Dr Laila Mastura Ahmad Apandi, Consultant Radiologist

1 October, 2023

Breast Cancer Awareness Month
Focusing on the
Fight and not the fright

Breast cancer and women:
Being a modern woman is challenging. The work-family-life balance sometimes permits little space for me-time, let alone the ‘boring and time-consuming’ medical check-up.

A common scenario will be:

“I am aware of my body and have no lumps in my breasts or any other signs of breast cancer I have 'googled' in the net.”

“I am a healthy woman. I live a balanced life, eat healthy food and exercise regularly. Cancer does not run in my family.”

Why would I waste my precious time and money for breast check-up?

SILENCE IS NOT ALWAYS GOLDEN

Unfortunately, early breast cancer typically has no symptoms. This is why we need to have regular screening. Breast cancer is a major cancer among women in Malaysia. Currently, there is no vaccine, diet, or lifestyle modification to prevent breast cancer. Women without a family history can still have breast cancer. The risk of having breast cancer in Malaysia is 1 in 20.

SURVIVING BREAST CANCER

In high-income countries, 9 out of 10 breast cancer patients have 10 years of survival. The national average in Malaysia for 10 years survival is 5 out of 10. The reason for this poor outcome lies in late detection and poor or delayed access to treatment, things that are potentially preventable. Screening is of utmost importance for breast cancer because screening helps detect the tumour when it is small and most easily treated.

SCREENING FOR BREAST CANCER

A mammogram is the gold standard for breast cancer screening for women above 40 years old. It detects microcalcifications, which are tiny calcium deposits that can often be the first indication of breast cancer.

However, in women with dense breasts, the mammographic study needs to be supplemented by ultrasound. Combining both mammograms and ultrasound reduces than risk of missing small cancer. Ultrasound is also a potential screening tool for asymptomatic and low-risk younger women (less than 40 years old).

What To Expect During Mammogram?

breast cancer

1

During mammogram, you will be asked to undress from the waist up and stand facing the mammogram imaging machine

2

A mammogram technician will carefully position one breast at a time between two imaging plates

3

The imaging plates will then gradually compress the breast. The same steps are then repeated to the next breast

4

Some women find this step uncomfortable, but breast compression allows for the most accurate readings and results

5

The pain experienced from mammogram varies from one person to another. Most woman experienced little discomfort rather than actual pain

5 Tips to Minimise Pain During Mammogram

The 7-Day-Rule

The 7-Day Rule

Your breasts are more sensitive a week before and during your menstruation days due to hormonal changes. To minimise pain, schedule your appointment when these hormonal changes are least likely to bother you, about 7 days before and 7 days after your first day of menstruation

Eat less salty food

Eat less salty food

Salty foods increase your body’s water retention including the breasts. Bloated breasts are more at risk of discomfort or pain during compression. Try to reduce the amount of salt in your food a week before your appointment.

Steer clear of caffeine for a day or two

Steer clear of caffeine for a day or two

Similarly, caffeine can potentially cause bloating. Avoid drinking your usual coffee, tea or caffeinated soft drinks. If you still need your daily coffee routine, switch to de-caffeinated options

Painkiller

Painkiller

You may consider taking an over-the-counter painkiller 45 to 60 minutes before your appointment to lessen the discomfort you may feel. Do not apply topical numbing creams or lotions as this may interfere with the diagnostic accuracy of the mammogram

R-E-L-A-X

R-E-L-A-X

When you are nervous, your body will be tensed. The tenser your body is, the less comfortable appointment. Keep your body relaxed by practicing calming techniques, like listening to relaxing music whilst waiting or breathing exercises

The 7-Day-Rule

The 7-Day Rule

Your breasts are more sensitive a week before and during your menstruation days due to hormonal changes. To minimise pain, schedule your appointment when these hormonal changes are least likely to bother you, about 7 days before and 7 days after your first day of menstruation

Eat less salty food

Eat less salty food

Salty foods increase your body’s water retention including the breasts. Bloated breasts are more at risk of discomfort or pain during compression. Try to reduce the amount of salt in your food a week before your appointment.

Steer clear of caffeine for a day or two

Steer clear of caffeine for a day or two

Similarly, caffeine can potentially cause bloating. Avoid drinking your usual coffee, tea or caffeinated soft drinks. If you still need your daily coffee routine, switch to de-caffeinated options

Painkiller

Painkiller

You may consider taking an over-the-counter painkiller 45 to 60 minutes before your appointment to lessen the discomfort you may feel. Do not apply topical numbing creams or lotions as this may interfere with the diagnostic accuracy of the mammogram

R-E-L-A-X

R-E-L-A-X

When you are nervous, your body will be tensed. The tenser your body is, the less comfortable appointment. Keep your body relaxed by practicing calming techniques, like listening to relaxing music whilst waiting or breathing exercises

The take-home message is, that we as a woman need to put our health concerns at a higher priority than our sense of anxiety towards mammograms. Mammograms significantly increase our chance of defeating breast cancer.

Early detection of breast cancer is worth more than the possible short moments of discomfort some may experience during a mammogram. After all, we are women, born to be strong and brave.

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