|
 A screening mammography is different from a diagnostic mammography. The former is reserved only for asymptomatic (without symptoms), well women with no breast problems or complaints such as nipple discharge or a breast lump. Women should also not be seeing a doctor for breast problems or be on medical follow-up for breast problems, to qualify for Medisave use.
Diagnostic mammography is used to investigate a woman who has a breast problem such as lumps, bloody nipple discharge and entails more views and other breast imaging tests, including ultrasound scans. The aim is to come up with a diagnosis, which may be breast cancer or benign lesions.
WHO SHOULD GO
A mammography is the best type of screening for breast cancer. BreastScreen Singapore, the national screening programme, recommends that women aged 50 and older be screened every two years. The Ministry of Health (MOH) is acting on the recommendations of the expert committee from the Academy of Medicine, Singapore, which conducted a review of health screening tests, including all available tests for breast cancer. Its findings indicated that for women aged 50 and above with normal risk, a mammography for breast cancer was backed by the best evidence.
CRITERIA FOR MEDISAVE USE
1. Be a Singapore resident aged 50 to 69 years.
2. Have not had a mammography for the last 24 months.
3. Have no breast symptoms or breast problems such as breast lumps or bloody nipple discharge.
4. Not be on medical follow-up for breast problems or seeing doctor for breast problems.
5. Not pregnant or breastfeeding.
HOW
-
Call a Medisave-approved clinic which offers mammography services to make an appointment.
-
The list of approved clinics will be out later this year.
-
No doctor’s referral is required.
-
No doctor’s imaging request forms will be entertained as one should not be seeing a doctor for breast problems to be eligible for such a screening.
-
Appointments are usually given within the first 10 days of the patient’s menstrual cycle.
-
Take with you any previous mammograms or breast ultrasound images for the appointment as they may be needed for comparison.
-
You may continue to take all food, drinks and medication on the day of the mammography.
-
Do not put powder on the breasts or armpits.
-
Do not wear any jewellery on your upper body.
-
Wear a blouse with a skirt or trousers instead of a dress. This makes it easier to undress for the screening.
On arrival, you will be asked to change into a hospital or a clinic gown. The female mammographer will interview you to ascertain if you have any breast problems, previous breast surgery or biopsy, a family history of breast cancer, if you are undergoing hormonal replacement therapy and also examine your breasts for lumps.
THE SCREENING
-
The mammography machine will take two X-ray views per breast.
-
The breast will be compressed with a plastic paddle just before an X-ray exposure is made.
-
You will feel tightness or discomfort for a few seconds. You will be asked to hold your breath and not move during these few seconds.
-
Firm breast compression is required because this results in a good quality mammographic image and reduces radiation dose to your breast.
-
The procedure takes less than half an hour.
-
You should get results within two to three weeks.
 WHAT DOCTORS LOOK OUT FOR
Radiologists are specially trained to look out for signs of breast cancer on mammograms such as suspicious masses, clustered microcalcifications (tiny specks of calcium deposits) and any distortion of the appearance of the breast. In screening mammography, benign lesions can be identified and will be ignored. If the radiologists spot anything suspicious, the patient will be referred for further tests.
COST
Under BreastScreen Singapore, based in polyclinics, subsidised mammography screening is available at $50. Women who fit the criteria can use Medisave to pay the $50 and do not have to pay cash. This is the most affordable way to get a screening. The cost varies at other radiology centres. The MOH will eventually accredit certain centres which fulfil the following:
-
quality assurance standards for screening mammography;
-
Medisave training and terms and conditions of Medisave use. These centres will be made known in due course but are likely to be hospital-based for the initial phase. The Medisave withdrawal limit for mammography is $300 a year. This is applicable for screenings done only in Singapore.
CALL
BreastScreen Singapore numbers:
Source: Dr Llewellyn Sim, the director of breast imaging at Singapore General Hospital’s department of diagnostic radiology, and Ministry of Health.
|