BLACK BREAST CANCER MAMMOGRAMS

MAMMOGRAM SCREENING

 

There are two types of mammograms
  1. Two dimensional (2D) – the traditional machine
  2. Three dimensional (3D) – A relatively new machine called Tomosynthesis (DBT)
 
TWO DIMENSIONAL (2D) TRADITIONAL MAMMOGRAMS
Mammogram machines are basically taking x-rays of your breast and this one can take 2 x-rays at the same time to get both sides of an image of breast tissue. These machines are good for identifying lumps that have already begun to develop. I think mine was 2cm size. Plus, my lump was slightly on the side of my breast, so I think it was relatively easy to find.
Sometimes the two x-rays can cross each other to give the impression that they can see a mass or calcification (deposits of calcium), that is not actually there. They call this a ‘false positive’. Mind you, you might still want a follow-up biopsy to double-check.
On other occasions, the potential lump can be so small, or the breast so dense as in young women with firm breasts, the mammogram simply cannot see it. This occurs 30 per cent of the time.
While this machine plays a crucial role in detecting early onset breast cancers, you must not over-rely on in especially if your instincts are saying something quite different to the results from this mammogram machine.
 
THREE DIMENSTIONAL (3) TOMOSYNTHESIS (DBT)
The DBT mammogram machine is relatively new but has the capability of seeing your breast tissue in much more detail. It combines multiple breast X-rays to create a three-dimensional picture of the breast. They are becoming the new gold standard for mammogram machines.
Specifically, DBT’s are much better at ‘seeing’ through dense tissue. So DBTs are used where there are no signs or symptoms of the disease, or where there are suspicions of a thickening of the skin (calcification) or a potential lump.
A studies in 2019 and 2021 revealed racial disparities exist in the type of screening mammography that women receive. Black women were less likely to receive a DBT mammogram, and less likely to be screened multiple times during the five-year period compared to white women. Make sure you ask to be breast screened with the DBT machine and DISCUSS THIS WITH YOUR DOCTOR IF NECESSARY.
 
WHAT DOES TAKING A MAMMOGRAM INVOLVE?
I’ve only had 2D mammograms, I think? Anyway, the best way I can describe it is to say it’s like putting your breast between two plates to have your breast squashed as flat as possible to make a pancake. I mean it. The flatter the breast the better the x-ray so I do try to co-operate but it’s not a comfortable experience. Reliability of the test may decrease depending upon the size of your breasts and the level of density to them. The bigger your breasts are, the greater the discomfort.
Basically, you sit there, and the machine works around you. The nurse sometimes moves your breast around like it’s a piece of meat to be moulded and shaped to fit in the machine more accurately, but it only takes a few minutes.
Just bear in mind that it is an x-ray, so you are being exposed to radiation. Have them as you need them but NOT if you don’t.
Also, if you have a swollen, tender breast mammograms might not be the best solution for you. There are alternatives so do not subject yourself to a level of unnecessary pain. Ultrasounds are reliable and might be better for you so DISCUSS THIS WITH YOUR DOCTOR but TAKE CONTROL!
 
WHEN SHOULD YOU HAVE A MAMMOGRAM?
One of the biggest reasons for our high mortality breast cancer rates is the late stage of our diagnosis. THIS IS A GLOBAL PROBLEM FOR BLACK WOMEN. By the time our breast cancer is found, it’s already advanced further than what it needed to. This doesn’t mean that it’s your fault but if you need encouragement to get yourself checked take a look at NAKED TRUTHS right now.
 
HOW BAD IS RADIATION FROM MAMMOGRAMS?
This is a highly contentious issue. Some experts say the level of exposure to radiation is minimal and relatively harmless.
“Radiotherapy can cause side effects, although many of these can be treated or prevented and most will pass after the treatment stops.
It’s difficult to predict what side effects you’ll get.
Side effects vary from person to person and depend on things such as the part of your body being treated and the type of radiotherapy you have. Ask your care team about the side effects you might get.”
NHS, UK Website, May, 2022
 
For people who receive low doses of radiation, the risk of cancer from radiation exposure is so small that it cannot be separated from exposure to chemicals, genetics, smoking, or diet.
– Cancer caused by radiation is not distinguishable from cancer caused by smoking or any other risk factor.
CDC, US Website,  May, 2022
 
On the other hand, there are a growing number of voices from all sides of the cancer spectrum expressing greater concerns for radiation exposure. For example,
“Mammography: Recent evidence indicates that the lower-energy X-rays provided by mammography resulted in substantially greater damage to DNA than would be predicted, and the effects of these exposures may be greatly underestimated when it comes to the risk of breast cancer.[33] For example, women who had multiple mammograms more than five years prior to diagnosis and started before age 35 had an increased risk of breast cancer.[34] Diagnostic radiation has been shown to increase risk for developing breast cancer in a dose-dependent manner for women who are BRCA positive and therefore more sensitive to radiation”.
Breast Cancer Prevention Partners, May 2022
 
SEE: THERMOGRAMS FOR A WIDER DISCUSSION OF THE ISSUES
 
WHY MAMMOGRAMS INSTEAD OF ULTRASOUND?
Ultrasound is good at evaluating surface lumps, but a mammogram is more able to detect deeper level abnormal lumps within the breast tissue.
Ultrasounds do not show microcalcifications – that’s tiny deposits of calcium in the breast – they accumulate around a tumor as the most common feature seen on a mammogram. 
 
ULTRASOUND SCANS DO NOT INVOLVE EXPOSURE TO RADIATION. 
There are no side effects and is normally pain-free except for the probe pressing over your skin or inserted into your body.
HERE’S THE ‘GLOBAL’ THING

 

  • CURRENT NATIONAL GUIDELINES FOR HAVING ANNUAL MAMMOGRAMS START AT AGE 50.
  • Black women younger than age 35 get breast cancer at TWICE THE RATE of white women and die from breast cancer THREE TIMES as often as white women.
  • WORLDWIDE, breast screening needs to be available at 35 years for young women of African Heritage. But remember, mammograms expose you to radiation and you don’t want to have radiation annually in your life for the next 30 odd years if you don’t need to. Risks can outweigh the benefits. 
  • However, most national mammogram guidelines in Western countries currently FAIL BLACK WOMEN even though it is internationally known through much research and publicity, that young black women are associated with aggressive breast cancers and late detection in the US, the UK and Europe.
  • In France, for example, the plight of black women is ignored with a nationwide breast cancer screening programme that aims to provide a mammogram, every two years, for at least 80 per cent of women aged 50 to 74 years.
  •  
    1. France follows the European Breast Guidelines but for a slightly earlier European age of 45 – 74 years.
    2. Based on CDC recommendations, annual mammograms begin in the US at 50 – 54 years.
    3. The NHS (UK) Breast Screening Programme invites all women from the age of 50 to 70for screening every 3 years. This means that some people may not have their first screening mammogram until they are 52 or 53 years.
 
In 2018, the Journal of the American College of Radiology recommended Black Women be added to the High-Risk Group for Breast Cancer. Other women at high risk on the list included:
 
  • Women with a gene mutation, such as a BRCA1 or BRCA2 linked to breast cancer
  • Women who previously had radiation to the chest or face
  • Women of Ashkenazi Jewish descent
  • Women with a strong family history of breast cancer, especially if a parent or sibling has been diagnosed
  • Women with a personal history of breast cancer
  • Women with dense breasts
  • Women with certain benign breast conditions
 
FOLLOWING THE DATA, BLACK WOMEN SHOULD BE PLACED ON THE HIGH-RISK LIST FOR BREAST CANCER IN EACH COUNTRY.
  • AFRICANS, CARIBBEAN AND INDIGENOUS PEOPLE HOME AND ABROAD, SHOULD BE GIVEN ADDITIONAL SUPPORT WITH A FOCUS ON EARLY DIAGNOSIS.
  • IF PINK RIBBON CHARITIES DO NOT SUPPORT THESE ABSOLUTE PRIORITIES WITH SOLID INVESTMENTS, DO NOT SUPPORT THEM. THEY PROBABLY NEED YOU MORE THAN YOU NEED THEM.
 
RADIATION EXPOSURE
Early detection is vital but with mammograms comes radiation exposure which can cause cancer. If you are in a high-risk group because you have Triple Negative Breast Cancer or the BRCA gene, for example, you could be invited to an annual mammogram from your early 30s.
 
MAKE A DISTINCTION BETWEEN EARLY DETECTION AND RADIATION EXPOSURE BEFORE YOU MAKE SUCH A LIFELONG COMMITMENT. MAMMOGRAMS PLAY AN IMPORTANT ROLE BUT CHECK OUT  ALTERNATIVE BREAST SCREENING METHODS TOO.
 
READ ABOUT THERMOGRAMS AND ULTRASOUND COMBINATIONS HERE TO CONSIDER YOUR WIDER OPTIONS.
 
CHECK OUT THE FOLLOWING:
  1. Men and Mammography
  2. Early Detection of Breast Cancer in Black Women
  3. Ghana Cancer Ward
  4. What to Expect During Your First Mammogram
  5. Mammograms in Jamaica
  6. The Promise (UK Documentary)
 

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