What Does My Abnormal Mammogram Result Mean?

Most women would find getting a mammogram uneventful with an estimated 10% of women needing further follow-up tests. Every eight out of 10 women reached out for follow-up tests found no presence of breast cancer. 1 In majority of the cases, the follow-up tests find normal healthy breast tissue or benign non-cancerous breast conditions. According to Breast Screen Singapore (BSS), for every 1,000 Singaporean women who are screened for breast cancer, about 100 women are reached out for further assessment. Amongst this group of women, about 30 would be required to do a breast biopsy and about five to eight women would find that they have breast cancer. Thus, if you receive an abnormal mammogram result, it is important for you to see a doctor who can recommend the next course of action required.  The doctor may order additional imaging scans to better identify the abnormal findings. These scans can include one or more of the following: Diagnostic Mammogram This second mammogram will be more detailed and may take longer than the initial mammogram. If any of the X-ray images of your breast from the first mammogram are not clear enough, the technician will take more X- rays of specific areas of your breasts, especially the areas that are of particular concern. X-rays of specific breast areas will be taken with higher magnification or cone compression views for more detailed images to determine the presence of any breast cancer. A 3D mammogram may be done coupled with an ultrasound. Learn more about the benefits of a 3D mammogram. Breast Ultrasound The ultrasound of the breast works by picking up on the echoes produced by the high-frequency sound waves to generate an image of the tissues and the internal structures of the breasts on the computer. A breast ultrasound is a useful test for women with denser breasts. During the breast ultrasound, the technician will apply a gel on your breasts and then place a small device called a transducer on it to create images of your breast tissues. This is a painless test and it does not expose you to radiation. Magnetic Resonance Imaging (MRI) A breast MRI takes detailed images of the tissues and the internal structures of the breast. It is recommended for women who have a high risk of breast cancer, for instance, with a family history of breast cancer or presence of a hereditary breast cancer genome. After evaluating the results of these tests, your doctor will be able to advise you. Here are the three possible scenarios: 1.    The abnormal finding was nothing to worry about. Your doctor may recommend you to return to your regular screening routine. 2.    There is nothing to worry about. However, your doctor may advise you to repeat in four to six months’ time for a closer follow-up to monitor any potential changes in the breast tissues over that period of time. 3.    Breast cancer is not ruled out. The breast specialist may recommend a breast biopsy. Breast Biopsy A breast biopsy is a procedure where a small sample of tissue from your breast is removed and examined for breast cancer cells. This can be done via fine-needle aspiration biopsy, core needle biopsy, stereotactic biopsy or surgical biopsy. After the procedure, the sample tissue will be sent to the pathologist for examination. If the result returns negative or benign, no breast cancer is detected. Your breast specialist will advise you on when to have your next mammogram and whether you need any follow-up assessments. If the result returns positive and breast cancer is detected, your breast specialist will discuss treatment options with you. Received an abnormal mammogram result and not sure what is the right action to take next? Our breast specialists at Solis Breast Care and Surgery Centre will guide you every step of the way. Book an appointment with us now here. Solis Breast Care and Surgery Centre is a one-stop assessment centre that focuses on breast care and health. Our services include screening, diagnosis, procedures, surgery and post-care. In collaboration with Luma Women’s Imaging Centre, we offer bespoke breast care and women’s imaging. Solis Breast Care and Surgery Centre partners Luma Women’s Imaging Centre and offers 3D Mammograms as part of its breast screening services. Article contributed and reviewed by Solis Breast Care and Surgery Centre and Luma Women’s Imaging Centre.
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Hold On – Do I Really Need A Biopsy?

Mammograms are used to detect signs of breast cancer, which is the top cancer affecting women in Singapore. Here, most mammograms are conducted in 2D, where two X-ray pictures are taken of each breast from two different angles. Sometimes, these images show breast abnormalities, but they may not be clear enough to distinguish between breast cancer and benign tumours. In cases like these, to confirm or dismiss the suspicion of breast cancer, doctors may recommend additional scans or conduct a biopsy, which is a procedure to extract a sample of breast tissue for testing. There are several types of biopsy procedures which the breast surgeon would recommend based on a few considerations such as the size and location of the suspicious area; the number of suspicious areas, and how suspicious it looks on the scan image. A core needle biopsy uses a larger gauge needle to collect samples about the size of a rice grain, while a vacuum assisted biopsy may be used to remove the abnormal area for assessment.  Sometimes, a lymph node biopsy may be required if irregularities are found under the arms. For bigger breast masses, an open surgical biopsy may be required. Most breast biopsies turn out to be benign, not cancerous. Biopsy may not be required A new technology called 3D mammography helps doctors capture multiple x-rays from different angles which are reconstructed by computer into digital images to create a 3D reconstruction of the breast. This provides clearer views of abnormalities within dense breast tissues. Greater clarity from a 3D mammogram reduces the number of false positives thereby decreasing the number of unnecessary biopsies. Be in control of your health It is important to see a doctor for further assessment if you received an abnormal mammogram report. It may not necessarily mean it is cancer. Gain clarity from a doctor on the next steps required to protect yourself against breast cancer. Solis Breast Care & Surgery Centre works with Luma Women’s Imaging to provide holistic and integrated breast care services. To increase the accuracy of the breast scan, ultrasound scans as well as a new diagnostic tool called MastoCheck can be used to help identify early-stage breast cancer. With MastoCheck, a small amount of blood is extracted to test for protein biomarkers that typically signal the presence of the disease. Solis Breast Care and Surgery Centre partners Luma Women’s Imaging Centre and offers 3D Mammograms as part of its breast screening services. Article contributed and reviewed by Solis Breast Care and Surgery Centre and Luma Women’s Imaging Centre.
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Protecting Yourself Against Breast Cancer

Breast cancer is one of the most common cancers among Singaporean women. More than 25 percent of all cancers diagnosed in women are breast cancers. According to the Singapore Cancer Registry Annual Report 2018, more than 2,000 women are diagnosed with breast cancer, and it accounts for an estimated 400 deaths each year. The chances of a Singaporean woman developing breast cancer in her lifetime is around 5 percent. Read on as we tell you what are the risk factors, signs and symptoms, early detection methods, the benefits of 3D mammograms and ways to prevent breast cancer. Let’s begin! Risk Factors Non-modifiable risk factors Age – Risk of breast cancer increases with age. Majority of women diagnosed with breast cancer are above 40 years of age although there are instances where younger women do get breast cancer Gender – Breast cancer also occurs in men, but they have a lower risk than women due to the female hormones’ oestrogen and progesterone. Men who do get diagnosed with breast cancer, most of the time only find out when it is at an advanced stage Hereditary – The two genes that have been identified with breast cancer are BRCA1 and BRCA2. If you have inherited either of these abnormal genes, you are likely to develop breast cancer Early menarche and late menopause – Early menstruation before the age of 12 and late menopause, after the age of 55, increases risk of breast cancer due to the prolonged hormonal exposure Having first child after the age of 35 History of previous breast cancer History of previous ovarian cancer  Modifiable risk factors Overweight and obesity – This is caused by high calorie and fat intake, coupled with a sedentary lifestyle. It ultimately results in higher levels of oestrogen in the body Excessive alcohol consumption Smoking Hormonal supplements – Oestrogen and progesterone supplements can increase risk of developing breast cancer. Post-menopausal women who use Hormone Replacement Therapy (HRT) increases their risk of breast cancer by 30% Signs and Symptoms Breast cancer is typically painless. When the cancer is first developing, you may not notice any symptoms. If you see any of these signs and symptoms, even if your recent mammogram showed normal findings, seek advice from a breast specialist immediately to get better clarity. The signs and symptoms include: ●      A lump or thickened skin in the breast ●      A change in size or shape of the breast ●      Changes to the skin over the breast such as red, dimpled or puckered skin ●      Persistent rash around the nipple ●      Blood discharges from the nipple ●      Abnormal discharges from the nipple ●      Retracted or inverted nipple (pulled inwards) The Singapore Cancer Society states that around 8 out of 10 lumps in the breast are benign or non-cancerous. The severity of the breast lumps can be categorised based on a woman’s age. Women 20 to 29 years of age – The breast lump is most of the time a fibroadenoma, non-cancerous in nature Women 30 to 39 years of age – The breast lump is mostly fibroadenoma or fibrocystic disease, non-cancerous. The outer area of the breast feels hard and is painful to touch Women aged 40 and above – Breast lumps in older women are mostly either breast cyst or breast cancer. The breast cyst is a fluid-filled lump which can be drained to remove the accumulated fluid Early Detection Self-examination If you are a woman aged 20 and older, it is recommended for you to perform a self-examination of your breasts for any signs of breast cancer once a month Raise your arms and as you lower them, press them firmly against your hips Inspect your skin, nipples and breasts for any abnormal changes Lie down and feel your breast and armpits for any lumps. Use the pads of your 3 middle fingers and move them in circular motions Gently squeeze your nipples for any bleeding or abnormal discharges You can do this when you are lying on the bed, in the shower or in front of a mirror. ●      3D Mammogram A mammogram is an X-ray of the breast to detect breast cancer early. If you are 40 years old and above, it is recommended for you to get a mammogram screening. It is the most reliable tool that is currently available to detect cancerous lumps before they can even be felt by hand. If you are aged 40-49, an annual screening is recommended. If you are aged 50 and above, it is recommended for you to get screened once in every two years. It is not advised for women below the age of 40. ●      Mammogram Ultrasound or Breast Ultrasound A breast ultrasound is more accurate in women aged 45 and younger. This imaging method of diagnosing breast cancer uses high frequency sound waves to generate an image of the tissues and internal structures of the breasts to find cancerous lumps. Consult your doctor on the benefits and limitations of going for a mammogram at this age. Note: Age recommendations are only guidelines and may differ for those with a family history of breast cancer or those who have other risk factors. Supplementary ultrasound may be ordered to increase accuracy of screening. Benefits of 3D Mammogram Accurate detection – 3D mammogram provides an estimated 300 images to create a 3D inner structure of the breast tissues. This helps to detect tumors easily. Even in dense or thick breast tissue, 3D mammography provides many angles to detect any lumps. In the conventional 2D mammogram, the thick breast tissue can cause shadows and hide the tumors from view Faster diagnosis of smaller cancers Lesser tests and anxiety – Since 3D mammogram is efficient in diagnosing breast cancer, this means that patients undergo lesser tests and experience less anxiety Safe and effective – Although getting a 3D mammogram exposes you a small amount of radiation, it has been determined that it imposes no additional risk. Researchers studying this radiation issue have found that the benefits of 3D mammograms outweigh far more than the risk associated with it. Prevention If you have a family history of breast cancer, it is recommended for you to start screening for breast cancer 10 years before the age, for example, your mother was when she was diagnosed with it Stay physically active and exercise regularly to suppress the secretion of oestrogen and reduce risk of breast cancer. This is also effective for young girls below 11 years to delay the onset of menstruation and exposure to oestrogen hormone Breastfeeding for more than a year helps to lower oestrogen levels in the body and reduce risk of breast cancer Eat a healthy diet Maintain a healthy weight Avoid alcohol Reference: https://www.singaporecancersociety.org.sg/learn-about-cancer/types-of-cancer/breast-cancer.html#overview https://www.singaporecancersociety.org.sg/get-screened/breast-cancer/mammogram.html#are-mammograms-painful https://www.singhealth.com.sg/patient-care/conditions-treatments/breast-cancer https://www.singhealth.com.sg/patient-care/conditions-treatments/breast-screening-self-exam-mammogram https://www.healthhub.sg/a-z/diseases-and-conditions/20/breastcancer https://www.ncis.com.sg/Cancer-Information/About-Cancer/Pages/Breast-Cancer.aspx Article contributed and reviewed by Solis Breast Care and Surgery Centre and Luma Women’s Imaging Centre.
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