Myths and misconceptions on mammograms still rife online

Breast cancer is one of the most common forms of cancer globally – in 2016 alone, 297 cases of breast cancer were reported, according to the Malta National Cancer Registry.

Mammograms are a critical part of diagnosing breast cancer; it is the process of using low-energy X-rays to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic massed, or microcalcifications.

In Malta, since the start of the national programme of breast screening in 2009, 80,000 mammograms have been performed.

In 2019 Malta had the best results for breast cancer treatment in Europe, with 87% of Maltese women who were treated for breast cancer surviving the disease – after operations and treatment, and with 87% being cleared safely from the disease after five years.

Health minister Chris Fearne said that the results gave a strong message of “hope to all Maltese patients.”

Mater Dei Hospital Radiologist Salvina Zrinzo, who specialises in breast imaging, says many misconceptions are still circulating, predominately online, that may deter women from seeking out the life-saving procedure in the wake of Breast Cancer Awareness month.

One of the most common misconceptions is that mammograms are painful – however, Zrinzo said that wasn’t necessarily true.

“Mammograms shouldn’t be painful, however, it does tend to depend on the equipment that is used, as well as the doctor that performs the procedure.” She said that communication between doctor and patient was key, adding that the temperature of the room played its own part.

Another misconception that Zrinzo debunked was the age in which a person should start getting regular mammograms. She highlighted that despite the government scheme, recommending that women should start screening from 50 onwards, in reality women should start screening for breast cancer from 40 onwards, even if they do not have a history of breast cancer in the family.

Zrinzo said that while breast cancer in women aged 40 to 50 was uncommon, when it did present, it was usually more aggressive due to the young age of the patient – and that the earlier a diagnosis was made the higher the survival rate.

“It’s a big myth that if you don’t have a genetic history, as well as having no symptoms, you don’t need to get a mammogram routinely – the majority of patients who have had breast cancer do not have a genetic predisposition. Genes are complicated, and you never know what genetic make-up your mother and father are going to produce,” Zrinzo said.  

She warned that it was important to understand that mammograms weren’t 100% effective. “Mammograms are accurate about 70% of the time, that’s why we usually accompany it with an ultrasound which brings that up to about a 95% accuracy.”

Radiation has also caused controversy, with many fearing that the effects on the body posed to a high of a risk. However, while Zrinzo did agree that radiation was harmful, she highlighted that with new equipment the risks were less. “For us, the benefits outway the dangers – however, it has a lot to with breast density,” which Zrinzo said tended to be less dense over the age of 40.

Zrinzo said that because of the risks they wouldn’t recommend a mammogram for anyone under the age of 40 – and that their first port of call would always be an ultrasound. She added that even for women over 40, multiple mammograms would normally not be performed in a short amount of time. “I would never perform two mammograms right after each other unnecessarily. However, it can be unavoidable in cases where further evaluation was needed.”

Zrinzo said that the guidelines recommended that women from 40 to 55-years-old should have a mammogram performed once a year. While women from 55 to 70-years-old should have a mammogram performed every year and a half. After 70, she recommended, that if the patient was healthy, it was worth keeping up with routine check-ups.

“If someone is worried about breast cancer – they should speak to their doctor and ask about genetic testing to see if they have a genetic predisposition – if that is the case then they will then be recommended how best to proceed by a medical professional,” Zrinzo said.