – white oval shapes

The mammogram, although it does compress the breast a bit, will NOT burst or displace the implant. And the implant will not prevent us from seeing a cancer on mammogram or ultrasound.

Pregnancy is the only condition in which a woman over the age of 35, is advised not to have a mammogram

Parklane Radiology Women's Imaging Centre has been awarded accreditation in MAMMOGRAPHY by the American College of Radiology (ACR).

This follows on the ACR accreditation in BREAST MRI Parklane achieved in 2017.

The ACR gold seal of accreditation represents the highest level of image quality and patient safety. It is awarded only to facilities meeting ACR Practice Parameters and Technical Standards after a peer-review evaluation by board-certified physicians and medical physicists who are experts in the field. Image quality, personnel qualifications, adequacy of facility equipment, quality control procedures and quality assurance programs are assessed.