Why getting a regular mammogram can save your life

Getting regular mammogram screenings is essential to keeping your breasts healthy. Screening, by definition, checks for disease when it is too early to cause symptoms or, in other words, when you feel normal. 

Singapore’s Breast Cancer Foundation says that for women aged 40 and above*, a mammogram in time  can help save their lives. Doing monthly breast self-examinations can also help detect breast cancer early. 

Associate Professor Tan Ern Yu, head of service (breast and endocrine surgery) and senior consultant at Tan Tock Seng Hospital (TTSH) – who also specialises in research on developing AI solutions for breast ultrasound  and screening mammography – agrees. “Getting regular mammogram screenings is essential because it can help detect cancer at an early stage. Early-stage cancers have a good outcome after treatment. Relapse risk is low and long-term survival rate is high,” she says. 

Dr Rameysh Danovani Mahmood, consultant radiologist and medical director of Specialist Women’s Imaging (SWI) Clinic, adds that catching early stage cancers translates to a few things: They are easier to manage in terms of treatment and surgical options. And the chance of the cancer spreading in the body is probably less.  

“We want to advocate for early detection before you even develop symptoms, because otherwise, it might be a sign that the cancer has already advanced far enough, or has spread throughout the body. That is why it is important to detect it early – even before you can feel it. 

"For small (early-stage) breast cancers, you are unlikely to be able to feel them because of their size but  yet this would confer the best chance of survival. If the breast cancer has grown large enough to be causing other associated symptoms, such as nipple or skin changes, there may already be a chance for it to spread to other parts chances of survival," he says.

2-D or 3-D mammograms – Is there a difference?

During a mammogram, the breast is compressed between two places to obtain an X-ray image of the breast. Mammograms used to only be available in 2-D, however, 3-D mammograms are now available as well.  

The former takes pictures of each breast from the front and the side, to create a single image (of each breast) that shows areas of overlapping breast tissue. The latter takes many pictures of each breast from various angles, showing each layer of breast tissue; a computer then combines these images to create 3-D views of the breasts. These images allow radiologists to get a more detailed look at the individual layers of tissue. 

Prof Tan says that 2-D mammograms are the standard in Singapore, and a 3-D mammogram is done in instances when an area on the 2-D mammogram needs to be evaluated in greater detail. She adds that an ultrasound is sometimes done to complement the mammogram in certain instances. The patient should do a 2-D mammogram first as recommended for screening. A 3-D mammogram and ultrasound may be  needed for further assessment, as decided by the clinicians.  

“There is no test that is 100 per cent accurate – all tests will have the tendency to miss some cancers. This is why we ask that women still see a doctor if they find a new symptom even after a normal mammogram screening,” emphasises Prof Tan.

Early detection is crucial

1/2

All women should go for regular  mammograms from the age of 40, though the frequency depends on one’s risk. They should discuss  the frequency of their screenings with their general practitioners and doctors, or they may visit the nearest polyclinic for subsidised mammograms.

The common assumption that one does not require a mammogram screening simply because they do not have a family history of the disease is a risky one.

"There seems to be a general misconception that there is some sort of protection from breast cancer if none of their family members are diagnosed with it. It should be emphasised that only about 15 per cent of breast cancers occur within known family history, and the vast majority (85 per cent) do not occur, meaning to say they are sporadic.

"For these vast majority of women, there is no way of knowing or predicting whether or not you're going to develop it. The best way is to detect it early by  scanning the breast, and mammograms  are the proven method for it," says Dr  Rameysh Danovani.

There is also the misconception that mammograms expose one to the effects  of radiation. However, TTSH’s Prof Tan is quick to debunk this myth. Radiation exposure from a mammogram is low, and it does not cause health problems as  “the radiation dose from a mammogram is 0.4mSv (millisieverts – unit of measurement for radiation)”.

She adds: “We are exposed to radiation every day, from the environment and natural sources like the soil and even our mobile phones. On average, an individual is exposed to 2.4mSv of radiation each year.”

Where to get a mammogram

Credit: Specialist Women’s Imaging (SWI) Clinic

2/2

Currently, 2-D mammograms are available at most polyclinics across Singapore. There are mammogram  subsidies for eligible Singaporeans. This includes Breast Cancer Foundation’s First Screen Fund, which provides fully subsidised mammogram  screenings for first-timers at polyclinics, for eligible Singaporean women aged 50  years and above, and holding valid blue or orange Community Health Assist  Scheme (CHAS) cards.

Singaporeans aged 50 years and above can benefit  from Health Promotion Board’s Screen for Life programme, which offers mammography screenings at a subsidised rate.

There is also the option to use one’s Medisave or the Medisave account of an  immediate family member at Medisave approved centres. Singaporeans aged 40 to 49 can opt for the Health Promotion Board’s Screen for Life scheme, which offers mammography screenings at a subsidised rate of $50 per visit. Considering a 3-D mammogram instead? Most, if not all, restructured hospitals offer 3-D mammograms. However, by default, 2-D mammograms are performed routinely.

*CONSULT YOUR DOCTOR ABOUT THE BENEFITS AND LIMITATIONS OF GOING FOR A MAMMOGRAM IF YOU ARE AGED 40 TO 49.