MAMI Urges Annual Breast Screening This Awareness Month

Every October, Breast Cancer Awareness Month gives women a reason to stop and think about their breast health, and this year MAMI (Melrose Arch Mammography) wants that pause to turn into a booked appointment. The Johannesburg breast imaging centre, based in Melrose Arch, keeps its advice simple: have a mammogram every year from 40, check your breasts regularly, and get imaging promptly if anything changes. Spring is here and the year is nearly over, so women who have fallen behind on screening still have time to book before the December holidays.

All of MAMI's breast services are in one department: mammograms, breast ultrasound and image-guided breast biopsies. Patients are seen by experienced radiologists and mammographers using modern equipment. No other unit in South Africa has been named a Breast Imaging Center of Excellence by the American College of Radiology (ACR).

The case for annual screening from age 40

Guidelines don't all agree on when screening should start. MAMI follows the consensus of numerous studies, which shows that yearly mammography from age 40 saves the most lives. Breast cancer peaks between 55 and 60, but the centre is seeing more cases in younger women, and these cancers are more likely to be aggressive and grow quickly. Starting at 40 is meant to find as many cancers as possible in the group at risk.

Why every year rather than every two or three? Some aggressive cancers can grow significantly in 12 months. Yearly imaging also lets radiologists compare each set of pictures with the last and spot very subtle changes in breast tissue. MAMI says that, largely thanks to mammograms and ultrasound, most breast cancers are now found when they are smaller than 2cm, and patients diagnosed at that stage have a five-year survival rate of 90%.

Today's mammogram is quicker and gentler

Many women delay a Mammogram because of stories about older machines or their own memories of them. MAMI uses 3D mammogram machines with tomosynthesis, which produce a detailed scan with minimal compression. The centre describes the modern procedure as very fast and pain free, so any discomfort passes quickly. The radiation dose is very low and considered safe even with yearly scans, and the lighter compression won't damage breast tissue or implants.

The centre also tackles a common myth: mammograms do not cause thyroid cancer. A thyroid shield isn't needed and may reduce image quality.

Some women hold back because of cost. MAMI points out that most medical aids pay for screening from screening benefits, not medical savings, even on a basic hospital plan. Women can phone the centre with their medical aid number to check their cover, or ask for a cash price.

Warning signs worth acting on

Yearly screening works best when women also know how their breasts usually look and feel. According to MAMI, a lump is the single most important symptom of breast cancer, and it often feels like a pea, stone or marble under the skin. Any new lump should be checked straight away with a mammogram and/or ultrasound, even though most lumps turn out to be benign growths, cysts or normal lumpy tissue.

Other changes should always be checked with imaging too. These include thickened or dimpled skin that looks like orange peel, a new asymmetry where one breast sits higher or has a dent, bloody or clear nipple discharge (especially if it happens on its own), a nipple that has recently turned inwards, and a dry, peeling rash on the nipple or areola.

MAMI calls a monthly Breast Examination at home an extremely valuable tool. Many women find it hard, though, because their breasts are naturally lumpy. The centre's advice is not to worry about that. Keep up the yearly imaging, and see a gynaecologist or GP, who will also do a manual examination.

Higher-risk women and the next steps

A family history of breast or ovarian cancer is one of the most important risk factors. Others include being overweight after menopause, taking certain hormone replacement therapies and never having had children. Women at high risk may need closer screening, such as a yearly MRI, or genetic testing, and should talk to their doctor about their options.

If imaging finds something that needs a closer look, MAMI performs breast biopsies under ultrasound or stereotactic guidance. The procedure is minimally invasive, done under local anaesthetic and usually takes 20 to 30 minutes, and the patient goes home afterwards. A biopsy either rules cancer out, which brings peace of mind, or confirms it and identifies the type so treatment can be planned.

MAMI belongs to a multidisciplinary breast cancer team of breast surgeons, reconstructive surgeons, oncologists, pathologists and radiologists. Patients diagnosed at the unit are referred straight to this team, and MAMI keeps helping with staging, localisation, monitoring chemotherapy and follow-up. It is also the only practice offering breast cancer cryoablation, a treatment that freezes selected small tumours instead of removing them surgically.

The accreditation behind MAMI

MAMI is the new face of the Parklane Women's Imaging Centre. The staff, equipment and radiologists are the same, now working from a new department at Melrose Arch. The Parklane breast unit was the first internationally accredited breast imaging unit in Africa. It was also the first and only department in South Africa to earn ACR gold seal accreditation, which it received for mammography in 2017, MRI in 2018, stereotactic biopsy in 2020 and breast ultrasound in 2021. In 2022 the ACR named it a Breast Imaging Center of Excellence.

Diagnostic radiologist Dr Peter Schoub leads the practice as managing director. He has focused on breast radiology for more than 15 years, holds the European Diploma of Breast Imaging and is an honorary lecturer in the department of radiology at the University of the Witwatersrand.

For women in Johannesburg, this October is a good reason to book their own Mammograms and to remind their mothers, sisters and friends to book theirs. Appointments can be made by phone, by email or through the online appointment form on the centre's website, and more details are at https://mammogram.co.za/.

About MAMI (Melrose Arch Mammography)

MAMI (Melrose Arch Mammography Inc.) is a breast imaging centre at 1st Floor, 10 Melrose Boulevard, Melrose Arch, Johannesburg. Its services include 3D mammography, breast ultrasound, ultrasound and stereotactic guided breast biopsies, breast cancer cryoablation, and bone density and body composition scans. The breast unit is accredited by the American College of Radiology for mammography, MRI, stereotactic biopsy and breast ultrasound, and holds the Breast Imaging Center of Excellence designation. It works as part of a multidisciplinary breast cancer team under the leadership of diagnostic radiologist Dr Peter Schoub.