By Dr Bertha Woon

Many people think that mammogram alone is sufficient to diagnose breast cancer. In fact, there are many different subtypes of breast cancer. Some are seen only on ultrasound breasts and not on mammogram. Some are seen on MRI but not visible on mammogram and ultrasound breasts. There is also a misconception that only women aged 40 and above require mammographic screening. In fact, women who are at a high risk of developing breast cancer should be screened earlier.

Every October, which is Breast Cancer awareness month, there are discounts for mammograms at X-ray departments. Many people take advantage of the discounts to go for screening mammograms. Women who are fearful of pain avoid it. However, this fear is unfounded because the pain lasts only a few seconds and experienced technicians position patients well to minimize the pain experienced.

Early detection increases cure rates. Below are four examples of husbands and best friends who assisted in getting patients to be diagnosed and treated in a timely fashion.

Couple A came to see me because Mr A said that his wife’s breast consistency was different. Mrs A thought that she was born this way and wanted to delay the consultation. However, Mr A persisted. Physical examination was as he said: the left breast was firmer than the right. Mammogram and ultrasound were normal. However, MRI Breasts showed that Mrs A had DCIS – ductal carcinoma in situ, stage 0 breast cancer. Mrs A was cured after skin-sparing mastectomy with immediate reconstruction. She did not require any chemotherapy nor radiotherapy because she was diagnosed at stage zero.

Mrs B had a normal mammogram and ultrasound breasts in July this year. However, in September, Mr B felt a lump on the right breast. Mrs B didn’t want to see a breast surgeon because she just had a normal examination in July. However, Mr B insisted that she had a check up. This turned out to be a good thing because she was diagnosed with stage 2 Breast cancer. If Mr B had not insisted, Mrs B would have delayed and her cancer would have spread if she had waited for her yearly follow-up.

Mrs C is a shy woman who had macerated tissue on her left breast for a few months accompanied by a bad smell for several months. She was fearful of seeing doctors and had isolated herself from her husband, who was bewildered as to why he was sent to the dog house. One day, she started bleeding through to her blouse, and her husband rushed her to see me. I urgently referred her to radiotherapy. Thanks to her husband, she was diagnosed and treated in time and is still alive today.

Mdm D is a lovely woman who accompanied her friend to mammographic screening. While there, her friend suggested that she should also undergo mammogram and ultrasound breasts since she was there already. Mdm D decided to spend the money on screening. As it turned out, the best friend was normal but Mdm D had a non-palpable 0.5 cm diameter cancer detected only on ultrasound and not on mammogram. Her good turn for her good friend, and her willingness to spend “unnecessary money”, saved her.

Relatives and friends are not only important during diagnosis, but also during the treatment process: surgery, chemotherapy, radiotherapy, and in the post-recovery period. Breast cancer patients usually have difficulty accepting the diagnosis at the beginning. Friends and relatives help to absorb and digest information, help them take notes, ask relevant questions and make decisions on their treatment. In my experience, patients with supportive husbands and relatives and friends do very well.