Breast Cancer: Knowing is Half the Battle

My grandmother had breast cancer. She lived till the age of 79. She died of pneumonia. She was diagnosed at 60. She had a mastectomy and chemotherapy and she lived on for another 19 years. I think the key to her long survival was early detection.

http://breastcancerpain.com

We all know that breast cancer is still the number one cancer in women. But like my grandmother, this should not make us live in fear.  We should be proactive.

So what, if breast cancer kills 400,000 women each year.

So what, if 1.4 million new cases are diagnosed every year.

You, me or your sister may be one of them but the important thing is to catch it early, nip it on the bud and move on.

 

How to check for breast cancer?

The World Health Organization NO longer recommends a self-breast examination. I repeat … doing a self-breast examination is NOT enough to catch breast cancer. If a tumor is large enough that your hand can feel it, it means you’ve had it for 1 to 4 years. And, it could be in its advanced stages already.

The gold standard for screening for breast cancer is still the Mammogram. It can detect cancer even before the mass is felt by the examining hand.

There are now two types of Mammograms: Traditional Film Mammogram and Full-Field Digital Mammogram.

Both methods use radiation and both will still cause some pain because the breasts have to be squeezed between two plates to take a radiographic photo. The difference is the manner of storage.

As in our old Kodak and Polaroid photos of yester-years, the film method uses negatives which tend to have artifacts, they take up so much storage space and can get misplaced in the hospital or at home. The digital, as the name implies, is digital. It can conveniently be stored, recopied and zoomed to magnify suspicious lesions. The downside is the price and availability.

In Makati Medical Center, digital mammography costs P2,800. They no longer offer the film mammogram. High Precision Laboratory offers the film mammogram at P900 but only in their Del Monte Branch. They still do not have the digital type.

Current data shows that film and digital mammograms have the same effectivity in detecting breast cancer. Digital mammogram has a slightly higher sensitivity in women with denser breasts and women at ages 40-49.

When doing a mammogram, remember that the tighter the squeeze, the more accurate the image. So a little sacrifice can be life-saving.

Next choice is the ultrasound or sonomammogram. It is less painful. Much like the ultrasound one gets on a pregnant tummy, the technician applies gel all over both breasts and sound waves are used to detect masses or cysts.

Since the sonomammogram is less painful, why can’t I get this instead? It is not that accurate. Yes, it can detect masses and cysts. But it tends to over diagnose cysts leading to a high incidence of false-positives. Many patients end up getting a biopsy done even if it is not necessary. And, sonomammograms cannot detect “calcifications” which can be early signs of cancer.

Sonomammogram costs P2,700 at Makati Medical Center and P1,300 at all branches of High Precision Laboratories.

When should I start getting a mammogram?

The recommendation for women 40-69 years old is a mammogram every year. This is then tapered to every two years once you hit 70 because tumors are slow-growing by then. Doing a yearly test at that age is unnecessary since you also want to avoid too much radiation exposure.

At times, I get a report on the mammogram saying …”The breasts are too dense it lowers the sensitivity of the mammogram. Please do a sonomammogram.”

This simply means that the patient’s breasts are still “full” or dense so the x-ray cannot penetrate the tissues and it cannot say for sure if there are no tumors hiding in the tissues.

This often happens to women who are in their 40’s to early 50’s. For these women, I make it a habit to give them two requests right away since I am almost 100% sure that they will be asked to come back anyway to do a repeat sonomammogram. It’s a waste of the patient’s time to keep her coming back to fall in line and undress in front of the technician, so why not do both at the same time.

Please also take note of your menstrual cycle when doing a mammogram. The breasts become normally lumpy 10-14 days before your next period. Doing a mammogram or sonogram on these dates might cause undue stress on your part because the result will reveal sometimes 10, even 20 cysts on both breasts! These are not permanent. They will disappear once you get your period. Therefore, to avoid this undue anxiety: Get your tests done on the 8th to 10th day of your cycle, Day 1 being the first day of your period. Got it?

What the results mean?

The final interpretation of the mammogram will have a Birads Score. This is not the same as a “stage” of cancer. This score simply tells us when to do the next mammogram.

Birads 0: means Incomplete (A repeat mammogram or sonogram is  necessary)

Birads 1: Negative (No abnormalities seen, repeat mammogram next year)

Birads 2: Benign (Yes , there is a cyst but it does not look cancerous, repeat next year)

Birads 3: Probably Benign (Yes, there is a cyst, but I am only 98% sure it’s benign, repeat after 6 months)

Birads 4: Suspicious Abnormality (There is a mass, it does not fulfill the classic characteristics of cancer, but it has a small to large chance [3-94%] of being cancer, please do a biopsy)

Birads 5: Highly Suspicious (Mass has a high chance [>95%] of being cancer, please do a biopsy ASAP)

Birads 6: Known Malignancy Proven by Biopsy (Cancer has been proven by previous biopsy, this mammogram is being done to check the extent of disease and surgery, make sure that final treatment will be done ASAP)

Finally, what to do if it is the big C?

Bad news: surgery is the only option acceptable in the medical field. I would recommend that you see a breast specialist.

Good news: both of the breast “guys” that I would recommend are girls:

Dr. Aldine Basa Asian Hospital Room 519 MWF 2-4pm Call 771-9293

Dr. Diana Cua Makati Medical Center Room 356 Circular Tower 1 Call 8888-999  loc 2356

Naturopaths and herbalists are fine, I have nothing against them. In fact, I recommend them for myomas and other BENIGN, non-cancerous cysts. But evidence-based medicine and personal experience from my patients show that they don’t work. Cancer is very aggressive. All of my patients who tried herbal medication first ended up also having surgery and the time delay aggravated the condition.

Please be vigilant and aware. Breast cancer is a silent killer. But early detection and treatment can help you live a long and fruitful life!

Live healthy! Live happy!

Doc D

 

 

 

 

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4 Comments

  1. filipinamd says:

    hello Doc,

    I am 42 years old and I recently felt a bukol on my right breast but I am so scared to see a Doctor. There are times that the bukol gets so big and there are times that you wont feel it. sometimes I can feel pain but not worst than what you feel before a period. and I have been reading about symptoms and anything about breast cancer. i check it everyday and I dont think it moves and i dont have kulani on my armpits either. I am thinking about seeing a Doctor on November, Can you recommend anyone in Baguio, and how much do you reccon it cost for a mammogram? Thank you very much.

    E.

  2. filipinamd says:

    Dear E,

    I know you must be so worried about your lump. Your “consuelo” is that if that lump is cancerous then it will not “come-and-go” as you describe. A cancerous lump will not go away. It is usually permanent on one part of the breast and it may even be enlarging.

    But please do not rely on my “on-line” advice. The best is still to see a doctor and have it examined. Unfortunately, I have no surgeon friend in Baguio.

    What I do know is that a mammogram here in Manila at High Precision Lab costs P900.

    Please do not delay E, see a doctor today!

    Doc D.

  3. Jhoey D says:

    Hi Doc!

    I must have seen you before at MMC, I’m a patient of Dr. Panlilio and Dr. Custodio, the (youngest patient I think of Breast Cancer, hehehe.) Just want to share this, I’m already done with the 6 cycles of chemo, and I’m now taking oral chemo theraphy. I agree with the early detection, I am just 24 years old when I Detected the cyst, and it is already in Stage II-A. Already had MRM. So to all the girls and the guys outthere, please see a doctor asap if you feel a lump on your breast. Thank’s Doc, for inspiring message. God Bless. ^_^

    • filipinamd says:

      Dear J,

      My heart goes out to you. I admire your strength and love for life! I can feel it through your words. Cancer should not defeat you, YOU should defeat cancer!
      Good luck to you J. Thank you for sharing your personal experience.

      Doc D