| The HUSM team with Family
Planning Association at work |
Much appreciated in the East Coast and Northern Johor ...
547 ladies benefited from the College of Radiology value added mammogram programme (CMP2008) with some from very poor background being granted full sponsorship of the cost of the mammograms. 85.2% had their first mammograms in CMP2008. This fulfils one of the aims of the CMP, to introduce this form of investigation for women with breast signs and symptoms, as well as in those of the appropriate age group where breast cancer incidence becomes more common. 30-31 women of 100 women diagnosed with cancers are made up of those with breast cancer (National Cancer Registry 2003-2005) and the peak age groups are from 40-59 years of age.
The 547 participants of the CMP2008 came from Johor (40.8%), Pahang (30.3%), Kelantan (26.9%) and the rest from Federal Territory Kuala Lumpur, Terengganu and Negeri Sembilan. The latter would have accessed the programme on visiting the target states of Johor, Pahang and Kelantan.
52.3% of the participants were Chinese, 41.1% Malays, 5.1% Indians and 1.5% were from other races including Siamese (Kelantanese). The mean age group was 56 years (from 34 to 81 years) for Pahang and Johor, whilst for the group in Kelantan, the mean age group was 46 years (from 29-71 years).
Although 11% had positive family history, only 2% (11 participants out of the 21 diagnosed on the mammogram to have slightly suspicious or suspicious lesions) were confirmed to have breast cancer (through tissue diagnosis). It is a known fact that a positive first degree (sister, mother, daughter, father, brother) family history of breast cancer is not a significant factor in a person developing breast cancer. In fact, the majority of those with breast cancer do not have any risk factors. For this reason, breast awareness should be promoted to all in the population.
37.1% of the participants needed adjunct ultrasound of the breasts for findings noted on the mammogram, at no extra cost to the patient. An adjunct or complementary test is one that adds information to the primary test, in this case the mammogram.
17 of the women needed biopsies (the majority were core needle biopsies) whilst 9 had fine needle aspiration biopsies (of which 3 were enlarged armpit lymph nodes). 11 of these proved to be cancer, the rest were benign breast disease.
The need for this CMP service in the East Coast is still sorely felt, as is in the southern state of Johor. The breast cancer support groups in Johor have expressed their request to have this programme run annually if possible. The logistics for Segamat was solved with CoR sponsoring the transport of women in and around Segamat to the International Islamic University Breast Centre in Kuantan, Pahang.
The CoR works through the breast cancer support groups because detection of breast cancer does not stop at detection, but also confirmation of diagnosis (where the CoR pays for the image guided biopsies of detected breast lesions suspicious of breast cancer), treatment and finally support and rehabilitation. Some hand-holding is needed for many women, especially with issues of how the family will be impacted by them going to hospital for treatment, when diagnosed with breast cancer.
Special thanks to the College of Radiology (CoR) accredited mammogram provider IIUM Breast Centre, Kulliyyah of Medicine, Kuantan, Pahang whose collaboration and meticulous data recording enabled analysis of the participants accessing the CMP2008. There were 2 sessions for the IIUM centre, the first from February to June 2008 and the other from June 2008, spilling over a little into the first half of January 2009.
In Hospital Universiti Sains Malaysia Diagnostic Imaging Department in Kubang Kerian, Kelantan, the session ran from July to December 2008, being interrupted by the monsoon floods. For the HUSM report by Dr Nik Munirah Nik Mahdi, click here. |
