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Oh, Mammogram.

Over 6000 women are diagnosed with breast cancer in South Africa each year. Breast cancer is the most prevalent type of cancer amongst Caucasian and Asian women, and the second most prevalent type in Black and Coloured women. With that said, a mammogram – an x-ray exam of the breast used to detect and evaluate breast changes – is the most effective method of detecting breast cancer. However, statistics show a suboptimal adherence to screening mammography. Kathryn Malherbe explains why, and gives us a glimpse of the make-up of a mammographer.

When should you go for a mammogram?

The American College of Radiology (ACR) advises mammography from the age of 40 years. However, if your mother had breast cancer in her forties, then you should have a routine mammogram from age 35.

What does a mammogram procedure entail?

A mammogram procedure, which is done by a mammographer (radiographer that

specialised in the field of mammography) lasts 10 minutes and consists of two x-ray

views per breast.

If there is any area of concern, the radiologist (a physician or doctor who has specialised

in the field of diagnostic radiology) will discuss the possibility of performing a biopsy,

which requires no special preparation and is a fairly minimal invasive procedure. An MRI,

PET or CT scan can also be used to rule out any concerns of the mammogram, but in

most areas this is not widely available and/or cost-effective.

To work as a dedicated mammographer, a special subset of skills is required:

Mammographers play an influential role in the way you, the patient, perceive

mammograms. We also have a complex role to uphold in our profession, necessitating a

high standard of technical competency, good communication skills, and the ability to limit

patient anxiety and discomfort.

Certain personality traits improve this involved task; namely respect, compassion, efficacy

and informed communication. It’s an emotional task; we walk the road with our patients

from the point of initial diagnosis, through treatment regime, recovery and annual surgery


It is sometimes difficult not to feel disheartened when a patient discovers a new malignant

lump after she had been diagnosed and treated for a similar cancer during the past year.

A 2014 study, by the University of Johannesburg, showed that there are four factors

attributed to a mammographer:

Trust Factor

  • Approachable

  • Honest

  • Informative

  • Gentle

  • Courteous

Care Factor

  • Patient

  • Friendly

  • Supportive

  • Empathetic

Safe Factor

  • Dedicated

  • Attentive

  • Observant

  • Calm

  • Tolerant

Communicator Factor

  • Quiet

  • Inquisitive

  • Talkative

  • Serious

  • Light-hearted

Exposing the mammogram myth:

There are numerous myths associated with mammograms; the most common being that

the compression of the breast is very painful, and can cause breast cancer. The latest

digital systems do not require excessive compression of the breast to produce a high

resolution image of the breast. The latest technology has its own internal system

parameters that improve the image quality and resolution for the radiologist. The

compression in itself cannot be associated as a causative factor to produce breast


Cancer is a very elusive disease and there are many factors that contribute to its

development, the most important of which are certain genetic markers that relate to the

initial growth of abnormal cancer cells.

Compression of the breast, or any form of trauma to the breast, has zero potential to be

the singular causative factor of producing cancer of the breast. It is more likely related to

a myriad of factors, more specifically certain mutated genetic markers that cause

abnormal changes within the cells of the breast, that multiply and divide (proliferate) to

form a lump in the breast, which proves to be a malignancy.

It has to be reiterated that the most important factor related to breast cancer is being a

woman and an increase in age. Family history only relates to 5-10% of all breast cancers


Join Breast Cancer Support Pretoria

Ladies of all ages are welcome to join us every second month of the year. We invite

expert speakers to come talk about interesting topics. Check out our Facebook page

Breast Cancer Support Pretoria or visit

Meet our expert - Kathryn Malherbe

Kathryn Malherbe is a senior mammographer working at LaVita Women’s Wellness Centre in Pretoria.

She is currently working on her Master’s degree, which focuses on lobular carcinoma of the breast, and the diagnosis thereof can be improved with

ultrasound detection tools.

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