Beating breast cancer

2017-10-17 06:01

BREAST cancer constitutes around 25% of all cancers in women and will affect one in 29 South Africans in their lifetimes.

“As frightening as the ‘Big C’ is to all people, the good news is that modern medical advances and early screening and diagnosis are seeing more women than ever before surviving and beating cancer with less aggressive and invasive treatment.

“The need for early and accurate detection simply cannot be emphasised enough,” says Dr Jackie Smilg of the Radiological Society’s sub-specialty group, the Breast Imaging Society of South Africa (Bissa).

The goal of screening tests for breast cancer is to find it before it causes symptoms. Breast cancers found during screening exams are more likely to be smaller and still confined to the breast. The size of a breast cancer and how far it has spread are some of the most important factors in predicting the prognosis of a woman with this disease.

As with all cancer screening, recommendations for breast cancer screening rely on a combination of factors involving evidence about the risk of the condition, the benefits and harms of screening, and the cost.

The gold standard for screening breast imaging remains the mammogram. Mammography reported by radiologists is the foundation of early detection of breast caner.

“The latest mammography technology, Tomosynthesis, has brought an entirely new dimension to the fight against breast cancer. Digital tomosynthesis creates a three-dimensional picture of the breast using X-rays. Contrast Mammography, where contrast investigates the vascularity of a lesion, is a new addition to breast imaging and promises to be a valuable problem-solving tool.

Adding annual screening tomosynthesis to 2D mammography beginning at age 40 is highly cost-effective compared with 2D mammography alone, according to a study published in the American Journal of Roentgenology [August 2016]” explains Dr Smilg.

In women with a significant family history of breast cancer or special circumstances, mammo-graphy can also be followed by ultrasound in both screening and symptomatic examinations and breast MRI.

Women are often irrationally persuaded by the fear of radiation risk, which is negligible, to use other “imaging techniques” such as Thermography or the SureTouch system.

“There is no evidence that either of these methods has any value in the screening and detection of breast cancer when compared with mammography. They may do harm by missing breast cancers,leading to delayed diagnosis and limited treatment options, if they are used as a substitute for mammography,” she warns.

“The short-term anxiety that could come from an inconclusive test result simply doesn’t outweigh the thousands of lives saved each year by mammography screening. Ultimately any inconclusive result warrants further and deeper investigation. Women should decide for themselves whether the short-term anxiety outweighs the risk of dying from breast cancer. When it comes to dealing with a potentially life-threatening disease as pervasive as cancer, it makes absolute sense to opt for the most effective, decisive and conclusive screening technology, which remains the mammogram,” adds Dr Smilg.

The RSSA/Bissa encourages all women to start regular mammography from the age of 40 and continue to do so every year until age 70, regardless of whether they have symptoms or have an abnormality – early detection is the key objective. Women at high risk, usually due to a history of breast cancer in a close family relative, should have annual mammograms and MRI, starting at an age five years before the age their family member was diagnosed with breast cancer or at 40 years – whichever comes first. High risk is defined as a lifetime risk > 20-25%. Your doctor will help you calculate this or it can be done on line at
- Supplied


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