Participant Profile & Analysis of the 2005 Mammogram Programme By State
A total of 612 women benefited from the programme. The distribution of participants were 40% from Terengganu and 60% from Johor. The programme was run in Johor from April to May 2005 while the Terengganu programme was run from September to December 2005.
 

87% were Chinese, 10.5% Malays, 1.8% Indians and less than 1% was from other ethnic groups. Much more needs to be done to reach the other ethnic groups. CoR's coordinator, Prof Dr Humairah, has reported that it takes great effort to encourage those in the rural areas in Terengganu to access the programme and it is imperative that education and outreach programmes continue.

There is obviously increased awareness amongst the Chinese since breast cancer in Malaysia has its highest incidence in the Chinese population (1 in 14 chance over the lifetime for getting breast cancer, compared to 1 in 24 for the Malays – National Cancer Registry 2002).
 

The mean age of the participants was 51 years while participants ranged from 35 years to 75 years of age! Discretion was exercised when the participant had breast symptoms and signs.

77.8% of participants were having their mammogram for the first time.

It is important that the first experience in mammography be a good one, otherwise the person may be put off another mammogram (perhaps a life-saving one) for the rest of her life.

Therefore, care must be taken to ensure the mammogram is performed by dedicated and trained lady radiographers. Interpretation by trained radiologists is also important in addition to the quality of the mammogram. Much can be done to allay anxiety of the procedure and also the results and this relies on skilled communication and care. 
 

Overall adjunct ultrasound (complementary to the mammogram) was done in 25.8% of the participants. However, there was great variability in the requirement for adjunct ultrasound between the various providers. Up to 57% of the participants in IIUM Breast Centre needed adjunct ultrasound. 

This could have been due to true variation in the type of breast density or abnormalities on the mammograms between the various centres or a difference in the threshold for use of ultrasound in complementing mammographic findings.
 

Only 7.4% of the participants had positive family history but none of these were found to have breast cancer at the time of this programme. 
 

90.2% of the mammograms were reported as either normal or had benign findings. This figure is similar to the past years' data.

7.4% were in the indeterminate group, while 0.8% were slightly suspicious and only 1.5% was highly suspicious. Of those that were highly suspicious – 3 eventually proved to be cancer on tissue sampling (biopsy). All 3 of these breast cancer proven participants were from Terengganu and had their mammograms at IIUM Breast Centre. For the other centres, one with highly suspicious mammogram findings had no follow up data at the time of this report. In the other case, the tissue sampling test (biopsy) proved to be non-cancerous while another has been referred to the surgeon and no further follow up information is available.

Proven Breast Cancers (on Tissue Diagnosis)
Four (4) participants were proven to have breast cancer. Three of them were Chinese, at 49, 55 and 59 years of age.

The 55-year old Malay lady with mammographic evidence of cancer has had a mastectomy. This lady had been on Hormone Replacement Therapy for 6 years.

All had no family history of breast cancer. The 55 year old Chinese lady never had children (nulliparous) while the rest had children. Two of them had breast fed their children. Again, our limited data shows that risk factors are not a big player in getting breast cancer and therefore, ALL women should be aware of their breasts!
 

Dr Humairah reported that most participants lauded the CMP and felt it was relevant, informative and helpful. The bad weather conditions hampered traveling from Terengganu especially in December. The Chinese were more responsive even though IIUM tried hard to recruit Malay participants. She attributed it to the more pro-active stance of Chinese women towards health awareness and maintenance. Dr Humairah in summing up said, “We should make greater efforts to target our campaign at the Malay communities and perhaps by involving their men folk in the awareness sessions, we could motivate them to come forward for their breast health checks!” 

She felt that the programme was effective and successful in introducing women to mammography for the first time. Many women expressed that their mammogram experience was not as painful or unpleasant as originally thought from information given by “friends”!!!
 

We need to reach out to the rural areas but our resources are limited. Healthcare professionals are encouraged to volunteer their services, especially if they are working in the rural areas or those parts of the country (such as in Sabah and Sarawak) where much still needs to be done. 

We are fortunate to have a volunteer in Sandakan for 2005/2006 and this year, we hope to take the CMP to Sabah again and even Sarawak. Together with our partners, we are also reaching out to Single Mums - yet another group that may need help to look into their breast health.

Breast Cancer Care Nursing is also not properly structured in Malaysia and together with our partners, National Cancer Society of Malaysia, Amanita, Edith Cowan University (Perth) and generous sponsors (BP Malaysia and Digi) an accredited module, the breast cancer nursing education course was successfully conducted in April 2006.

The Closing Ceremony of the course was graced by Yg Berbahagia, Datin Azrene Abdullah, Chairperson of PRIDE and the report of the course itself can be found here.
 

<<< Back to 2005 Subsidised Mammogram Programme Report

“Please don’t stop the subsidised mammogram programme!”


“The CoR Subsidised Mammogram
Programme has been much anticipated in
Johor as previously
many of our ladies had
to go to Singapore or other states in Malaysia for their mammograms. There are many who
were unable to access
the CMP in 2005 and we hope that the College of Radiology will run the programme in 2006 in Johor so that the others can access it at a subsidised rate. There are also those from
2005 who had abnormal mammograms who need a follow up in 2006. We will help to raise funds
to provide the subsidy if funds are inadequate.”

Ms Doris Wee, President of the Breast Cancer Support Group, Johor Bahru and also co-ordinator for the CMP2005 in Johor.

Thank you,
CoR MP!

“On 25^th August 2004,
I had my first mammogram and it showed I had breast cancer. I had not felt anything in my breasts
at all! I would not have thought about a mammogram if not for the College of Radiology’s breast
cancer awareness programmes and specifically the provision of mammograms at subsidised rates. Fortunately my friend
had heard about it and told me to go for one. I feel this is a good programme for creating awareness and also helping women to
access mammograms
by providing a subsidy. This programme should be ongoing!” - Mdm SL Ang, 57 years old and a retired civil servant.