SCREENING FOR BREAST CANCER

Understading breast cancer imaging methods available in Malaysia. Imaging modalities commonly used in Malaysia include ultrasound, mammography and Magnetic Resonance Imaging (MRI).

ULTRASOUND

Ultrasound, which trasmits high-frequency sound waves through the breast, can determine whether a lump contains fluid (cyst) or solid mass. The sound waves bounce off surface (tissue, air, fluid) in the breast and these are recorded and transformed into video or images. Ultrasound serves as an adjuvant imaging modality to mammography (analogue or digital), which is currently the only tool used for screening of breast cancer. Ultrasound is recommended as an adjuvant imaging method for women with dense breasts irrespective of age. Ultrasound can also be performed on men who present symptoms such as breast lumps, breast pain and nipple discharge.

MAMMOGRAPHY

Mammography is currently the only available imaging modality for screening of breast cancer. A mammography exam is an x-ray of the breast used to detect changes in the breasts such as calcifications or masses (cyts and tumours). Mammograms usually involve at least two views taken from different angles of the breast –  top to botton, side to side. Today, digital mammograms enable doctors to zoom in on the result, resulting in more accurate readings. Although mammography uses radiation, the dosage used is within a safe range and does not pose any health risks for the individual. Women above the age 40 as well as those who have a family history of breast cancer or who are BRCA positive are advised to undergo mammography once a year.  Mammography can also be performed on men who are suspected of having breast cancer.

MAGNETIC RESONANCE IMAGING

MRI is an emerging method for screening breast cancer. However, MRI serves as an adjuvant imaging tool and is only used for screening post operative breast and patients with breast implants or silicone injection and in young female patients who receive radiotherapy that is exposed to the breast for conditions such as lymphoma. MRI is not recommended as screening tool for the general public because it is expensive and not accessible to the public, especially those in the rural areas.

TOMOSYNTHESIS

Unlike mammograms, digital tomosynthesis takes multiple x-ray pictures to create highly focused three – dimensional pictures of the breast using x-rays. The breast is positioned the same way it is in a conventional mammogram, but nly in a conventional mammogram, but only a little pressure is applied – just enough to keep the breast while 11 images are taken during a seven-second examination. Currently, the use of digital tomosynthesis is limited to research only and has not yet been recommended as a screening tool for breast cancer.

However, the private healthcare sector can help to support the health ministry by making their breast screening and ensuring their consultants (obstetricians, gynecologist and physicians) counsel and examine their female patients (especially those above 40 years old and in high risk group) vigilantly for breast cancer. (Source: Health&Beauty)