Truths and myths about mammograms (every woman should read these)

September 9, 2019

At the beginning of this year I had my first mammogram, and while the results were clear and therefore a huge relief, the whole experience was quite distressing (I wrote all about it here, at BabyYumYum). 

This absolutely won’t deter me from going back, but it reminded me just how unprepared I was, and how little I knew at the time about mammograms.

Dr Justus Apffelstaedt, specialist surgeon with an interest in breast, thyroid and parathyroid health, sent me this fantastic piece on mammograms, which I thought I’d share on my blog.

If you have any other questions,
please leave them in the comments section, and I’ll forward to Dr Apffelstaedt
for answers.

If you have any other questions, please leave them in the comments section, and I’ll forward to Reach for Recovery for answers.

Can mammograms cause breast cancer?

No. For over 40 years, millions of women have
undergone mammography. As with all radiography, it involves exposure to X-Rays,
but the dosage levels used are very low.

Mammographic techniques have also improved greatly
over the past years. Our Full Field Digital Mammography machine uses only 0,1
to 0,2 rad’s per x-ray, which is an extremely low dosage of radiation.

The question has also been asked whether compression
can cause breast cancer. Breasts are extremely resistant to even major trauma
and the compression during mammography doesn’t affect the breast tissue at all.
It’s essential that the breast be compressed if a useful mammogram is to be
obtained. Breast tissue is spread out to allow breast structures to be seen.
Compression also means that the x-ray dose required can be reduced.

Patients should make sure that they have their
mammograms done at a centre where modern mammography units are in use.

I’ve been told that mammograms are very

Although the breast is compressed, many women who
undergo mammography do not experience any pain. Women with very sensitive
breasts may experience slight discomfort provided the mammogram is performed
properly. In cases where the breasts are painful before the mammogram, the pain
should be treated first and only when the woman is pain free, should the
mammogram be taken.

Mammography is an examination of the anatomical
integrity of the breast and therefore has no place in the evaluation of breast
pain as breast pain is usually a functional problem (that means due to hormonal
influences) and not an anatomical problem (such as a cancerous growth).

Is there any other exam that can be provided instead
of a mammogram?

Mammograms remain the best tool for screening, however
for particularly dense breasts, an Automated Breast Volume Scan is recommended.
This is a very sensitive and powerful form of ultrasound that creates a 3D view
of the breast.

At what age should I get my first mammogram?

Unless you have a family history of breast cancer, or
if you have other risk factors associated with breast cancer, you should start
regular mammograms from the age of 40.

At what age should I begin screening if there is
breast cancer in my family?

If there is breast cancer – mostly at a young age – (or ovarian cancer or prostate cancer in men below the age of 50) in your family, you should speak to your medical practitioner. Once a full history is completed, they will be able to advise you on your next steps. Screening may be required from an earlier age than the norm, but each case needs to be evaluated on its own merits. 

How should I prepare for a mammogram?

No preparation is necessary before a mammogram.
However, it is advised that you do not wear moisturiser, perfume, talcum powder
and jewellery. These measures will ensure a best quality mammogram.

On the day of the exam, wear comfortable clothes. It
is not required to have an empty stomach for a mammogram.

If you are on medication, do not interrupt your
treatment but let the medical staff know which medications you are taking.

Is the mammogram more effective on a certain size of

The result of a mammogram is not related to the size
of your breast. However, for very dense breasts, an ultrasound using the
Automated Breast Volume Scanner may be indicated.

I would like to have cosmetic breast surgery. Should I
have a breast check-up first?

Prior to having cosmetic surgery, it is always advisable to go for breast cancer screening. Any surgery to the breasts will make future evaluation of the breasts more complicated and it therefore increases the chances of missing an existing cancer.

I have breast augmentation. Can I still have a

Yes. Breast augmentation does not constitute an
increase in glandular tissue, therefore you are not more at risk. It is
necessary that an experienced Mammographer takes your mammogram as special
techniques are needed to demonstrate as much breast tissue as possible.

If my breast check-up is fine, why do you recommend
that I have a mammogram every year?

Most international cancer society’s recommend annual
mammographic screening as the best method of detecting breast cancer early.
Early detection greatly increases the chances for survival and greatly
decreases the chances of a mastectomy being necessary for treatment. The longer
the interval between screening visits, the more cancers are detected as palpable
lumps and the  chance of survival is much
lower than when the cancer is detected only on mammography or ultrasound.

What is the best time in the month to have a mammogram
done? My breasts are tender during menstruation.

We recommend you have a mammogram about a week after menstruation when your breasts are less tender. A mammogram should only be mildly uncomfortable, however, if you are concerned about the tenderness of your breasts, it is advisable to see a trained breast health physician. In this instance, a clinical evaluation and an ultrasound can be done.

Which breast cancer organisations
can I support?

There are numerous breast cancer organisations doing wonderful work in South Africa. One such organisation is Reach for Recovery, the all-female NPO, which is one of South Africa’s oldest breast cancer support organisations. Since 2011, through their national Ditto Project, they have provided over 5000 indigent women, who have undergone mastectomies, with silicone breast prostheses.

Reach for Recovery hopes that all South African women can have access to the tools that they need to live a normal, healthy post-operative life.  If you’d like to donate to Reach for Recovery and help more breast cancer survivors get breast prostheses, click here.


Stock images: Angela Yeho/Shutterstock

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