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Breast cancer is the most common cancer in women worldwide, and the disease is on the rise. In Singapore, the incidence of breast cancer has almost tripled in the last four decades. According to the Singapore Cancer Registry, more than 9,000 women were diagnosed with breast cancer between 2011 and 2015. That's nearly 2,000 new cases each year.
Early detection is key
The good news is that early detection and treatment of breast cancer can significantly improve outcomes. When cancer is diagnosed early, more treatment options are available and the chances of survival are better. More than 90% of women diagnosed with early breast cancer remain in good health and no longer have disease after 5 or more years, compared to about 15% of women diagnosed at the most advanced stage.
Track regularly even if you feel good
Currently, the most reliable breast cancer screening tool is mammography. Mammograms can detect tiny masses of early breast cancer before you or your doctor can smell them by hand. This is also why the Singapore Health Promotion Council (HPB) recommends that women over the age of 50 regularly have a mammogram, even if they feel comfortable. You can use your health insurance, such as an integrated protection plan *, to cover the costs of your mammogram.
How is mammography done
Mammography is essentially a radiological examination of the breast. Using low energy x-rays, the machine captures a breast image with all the underlying abnormalities.
The two main types of mammography are film mammography and digital mammography (also called full-field digital mammography). The main difference between them lies in how the breast image is captured – on a photographic film or in digital form on a computer.
For both types of mammograms, the examination procedure is the same. First, an experienced technologist positions and gently compresses the breast between 2 transparent plates. Then, a specialized x-ray machine takes 2 pictures of each breast under 2 angles. Breast compression is necessary to reduce the thickness of the breast, which improves the quality of the image by reducing overlapping shadows.
Is a mammogram painful?
Different women may experience various levels of discomfort, and those with firm, dense fibrocystic breasts are more likely to experience mild pain.
How can you reduce discomfort?
Women can schedule their mammograms one week after their menses. This avoids the period of increased sensitivity and tenderness of the breasts that tends to occur just before and during the menstrual period.
You can take a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, about 45 to 60 minutes before the procedure.
You can also ask the hospital if a cushion will be provided during your procedure. The damping between breasts and plates can help to greatly reduce discomfort.
Who should have a mammogram?
Early breast cancer usually has no symptoms. HPB recommends mammographic screening once every 2 years for women aged 50 and over. Women between the ages of 40 and 49 must consult a doctor about the advantages and disadvantages of mammography. If screening is done, HPB advises to do so every year.
If you experience any symptoms or changes in your breast, you should consult a doctor to find out if you need to have a mammogram.
Symptoms to watch for include:
- A lump or mass in the chest
- Swelling of all or part of the breast (even if no distinct mass is felt)
- Skin irritation or dimpling (sometimes resembling an orange peel)
- Breast or nipple pain
- Nipple retraction (turning inward)
- Redness, desquamation or thickening of the skin of the nipple or breast
- Nipple discharge (other than breast milk)
Screening is also recommended for women at higher risk of breast cancer, such as those with a family history of the disease. See a doctor who can help you assess your risk.
Benefits of mammography
Mammograms have minimal side effects. The discomfort felt during the procedure varies from one person to the other and also depends on factors such as the timing of the exam according to your menstrual cycle and the technologist's skills. Compression of the chest should not cause bruising and most women do not feel persistent pain afterwards.
If you are concerned about the safety of X-ray exposure, rest assured that modern mammography machines use low doses of radiation. The American Cancer Society estimates that a screening mammogram gives the same amount of radiation that a woman would be exposed to her natural environment over a period of about 7 weeks.
Local health authorities claim that the benefits of mammography outweigh the risks of radiation. Most importantly, mammography allows your doctor to detect breast cancer at an early stage before you feel any symptoms. It allows your doctor to detect changes in the breast, such as small white spots (calcifications), nodules or tumors (masses) and other suspicious areas (densities) that may signal cancer. Mammography can also help your doctor decide if additional tests are needed.
In Singapore, doctors fear that some cases of breast cancer will be detected only at an advanced stage. More women need to be aware of the benefits of regular screening. When breast cancer is discovered early, the treatment is less radical and more expensive. Plus, the chances of a full recovery with a full return to a normal lifestyle are higher.
Considering your options
For your comfort and privacy, you can choose to have your mammogram in a private hospital, where you can use your MediSave to help you offset costs. At Mount Elizabeth Hospitals, the procedure is treated as a day case, so you do not need to stay overnight. The mammogram takes only about 20 minutes and the results of your analysis will be available the same day when collecting your results in person. A specialist will then explain the results in the same day or on the desired date as soon as possible. Doctors advise you to review your results as soon as possible to clear up any anxiety.
Fixed price packages are available at Mount Elizabeth hospitals so you know exactly what to expect. If you have an integrated shield plan covering private hospitals and a full pilot *, you may be fully covered for the mammogram package. Call +65 6812 3776, WhatsApp +65 8799 7787 or send an email to [email protected] to find out if your insurance plan covers you for Mount Elizabeth Hospitals.
* Baths and conditions of application. Valid for full riders purchased before April 1, 2019. For more information, visit checkmyhealthcoverage.sg or contact the number listed above.
Article reviewed by Dr. Wee Siew Bock, General Surgeon at Mount Elizabeth Hospital
The references
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