Stephanie Fsadni learns that some women seem to be slipping through the net of breast cancer awareness campaigns. Malcolm Crockford reaches out to those who may not be exposed to the facts through the media and to girls in secondary and tertiary education

Many women are aware of the benefits of regular mammography nowadays, but some may still shy away from this procedure for fear of being told they have breast cancer, claims Malcolm Crockford from The Radiology Clinic.

“Sadly, when it does hit these ladies, it is often more advanced and this usually means more aggressive treatment and, possibly, even death,” he says.

According to Dr Crockford, this “natural fear” of being told of cancer needs to be handled by continued health promotion.

“Breast awareness has increased over the past 20 years due to a combination of private and government entities contributing to October’s Breast Awareness Month campaigns and local media, but there are females who still need to be targeted.”

He refers to women who may not be exposed to the facts about breast cancer transmitted through the media; and to girls in secondary and in tertiary education, who “need to be informed about breast care at an early age”.

Statistics show that one in eight women gets breast cancer and the incidence of this disease has increased steadily over the last 40 years, with no definite cause for this rise known

Dr Crockford is also concerned about certain misconceptions, including that the mammography process can hurt.

“This is not true. With the correct training of the female radiographers who carry out the mammogram – which is done in a quiet, relaxed atmosphere – most women will only feel a moment of pressure,” he maintains.

Another common misconception relates to the radiation dose: “With digital mammography, the radiation dose to the breast is almost zero and is half the cosmic radiation dose the woman receives from the sun for each year of her life here in Malta. It is true that the sun’s rays can produce a nice tan (sometimes skin cancer too!) but a minimal dose in mammography does save lives.”

Statistics show that one in eight women gets breast cancer and the incidence of this disease has increased steadily over the last 40 years, with no definite cause for this rise known.

Dr Crockford says that long lists of risk factors for breast cancer have been developed, but that these should only serve to try to encourage more women to present themselves for the test. Mammography can detect breast cancer up to 18 months before a lump is felt.

He also states that the decrease in the number of women dying from breast cancer in Malta over the last 10 years is mainly attributed to early detection by mammography.

Dr Crockford believes all women over the age of 35 years should undergo screening. He suggests this age for the first breast screening “since the incidence of breast cancer begins to increase steadily from the age of 34”.

Like many other cancers, however, this form of cancer is more common the older a woman gets.

“The chances of getting breast cancer peaks at around 70 years old, where it is around 40 times more common than at the age of 40. Unfortunately, it remains very common right up to passing away.

“No one knows what causes breast cancer but the older a woman gets, the more likely it is that the multiplication of the breast cells goes haywire and hence cancer cells develop.”

Dr Crockford also suggests that mammography is continued into mature age and stopped only if other conditions, like significant heart disease or strokes, impede one’s normal life. It should also be carried out regularly at 12 to 18 monthly intervals.

“A woman should not wait to feel a lump before she calls for an appointment,” he continues.

Dr Crockford is adamant that breast awareness campaigns need to be carried out throughout the whole year and not only in October.

“The Government is already providing a fairly comprehensive symptomatic breast service at Mater Dei and a screening service has also recently been introduced. The media should contain regular clips, and radio and television programmes relating to breast cancer should happen all through the year. Meanwhile, the private sector continues to develop its own services with new digital imaging and biopsy techniques that help to speed up diagnosis and take the pressure off the busy government services.”

He emphasises that the parties concerned need to keep putting across the message that all women are susceptible to breast cancer and it can still occur in a woman who chooses not to have a mammogram.

“I have all too often seen the panic of a woman just realising she has a breast cancer, which she could have picked up earlier, and her instant fear that her loved ones may not continue to rely on her presence and support.”

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