Friday, April 15, 2016

Screening Mammogram, One Step Away From Breast Cancer

The Mammogram machine

In the past two weeks, I have done two visits for my regular well woman examinations.  Last Friday was the pap-smear procedure, and this Friday morning was the mammogram procedure. I have been doing a routine pap smear  since I had a baby over nine years ago, and the mammogram since I turned 40, two years ago.

In America, breast cancer is considered as the number two killer in women after heart disease. Therefore; doctors, the government, the American Breast cancer foundation, and health providers have been boosting awareness in encouraging women, especially those who have breast cancer history in their family and women over 40, to get routine mammogram screening.

My mother had a history of cyst when she was 40 years old and it was removed from her breast. Less than two years after that, I discovered that I had the same diagnosed when I was only 17 years old. I first discovered a little lump on my right breast when I was 16 years old but I was too embarrassed to tell anyone. Not until a year later, I realized the lump became bigger, I freaked out and I told my mom. She rushed me to see a doctor the next day and I went on surgery two days after that. Both of us are very grateful that the cyst is not cancerous. I remembered how scared my mother and I were at that time. I think she was scared and concerned more for me than she ever had for herself. At some point, she felt guilty, thinking she's the one who passed it onto me.

What are the risk of Asian woman like me to get breast cancer? In the past, breast cancer occurred less in Asian women compared to Western women, and research says the reasons might be because Asian women tend to eat more fresh vegetables, they are able to maintain their weight, they exercise more and they drink less alcohol and they do not smoke.
Based on the studies done by global Breast Cancer Association, breast cancer is now being diagnosed frequently among Asian women, especially among younger women. The possible increase in breast cancer diagnoses among Asian women can be caused by:

1. More younger women in Asia adopting typical Western diet and life style
2. Environmental factors such as higher levels of pollutions as a result of rapid industrial growth
3. 70% of women in Asia don't get regular mammograms.

Being Asian myself and having to hear many stories about friends of a friend in Indonesia who got defeated by breast cancer, has raised me a concern. When I was in college, that was back in 1995, a mother of my friend died after a long battle with breast cancer. That was the first victim of breast cancer that I knew and since then, I heard more and more stories about friends and friends of friends who lost their battle to breast cancer.

At my mammogram appointment this morning,  I met a woman, maybe a few years older than me, who was diagnosed with breast cancer. When I got back home, I've decided to share a little information about the importance of routine mammogram for our well being and hopefully in a different occasion I can share the importance of cervical screening. This writing is done especially for you, my fellow Indonesian women. Those of us in Indonesia mostly are not well aware of the importance of the cervical and breast screening.

The dressing room before I headed to the mammogram lab

Screening Mammogram

What is it? A screening mammogram is an X-ray of the breast cancer that is given to woman who has no clear signs of symptoms of breast cancer. It is important to distinguish between screening mammogram and diagnostic mammograms. Diagnostic mammograms are used to diagnose women who have specific signs or symptoms. Any woman who notices a lump in her breast, discharge from the nipple, or other skin changes on her breasts should seek care as soon as possible, and not wait for a routine screening mammogram or physical exam.

Who should get screening mammogram?

Women at higher risk of breast cancer, such as those with a personal history of breast cancer, or an abnormal biopsy result, should have a screening mammogram every year.  Women who has personally history of breast cancer (mother, sister or daughter) should have screening mammogram  as early as age 35. Women with no high risk of breast cancer should have routine screening mammogram, every two year, when they reach the age of 40. You should always ask and please please never hesitate or be embarrassed to tell your doctor if you find something unusual is happening to your breasts.

What are the benefits screening mammogram?
Screening mammogram can help find abnormal changes in the breast even before a lump is large enough to be felt by a breast exam. Finding breast cancer early allows a woman to get treatment before the cancer spreads to other parts of the body. When breast cancer is found early, it can often be treated without taking out the entire breast or lamps nodes near it, or without the use of chemotherapy.

Is there a harm of screening mammogram?
Like many other screenings, mammograms are not always 100 percent correct. Sometimes mammogram find lumps that will never turn into cancer, and sometimes mammogram miss lumps that really are cancer.
When mammogram find lumps that are not cancerous, the worst that can happen to women are anxiety, fear, worry, discomfort and inconvenient but after all that drama, we can only be grateful with big sigh of relief.
When mammogram miss lumps that really are cancer, this can turn into the scary part. According to my Ob-Gyn, the tissue in the breast of younger women age 40-49 are thicker, so lumps are harder to see. Mammography fails to find about 25% of the breast lump of women at this age. Many women in their forties whose mammography results are negative may get a false sense of security that makes them pay less attention to important changes in their breast.
My Ob-Gyn also told me that my breasts are lumpy, but that does not mean I have breast cancer. Some women's breast are like that. So in the past two mammograms I had since I turned 40, they always had to do the screening (certain angle when they took the X-ray of my breasts) more than once, which I found to be inconvenient but I'd rather have them do that to be sure. I certainly don't want them to miss anything.

Is there other breast cancer detection methods?

According to my Ob-Gyn (yes people, I ask awful lots of questions when I saw my Ob-Gyn, and I often miss some), there are other types of detection methods. They are Breast Self Examination and Clinical Breast Examination.

Breast Self Examination involves feeling, looking at, and checking your own breast to find changes or lumps that maybe breast cancer. The best time to examine your breast for women who still menstruate is 7 days after your menstruation starts. Your breasts are least tender and least swollen at this time. If you no longer have menstruations, or if you are pregnant, you should pick a day such as the first day of the month - to remind yourself to examine your breast. If you are breastfeeding, pick a day such as the first day of the month after you have expressed your milk. Your breast are the least enlarge at that time. For more information on how to do your own breast self examination, please go online.

Clinical Breasts Examination is an examination done on your breasts by health care professionals such as your Ob-Gyn as part of your regular medical check-up. This examination should be done by health care professional well trained in the technique.

Indonesia has been positioned as one of the country with the increasing diagnosed of breast and cervical cancer by World Health Organization (WHO) and I don't think this is something that we should take lightly. Because the number of breast cancer in Indonesia and among Asian women are increasing, the government and health care systems need to boost awareness of breast cancer risk and the importance of annual screening. If you are women over 40 or if you are younger than 40 but you have history of breast cancer in your family, or you suspect something unusual with your breast, please do NOT hesitate to see your doctor. Don't be like me when I was 17. I was dumb and not very knowledgeable.

Breast cancer no longer picks their victims, it can happen to anyone. No matter what your ethnicity is or where you live, or no matter how old you are or how healthy you think you are, there are steps you can take to lower your breast cancer risk or to catch it early. Some Indonesian women and Asian women in general are tend to be shy away especially when it comes to discussing our women's health issues with our doctors. We think it is too private to discuss. Let's change that habit. Do it for yourself, or at least do it for the people you love. And don't forget, eat healthy (I need to keep reminding myself about this habit as well).

Have you scheduled your next mammogram or pap smear appointment yet?

In the left corner is where I was being screened this morning


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