Is there a place where I go could for such a screening, not at subsidised prices, but where it is relatively cheaper than if I opt for the private hospitals? 

ML, 13 Nov 2002

A The breast is a sensitive organ and some sensation is expected especially in relation to the hormonal changes with each menstrual cycle. Get to know what your breast is made up of by reading the article “All About the Human Breast”

http://www.radiologymalaysia.org/breasthealth/Who/allabout.htm

With some understanding as to what your breast is made up off, it will help you to understand the changes that you experience. It is very subjective and extremely variable from woman to woman. 

The subsidised mammogram programme is targeted at poorer women who find it difficult to fork out the RM120 to RM165 (average price in private centres) for an annual mammogram. For those without symptoms, normally, a screening mammogram is only recommended after the age of 40 years.  

To run a subsidised mammogram programme (SMP), funds are needed. Therefore this programme can only be possible with generous donations from corporates and individuals.

The amount paid in a subsidised mammogram programme is about 30-50% of the usual price a person pays in a private centre. Reports on the first SMP in 2001 is available here:

http://www.radiologymalaysia.org/breasthealth/BCAC/2001Reports/index.htm 

Since the cost is really not exorbitant (compared to the cost of a facial, body massage or hair perm in a big city), and only needs to be done once a year for the average symptomless lady above the age of 40 years, it is actually affordable even without a subsidy, i.e. if you have “saved” for it regularly.  

Mammograms require specifically greater and more stringent quality control and many other factors to ensure that the films taken are of sufficient quality. It is best to contact the hospitals or mammogram centres most convenient to you and find out about their prices. Although just an overview, some of the factors to consider when choosing your centre can be found in this article:

http://www.radiologymalaysia.org/breasthealth/BreastImaging/choosing.htm

Editor
 

Aderline 29 Oct 2002

A Yes, due to the hormonal changes, most women have some “kind” of breast pain, discomfort or engorgement in one part or parts or the whole of the breasts. Most often, the pain is felt most just before the period is due. Sometimes, the breast may “enlarge” slightly just before the period and then, everything subsides after that.

It is best to become aware of your own menstrual cycle changes as well as how your breast looks and feels. Read more in the section on SBE at http://www.radiologymalaysia.org/breasthealth/SBE/index.htm 

Editor
 

Amy 26 Nov 2002

A The answer to your question is similar to that for EM’s query on her breast pain. In addition, you may find it helpful to read the following articles: 

http://www.radiologymalaysia.org/breasthealth/About/howcanitell.htm 

http://www.radiologymalaysia.org/breasthealth/YoungerWomen/lessthan35b.htm 

Editor
 

Since the year 2000 I could feel the pain in my right breast off and on. I went to my family doctor who is also a gynaecologist and was advised to have a mammogram done. The first was done on 25.11.2000 and the report says:

“There is a small well defined 4 mm nodule in the right breast quadrant at the axillary tail region been only in RML. It appears benign most likely due to hypertrophic lymph node or cyst or fibroadenoma.” I was recommended to have another mammo in  6 months to 1 year for further evaluation. The last time my mammo was done 5-10-2002 and the result was the same just that it was likely due to a lymph node. But what keeps nagging me is the breast pain that comes and goes off and on. My doctor gave me only painkillers .Please advise me for I am in a dilemma on the issue.   

EM, 4 Nov 2002

A The medicine given to you to stop the breast milk production in 1998 is not harmful to you and is not related to the current problem of breast pain. The mammogram reports suggest the small nodule on the right is a benign (non-cancerous) lesion. Again, at that size of 4mm, it is unlikely to be related to your breast pain. 

You have not stated exactly where the breast pain is, whether it is always in the same spot of your breast and what the nature of the pain is. From the information given, this breast pain is intermittent and only felt off and on. This is a very common symptom and many times, it is related to the changes in the breast due to hormonal changes during your regular menstrual cycles. The engorgement, distension related to hormonal changes can cause pain. Most times the pain is diffuse, comes and goes, and may be in different parts of the breast at different times.  When the pain is very severe, painkillers may help. It would be helpful to wear the right sized bra, and comfortable clothes during the times of the month when the breast pain is worse. Since you have already been investigated for your symptoms and they prove to be normal, it is very unlikely that your breast pain is due to cancer. However, do try to learn to be aware of your breast texture and appearance (which can be acquired through regular, systematic self breast examination (SBE)).

More information on SBE can be found at:

http://www.radiologymalaysia.org/breasthealth/SBE/index.htm 

You can read more about “non-cancerous” changes in the breast at:

http://www.radiologymalaysia.org/breasthealth/BM/PenyakitPayudara/kelainan.htm

Editor
 

Q  Saya selalu melakukan pemeriksaan payudara sendiri, tetapi tidak pernah memicit payudara. Baru-baru ini saya picit payudara saya ada keluar cairan/air berwarna jernih (clear in color). Adakah ini salah satu dari tanda kanser? Tolong jelaskan pada saya secepat mungkin, supaya saya dapat mengambil langkah yang sewajarnya.

Mama 24 Okt 2002

A Lelehan puting payudara selalunya adalah kerana kelainan bukan kanser. Walaubagaimanapun, saudari/puan perlu diperiksa dan bergantung kepada umur saudari/puan, anda mungkin memerlukan siasatan radiologi yang selanjutnya. Seperti yang tercatat di jawapan kepada soalan pembaca yang bertopik ”Kulit Puting Payudara pecah...”, secara amnya, surat rujukan ke Klinik Payudara kerajaan boleh didapati selepas berjumpa klinik pesakit luar kerajaan.

Pengarang
 

Q I am 32 years old. Two years ago I discovered a lump on my right breast. I had an operation and the biopsy result showed that it was a fibrodenomatosis (non malignant). However, six months later during SBE I discovered a few more lumps on the same breast. I went for another round of ultrasound and my surgeon assures me that they are benign lumps, therefore operation was not necessary. Early this year I went for my routine checkup and the radiologist discovered a few more lumps on my left breast. However, there was no substantial growth in their sizes. Total I have 5 lumps on my right breast and 7 lumps on the left ranging from 8mm to 5mm.

I tried to seek second opinion but was told that they are benign growths and nothing to be alarmed of. I was advised against going for further operations as my breasts as the tendency to develop such lumps. My surgeon could not tell me exactly what the cause of it is. I was told it might be due to hormone changes.

As I've read a lot about breast cancer and how early detection could save one's life but I am not too sure what should I do? I am also afraid that these lumps might turn malignant later on but every surgeon that I consulted could not give me the answer. Should I consult a surgeon or oncologist? What would be your best advice, should I remove both my breasts?

U120609 21 Oct 2002
 

A I think you should try to read more about breast lumps and a good place to start would be on the website in the articles section where there are a few topics for the younger women with benign breast conditions, such as you have.

http://www.radiologymalaysia.org/breasthealth/YoungerWomen/index.htm

The majority of the "breast lumps" are benign - up to 90%. It's like living with moles on your face or hands. We cannot control the number of moles that develop on our face and hands, and while some people can go through life without even 1 mole on on exposed area, others develop them by the dozens! Moles may turn cancerous or a cancerous mole may grow, but do we remove every mole on our body? Obviously not. We are advised to keep a watch on our moles and should we see unusual growth or ulceration of the mole, we must see the doctor immediately.

Therefore, it may help to think of your breast lumps as such. As to whether these will turn malignant ever...theoretically, as long as they contain glandular tissue, there is always a remote theoretical possibility. It's more like you should be aware of the changes in your breasts, so that you will know when there is a NEW CHANGE that is not where your "usual" lumps/lumpiness are. Remember just because you have non cancerous changes in your breasts, other parts of your breasts cannot develop cancer. It is extremely rare that one of your benign fibroadenomas turned malignant but something new might grow that is not a benign fibroadenoma.

If any of your breast lesions cannot be palpated (in other words cannot be felt with your hands), then, you know you need to follow up at least once a year anyway by ultrasound. At any time, should the radiologist (Specialist doctor in radiology) examining you suspect anything is amiss; you will proceed to a mammogram at any age. Any lump that you can feel that is rapidly growing will need immediate assessment, hence the importance of doing a GOOD self breast examination ONLY ONCE a month. No short cuts and the technique must be correct. Please do read the section on SBE http://www.radiologymalaysia.org/breasthealth/SBE/index.htm and you should be on regular follow up with your surgeon and the radiologist.

Early detection means being breast aware, seeing your doctor when something unusual or a change has been detected and that which worries you. This way, should there be any change due to a breast cancer, you would have had it detected at an early stage where chances of cure is very good. You should not be too anxious and worry unnecessarily because if you take interest in being breast aware, you are already doing the best you can in taking charge of your breast health.  

Editor
 

Please click here for Topic Index

Website Links

“CancerStory.com is a self-funded, non-profit site set up in memory of its founder's beloved mother who was taken away from the joys of life by cancer. She battled with colon cancer for three years and eight months. Through this web site, the founder hopes to share her late mother's cancer experience and help cancer patients and their families face the overwhelming tasks of seeking the best treatment, gathering information and preparing for the battle against cancer.”

Click Here to visit

Many thanks Kamal for submitting this link - Editor

“The National Cancer Centre Singapore – Inspired by Hope, Committed to Care: This website seeks to answer some of the common questions which you may have when you or your relative has been diagnosed to have cancer. It hopes to explain, in simple terms, what cancer is, what treatment is available for cancer, what are the causes of cancer, and information on the more common types of cancer, i.e. lung, colorectal and breast cancer.“

Click Here to visit

Thanks Margaret Ho for submitting this link - Editor
 

Perak Palliative Care Society

Our reader CYC of the PPCS, wrote about how Radiology Malaysia, in particular the Breast Health Info Centre might aid in the noble deed of caring for the terminally ill. In return, we asked for more information on the PPCS and this is what CYC shared with us. Thanks CYC for your contribution!

Click Here for more information.