(ROJ-BCAW) Mammography – When is It Needed?

(ROJ-BCAW) Mammography – When is It Needed?

by Reynaldo O Joson on Friday, October 21, 2011 at 12:46am

ROJ Breast Cancer Awareness Write-up (ROJ-BCAW-11oct21)

 

Mammography – When is It Needed?

Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg

October 21, 2011

 

Mammography is an x-ray of the breasts.

 

Mammography can be used for screening for breast cancer in those persons without a palpable breast lump but have significant risk of having a non-palpable breast cancer.  It can also be used for assessment of a palpable breast lump.

 

Screening Mammography Guidelines

 

There are varying mammogram guidelines from different organizations about when to begin mammograms.  Some would recommend screening starting at age 40 and others starting at age 50.

 

The U.S. Preventive Services Task Force (USPSTF) — a group of health experts that reviews published research and makes recommendations about preventive health care — recommend screening mammograms be done every two years beginning at age 50 for women at average risk of breast cancer.  USPSTF says the benefits of screening mammograms don’t outweigh the harms for women ages 40 to 49. Potential harms may include false-positive results that lead to unneeded breast biopsies and accompanying anxiety and distress.

 

Many European countries, including England, recommend screening to start at age 50.

 

The Philippine College of Surgeons supports the recommendation for annual screening mammography for women aged 50-74. [Ref: Philipp J Surg Spec 2003; 58(1) 22-26.]

 

Screening mammography are usually not done in persons 30 years old and younger because the breast tissue in this group of persons is too thick and too dense to get a clear picture.

 

Diagnostic Mammography Guidelines

 

Diagnostic mammography can be used to evaluate a patient with abnormal clinical finding such as a breast lump.  However, this should only be requested by a breast specialist who has initially done a physical examination of the breast of the patient and who thinks a mammography is needed for a more definitive diagnosis.

 

Advocacy and Advices:

 

There are a lot of unnecessary mammography going on in the community because of demand creation by owners of mammography machines, misleading advertisement and undue fear of breast cancer.  Be aware of the indications mentioned above and use them as guides on deciding whether a mammography is needed or not.  There are pros and cons in having a mammography.  If medical advices are needed, the best physician to go to is a breast specialist, who usually carries a title of general surgeon and who devotes most of his / her medical practice to managing patients with breast concerns.

 

References:

 

Siguan SS, Atilano AA, Medalle ER.  Patterns of mammogram utilization and clinical profile of patients who underwent mammography at Cebu (Velez) General Hospital. Philipp J Surg Spec 2003; 58(1) 22-26.

 

Co CS, Tan-Paredes M, Bisquera OC, Penserga E, Joson RO. A Survey on Mammography Utilization in the Philippines with Focus on Certain Quality Parameters A Multi-center Cooperative and Collaborative Action Research Study

http://mcccars.tripod.com/mammo_study_2003.htm

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