When to get that mammogram
40, 45 or 50? Know what are the guiding principles for screening
Women are advised mammograms every year after 40. But some studies say physical exams are enough. What is advisable? Dr Ramesh Sarin, senior consultant, surgical oncologist, Indraprastha Apollo Hospitals, says: “Regarding mammogram recommendations, there is an ongoing debate in the medical community. While many organisations advise annual mammograms for women over 40, some studies suggest physical exams may be sufficient for certain groups. The American Cancer Society recommends annual mammograms starting at 45, while the US Preventive Services Task Force suggests biennial screening from 50. Ultimately, the decision should be personalised, based on individual risk factors, family history, and personal preferences. Women should consult their healthcare providers to determine the most appropriate screening schedule. Factors like breast density, genetic predisposition, high risk factors and overall health play crucial roles in this decision. It is important to note that while physical exams are valuable, they may not detect early-stage cancers as effectively as mammograms. Regular self-exams, combined with clinical breast exams and appropriate imaging, form a comprehensive approach to breast health monitoring.
Which kind of mammograms are advised — 2D or 3D?
3D mammography (tomosynthesis) is increasingly recommended over traditional 2D mammograms. 3D mammograms provide multiple images of breast tissue layers, offering a more detailed view and potentially reducing false positives and callback rates. This technology is particularly beneficial for women with dense breast tissue, where traditional mammograms may be less effective. 3D mammograms can detect smaller tumours and provide clearer images of overlapping tissue, leading to earlier detection and more accurate diagnoses. However, 3D mammograms may not be universally available and can be more expensive. Some facilities offer combo 2D/3D mammograms for comprehensive screening. While 3D mammography is becoming the preferred option in many clinical settings, 2D mammograms remain an effective screening tool. The choice between 2D and 3D often depends on availability, insurance coverage, and individual risk factors. 2D and 3D together gives slightly increased risk of radiation but let your doctor decide the need for 3D.
What are warning signs to see a doctor regarding breast cancer?
Warning signs for breast cancer that warrant immediate medical attention include a new lump or mass in the breast or underarm area, thickening or swelling of part of the breast, skin irritation or dimpling, breast or nipple pain, nipple retraction (turning inward), redness or flaky skin in the nipple area or breast, nipple discharge other than breast milk, and any change in the size or shape of the breast. It is crucial to note that these symptoms don’t necessarily indicate cancer but should be evaluated promptly.
Regular self-exams can help women become familiar with their normal breast tissue, making it easier to detect changes. Unusual persistent pain, changes in skin texture (like puckering or orange peel appearance), and swollen lymph nodes under the arm or around the collarbone are also concerning signs. Any unexplained changes lasting more than a few weeks must be brought to a healthcare provider’s attention.
AI is said to be a better diagnostic for breast cancer. Is it available in India, where and in what form?
AI-assisted breast cancer diagnostics are emerging in India, but widespread availability is still limited. Some major hospitals and diagnostic centres in metropolitan areas have begun incorporating AI algorithms into their mammogram interpretation processes. These AI tools are typically used as a second reader to assist radiologists, potentially improving detection rates and reducing false positives. In India, AI in breast cancer diagnostics is primarily found in the form of software integrated with existing mammography equipment. Companies like Niramai have developed AI-based thermal imaging technology for breast cancer screening, which is being piloted in some Indian healthcare facilities. However, it is important to note that AI diagnostics are not yet standard practice across India and are mainly available in urban centers and larger healthcare institutions. Patients interested in AI-assisted diagnostics should enquire with major hospitals or specialised cancer centers in cities like Mumbai, Delhi, Bengaluru, and Chennai for the most up-to-date availability.
