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Have you had your mammogram yet?

<p><img src="/nairobi/PublishingImages/Mammogram%20body%20image.jpg" alt="" style="margin: 5px; font-family: helvetica;"/> </p><p><span style="font-family: helvetica;"><em><strong>Caption:</strong></em><em><strong> Dr Rose Ndumia, Consultant Breast Radiologist at Aga Khan University Hospital analyses a mammogram scan </strong></em>
</span></p><p><span style="font-family: helvetica;">Annual medical checkups especially to screen for cancer are very crucial in enabling us to take charge of our health as well as assure better clinical management outcomes should any problems be detected. One such recommended annual test for women is a screening mammogram. Here&#39;s what every woman should know about mammographic screening.
</span></p><p><strong style="font-family: helvetica;">What is screening?</strong></p><p><span style="font-family: helvetica;">This is a test done to assess for indicators of a certain disease in the population when there are no signs or symptoms of the disease, that if found would then need confirmation.</span></p><p><span style="font-family: helvetica;">For example, a pap smear is done for cervical cancer screening.
</span></p><p><strong style="font-family: helvetica;">What is the recommended screening tool for breast cancer?</strong></p><p><span style="font-family: helvetica;">Mammography is the worldwide gold standard screening tool for the detection of early breast cancer and has been shown to result in a 40% reduction in mortality. It is done in women without symptoms (screening mammogram) and also in those with symptoms (diagnostic mammogram).
</span></p><p><strong style="font-family: helvetica;">What is a mammogram?</strong></p><p><span style="font-family: helvetica;">It is an X-ray of the breasts that involves taking 2-dimensional images of the breasts in two views. There are different types of mammogram machines, with digital mammograms providing the best image quality.
</span></p><p><strong style="font-family: helvetica;">What is digital breast tomosynthesis (DBT)?</strong></p><p><span style="font-family: helvetica;">This is additional technology found only in digital mammography that allows for 3-dimensional evaluation of the breasts. It allows for evaluation of the breast in thin slices resulting in increased detection of early breast cancer and reduces the number of patients that have to be recalled for additional breast imaging.
</span></p><p><strong style="font-family: helvetica;">When should I start having a screening mammogram and how often should I do it?</strong></p><p><span style="font-family: helvetica;">The Kenya Screening Guidelines recommend screening annually from the age of 40-55 years and biennially from 56-74 years. If you are under the age of 40 years, you may have a breast ultrasound done. The mammogram can be normal and a breast cancer develops thereafter and hence it is recommended to get screened on a regular basis based on your age.
</span></p><p><strong style="font-family: helvetica;">How do I go about getting a mammogram done?</strong></p><p><span style="font-family: helvetica;">You can walk into the radiology department during normal working hours and request to have it done, upon which you will be provided with a questionnaire to fill out and your mammogram will then be performed. You may also call the Radiology Department Reception Desk to make a booking which is usually the norm during the cancer awareness months owing to the high volume of requests that we receive at this time. You can also ask your doctor to request the test for you.
</span></p><p><strong style="font-family: helvetica;">How should I prepare for the mammogram?</strong></p><p><span style="font-family: helvetica;">It is recommended that you wear a two-piece outfit as you would need to remove the upper body clothing to get the mammogram done. Additionally, avoid applying lotions, deodorant or talc as this can interfere with the images. If you have already applied any of these, kindly inform the technologist who will then provide you with wipes to clean these off. If possible it is better to perform the mammogram on the second week of your menstrual cycle when the breasts are less likely to be sore due to hormonal changes.
</span></p><p><strong style="font-family: helvetica;">How long does it take to get a mammogram done?</strong></p><p><span style="font-family: helvetica;">It takes about fifteen minutes.
</span></p><p><strong style="font-family: helvetica;">What should I expect during the mammogram?</strong></p><p><span style="font-family: helvetica;">You will have a female technologist perform the mammogram. She will place the breasts between two paddles and apply compression before acquiring the images in two views. The compression is applied for only a few seconds and will be automatically released immediately after the images are acquired.
</span></p><p><strong style="font-family: helvetica;">Can I have a screening mammogram if I am pregnant or breast-feeding?</strong></p><p><span style="font-family: helvetica;">Yes you may have screening mammography. However, for pregnant patients they will require lead shielding to be applied over the abdomen and pelvis to minimize radiation exposure to the fetus.
</span></p><p><strong style="font-family: helvetica;">Will I need additional tests after the mammogram?</strong></p><p><span style="font-family: helvetica;">It will depend on what is seen on the screening mammogram. If your breasts are dense or an abnormality is detected, then further evaluation using breast ultrasound would be requested. The mammogram tests are reported by a Radiologist with specialized training in breast imaging.
</span></p><p><strong style="font-family: helvetica;">What does it mean to have dense/lumpy breasts?</strong></p><p><span style="font-family: helvetica;">Dense breasts mean that you have more glandular tissue than fat in the breasts. The images look more white which making it difficult to pick up masses on mammography since they also appear white.
</span></p><p><strong style="font-family: helvetica;">If I have dense breasts, at what age should I do a mammogram?</strong></p><p><span style="font-family: helvetica;">You should follow the same imaging guidelines as other average risk patients and start screening at the age of 40 years. You however have to combine your mammogram with breast ultrasound imaging in order to assess for any small masses that may have been obscured by the dense parenchyma.
</span></p><p><strong style="font-family: helvetica;">Do I need to bring my previous mammograms?</strong></p><p><span style="font-family: helvetica;">Yes, you will be required to bring any prior breast imaging (mammogram and ultrasound) if it was done at an external facility. The previous images assist in assessing for interval changes which can be a sign of early breast cancer and also confirms if a finding has been stable and does not require further evaluation. If the external images are on CD format, we can upload them onto our electronic records (PACS system) for future reference and you would not have to bring them again during your next visit. If you have had your mammogram at our hospital, there is no need to bring the prior images as they would be stored on our PACS system.
</span></p><p><strong style="font-family: helvetica;">What is a biopsy?</strong></p><p><span style="font-family: helvetica;">This is a procedure performed when a suspicious finding is found on diagnostic imaging. A small tissue sample is obtained from the suspicious finding and sent to the laboratory in order to obtain a final diagnosis. The procedure is performed under local anaesthesic and under image-guidance to ensure accurate sampling of the area of interest.
</span></p><p><strong style="font-family: helvetica;">What should I do once I have the biopsy results?</strong></p><p><span style="font-family: helvetica;">You need to discuss the biopsy results with your doctor. You can also be seen by one of our Consultant Breast Surgeons at the breast clinic.
</span></p><p><strong style="font-family: helvetica;"><em>By Dr Rose Ndumia, Consultant Breast Radiologist at Aga Khan University Hospital, Nairobi</em></strong></p><p><span style="font-family: helvetica;"><strong><em>This article was first published in Business Daily on April 8, 2022</em></strong>

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