Do you have any questions around breast health? Have a look at our frequently asked questions to find out more information.
Why do you recommend that I have a mammogram every year?
Most international cancer societies recommend annual mammographic screening as the best method of detecting breast cancer early.
It is recommended from the age of 40, unless indicated earlier.
Early detection greatly increases the chances for survival and greatly decreases the chances of a mastectomy being necessary for treatment.
Why do I need the clinical AND mammogram AND ultrasound examinations?
There are rare forms of breast cancer (inflammatory breast cancer and Paget’s disease of the nipple for example) that can only be diagnosed by doing a clinical examination – these cancers usually cannot be seen by doing a mammogram and/or ultrasound. 5-10% of breast cancers can only be seen on a mammogram in the form of calcifications which do not always show up on ultrasound. Conversely about 5-10 % of breast cancers cannot be demonstrated on mammogram as they appear like the other normal structures of the breast, but then can be seen on ultrasound. By doing all three examinations in one visit we are able to correlate all findings and are thus better able to diagnose a cancer if it is present.
Most important uses of ultrasound in breast imaging are:
- As a primary screening tool for women under the age of 40, who do not yet require a mammogram.
- Cyst vs. solid characterization of clinically occult mammographically detected or palpable breast masses.
- Evaluation of asymmetric tissue on mammogram.
- Evaluation of palpable masses in women who are pregnant, breastfeeding or under 40 years of age.
- Guide for interventional procedures (cyst aspiration, preoperative localization, fine needle aspiration and core biopsy).
How is Automated Breast Volume Scanning different from regular breast ultrasound?
With Automated Breast Volume Scanning (ABVS) , which is 3D, the probe is moved automatically at a constant speed over the breast while images are constantly recorded. Post-acquisition image manipulation is possible with ABVS – such as three-dimensional reconstructions and rotations. Checking of images of the entire breast can be performed at a later stage as image acquisition and interpretations are separated, enabling review of images by several readers. These features greatly enhance the detection of small lesions especially in dense breasts.
What causes breast cancer?
The exact cause or origin of breast cancer is still being investigated by the medical profession.
In the case of breast cancer though it has been proven that certain factors do play a role in the risk for developing breast cancer. If these factors are present you are at higher risk for developing breast cancer;
- Age (older)
- Being female
- Age at first childbirth (older)
- Age at first period (younger)
- Age at menopause (older)
- Alcohol consumption
- Ashkenazi Jewish heritage
- Body weight (heavier)
- BRCA1 or BRCA2 gene mutation
- Breast density (high)
- Family history of breast cancer
- Hyperplasia (benign breast condition)
- Lobular carcinoma in situ (LCIS)
- Personal history of cancer
- Radiation exposure from medical imaging
- Radiation treatment during youth
When should I have genetic screening for breast cancer?
In any of the following cases you may consider genetic testing. Make an appointment so that your family history may be discussed and an appropriate recommendation can be made.
- one or more women in your family were diagnosed with breast cancer at age 45 years or younger.
- Family history of cancers, such as prostate cancer, melanoma, and pancreatic cancer.
- There are breast and/or ovarian cancers in multiple generations on the same side of the family.
- A female relative is diagnosed with a second breast cancer in the same or the other breast or has both breast and ovarian cancers.
- A male relative is diagnosed with breast cancer.
- There is a history of breast and/or ovarian, pancreatic, or male breast cancer in a family of Ashkenazi Jewish ancestry.
When Should I have MRI of the breasts?
If you are at high genetic risk for breast cancer or already proven to be a BRCA gene carrier a MRI is indicated once a year. Please discuss this with your doctor at our multidisciplinary health care centre.
Are mammograms very painful?
Although the breast is compressed, many women who undergo mammography do not experience pain. Women with very sensitive breasts may experience slight discomfort. It is also important to relax. When you are relaxed, the pectoral muscles behind the breast relax, which should result in a painless mammogram. Breasts are usually the least sensitive at about 2 weeks after menstruation starts, so this may be the best time of the month to schedule a mammogram, if this is a concern.
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 rads per X-ray, which is an extremely low dose of radiation. This is equated to the cosmic radiation of about 30 minutes of air travel.
The question has also been asked as to whether compression can cause breast cancer. The answer is that compression doesn’t affect the breast tissue at all. For a useful mammogram, it is essential that the breast be compressed as the breast tissue needs to be spread out to allow breast structures to be seen.With appropriate compression the X-ray dose required can be reduced.
Does using antiperspirant cause breast cancer?
Does wearing an underwire bra cause breast cancer?
Does using a cell phone cause breast cancer?
Does using a microwave oven cause breast cancer?
None of the above has been proven by science to cause breast cancer
Why are my breasts so painful if no abnormality is found?
Breast pain is usually due to hormonal influences on the breasts. During the menstrual cycle the breasts are being prepared for a pregnancy and subsequent breastfeeding in the same way that the womb is being prepared. The amount of fluid that is normally found in the breasts increases in volume (thus the milk glands and ducts literally swell up) up until menstruation when the hormone levels change the fluid gets reabsorbed again. Breast tissue is not static and as we get older the breast tissue is replaced by fatty tissue. This process starts around 40 years of age, but varies significantly between women. It causes a degree of fluid imbalance in the breast which may lead to new symptoms of breast tenderness or worsening of old symptoms. We call this process involution.
It is always good to have a thorough breast examination if any new breast symptoms arise. If no abnormality is found upon such a review, one of the following may be tried (try one at a time giving 4-6 weeks to monitor effect; 1-3 NOT recommended during pregnancy):
- Evening Primrose Oil 1-2grams 3 times per day.
- Mastodyn 2 tabs 3 times per day.
- Kelp 2 tabs 3 times per day (not to be used if you use thyroid medication or are being monitored for your thyroid).
- Low fat, no refined carbohydrates, high fibre diet.
- Minimise caffeine intake – bearing in mind green tea also contains caffeine.
I would like to have cosmetic breast surgery. Should I have a breast check-up first?
Before having cosmetic breast surgery, it is recommended that you go for breast cancer screening. Any surgery to the breasts will make future evaluation of the breasts more complicated and can increase the chances of missing an existing cancer.
I have breast prostheses. Can I still have a mammogram?
Yes. Breast augmentation does not constitute an increase in glandular tissue, so you are not more at risk. It is however necessary that an experienced mammographer does your mammogram, as special techniques are needed to demonstrate all breast tissue.
Good mammographic technique is of cardinal importance in producing high quality mammography.
What is the best time in the month to have a mammogram done? My breasts are tender during menstruation.
A mammogram should only be mildly uncomfortable. However, if you are concerned about the tenderness of your breasts, it is advised that you see a trained breast health physician. In this instance, a clinical evaluation and an ultrasound can be performed. If anything suspicious is detected, an immediate mammogram may be required. If nothing is found but the tenderness persists, you may be advised to start treatment and postpone the mammogram for a few weeks until your breasts return to normal.
It is important to note that an ultrasound does not replace a mammogram, which remains the best tool for the diagnosis of breast cancer.
2-3 grams of Evening Primrose Oil per day for 2-4 weeks is noted to reduce breast tenderness.
Can an injury to the breast cause breast cancer?
Breasts are very resistant to injuries and an injury to the breast cannot cause breast cancer. Severe trauma can cause fat necrosis when tissue dies off. This is felt as a lump and can at times be mistaken for cancer on a mammogram. Fat necrosis is not a form of cancer and does not develop into cancer over time.
What types of signs should I look out for?
- Lumps of any size or thickening of the breast tissue and or axillae.
- Any kind of skin change to the breast, areola or nipple area.
- Changes in the shape of the breast or persistent discomfort.
- Discharge from the nipple – that is not associated with pregnancy or breast-feeding.
How can I examine myself for lumps in my breasts?
Below is an infographic to visually give you a step by step guide on how to examine your breasts.