Should mammograms be a standard test?

mammogramAre mammograms the ultimate for breast cancer and should a policy for South Africa ask for this as a standard service for our women?

In a country where our National Cancer Registry does not provide us with accurate figures of the number of women that are diagnosed with Breast Cancer, and our figures are mainly based on western models there is a lot of research and data that still has to be collected to say empathically yes all women above 50 or even 45 should have a mammogram.

What we should rather focus on is that we determine what is the risk profile for ALL South African women.

What is the TRIPLE TEST

  • A Clinical Breast Examination by a trained health professional
  • A mammogram is an Image of the Breast taken by a trained radiographer. Cancer usually looks white on a mammogram and nearly 15% of Breast Cancers are not seen on a mammogram. It is particularly unreliable in young women, women with dense breasts, women with prostheses and women with lobular cancer.
  • Ultra sounds should be done if a woman has a palpable mass (lump) but a normal mammogram or if the breasts are dense.  Ultrasounds should be the first imaging done on a woman under the age of 35 years of age.

If there are areas of concern, a Fine Needle Aspiration (FNA) and core biopsy and determination of Estrogen Receptors should be done.

The Breast Health Global Initiative Guidelines for Breast Health and Cancer Control suggest that as a limited level of service that we can advocate for as a minimum services – limited service level indicates a seconde tier resources or services that are intended to produce major improvements in outcome such as increased survival and are attainable with limited financial means and modest infrastructure; limited level services may involve single or multiple clinical interactions.

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