Breast Cancer Prevention: Mammography Is Key

I encourage all colleagues to support local medical effort geared towards curbing the menace of breast cancer.

3-5 years before ductal carcinoma in situ is significantly grown enough to be clinically palpable,
screening mammography helps to diagnose it in most cases, and it is only at this stage that treatment options may guarantee a cure.

It therefore means that normal breast palpation findings (negative for breast mass) in an apparently asymptomatic female do not exclude occult breast mitotic disease.

In the same vein, a negative (normal) breast ultrasound scan does not absolutely exclude occult breast malignancy.

However, negative breast ultrasound scan and mammography examination carry very high negative predictive value for breast malignancy.

The goal therefore is ‘early diagnosis’.

Who needs a mammography

As part of our routine professional practice

All women 40 years and above should be encouraged to have annual screening mammography, with images reviewed by a radiologist. This way, proper Bi-RADS score assessment is done to triage those who would need tissue biopsy from those who would not.

For high risk females such as those with first degree family history of premenopausal breast cancer or those with histologic risk factors found at previous breast surgery (e.g. atypical ductal hyperplasia), screening mammography should commence at 35 years.

In addition, any symptomatic woman 35 years and above having a breast lump or other clinical evidence of breast cancer should undergo diagnostic mammography.

Any woman presenting with breast lump following augmentation mammoplasty should do diagnostic mammography.

And all men presenting with a suspicious breast lump should undergo diagnostic mammography.

Food for thought

” Late presentation of patients at advanced stages when little or no benefit can be derived from any form of therapy is the hallmark of breast cancer in Nigerian women”…..Okobia et al (2006).

As clinicians, we could help reverse this ugly trend by practising screening of patients who present to us for other reasons; it could save many lives.