Dr Rajendra Rampaul
Breast oncologist and medical director
at Pink Hibiscus Breast Health Specialists
It is well known both amongst our women and the broader population in Trinidad and Tobago that breast screening has some negative perceptions. The fact is that not many women screen. And even for those who do perform breast screening, they always have a lot of concerns. Beyond that, there are even more concerns and misconceptions among the women who avoid screening.
The truth is that screening gives our women the best chance of finding breast cancer at an early stage, and with modern treatment, it gives them the best chance of successfully treating breast cancer and being able to achieve a cure. To be cured is the best gift you can give yourself.
Unfortunately, this simple fact may not be enough to help understand the importance of breast screening. Screening does not prevent breast cancer, but it does allow you to diagnose it at a very early stage, and, just as important, it allows you to know that you are healthy when your screening tests have returned as normal. It is important to appreciate that every woman is at risk, and taking steps to reduce this risk can help save lives. We, who look after women with breast cancer, know that this task is not easy, but it is very important.
Dr Rajen Rampaul
Timothy Chasteau
Breast Cancer In Men
We believe that everyone should practise awareness as a preventative measure for breast cancer. And this is not limited only to women. Men can get breast cancer. Yes, it is rare, but it does present the same problems and threats to your life as women with breast cancer, and therefore, it is just as important to be able to practise awareness in men.
The difference with women is that they have mammography. Men do not possess enough breast tissue for mammography to be of use, and they must rely on self-examination. Our advice to all men is to get to know your body and practise monthly self-examination. That is the very minimum that we recommend, and it is also completely free, and you can do this in the privacy of your bedroom.
Breast Screening For Women
For women, we recommend that you get an annual clinical examination, a mammogram, and an ultrasound. This is currently best practice, and the latter test, which is the ultrasound, is critical, especially in younger women who may have dense breast tissue.
One of the most common questions we get asked is whether both a mammogram and an ultrasound should be done, and why not one or the other. The answer is that together they form the most powerful combination of screening tools for the average woman at risk.
While it is very straightforward, it isn’t always easy to encourage patients to do it. Many women don’t necessarily understand breast cancer risk. Many women don’t know the facts about breast cancer, for example, how common it is, what exactly ‘breast screening’ is, and most importantly, how much they can benefit from it. Even when we talk to patients about screening, many misconceptions arise. Many questions are asked, but if left unanswered, these concerns will often lead to women making incorrect decisions about their health.
Let’s encourage women to participate in breast cancer screening
Luckily, modern digital mammography is painless, and at our centre, I am pleased to say patients do not experience pain when they come for their annual breast screening. Many women also have a false sense that they do not need mammography, they do not need screening, and that breast cancer will not happen to them, as there is no one in the family with breast cancer or other cancers. This is, of course, not correct, and only some breast cancers are due to family members passing on the genes that cause breast cancer.
Similarly, many women fear that there might be serious radiation exposure. That is not correct in that modern mammography has very little radiation. Some women fear getting bad results, and others may say, ‘I don’t notice anything abnormal about me, and therefore I don’t need to be screened.’ Again, we will say that these are not correct perceptions, and getting to understand how your body will change as you age, especially in the 40 to 70 age group, is very important, as this will help to guide you and make you stronger and more encouraged to get your breast health checked every year.
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Let’s focus on awareness and screening
Five ways to encourage breast cancer awareness and screening:
1. Speak to your doctor or district health nurse at the health centre about your individual risk and enrolment for annual screening. It’s important that a breast cancer risk assessment is conducted to identify risk factors and discuss these with their local nurse or doctor. Women often don’t understand risk, and they may feel a false sense of security, especially as they may not feel a distinct lump and may not experience pain. A point that must be emphasised is that breast cancer in the early stages is a painless disease, very much like a silent killer, and therefore waiting to feel a lump is not the way to look after your breast health.
2. Acquire more information from your doctor and nurse about breast imaging, that is, a mammogram and an ultrasound.
3. Be sure to seek information from sources that are reliable and credible, as some internet sources can also be a major deterrent to screening.
4. Coordinating your screenings with your friends and family to make it a more enjoyable experience. We encourage someone to have a screening with a relative, which we call a Pink Hibiscus Buddy Pass.
5. Women need to maintain healthy behaviours, which can help to reduce breast cancer risk:
• Maintain a healthy weight, ensure that you are eating a very balanced diet, and avoid excessive sugar and unhealthy fat.
• Incorporate regular exercise, which helps to lower and regulate oestrogen levels.
• Keep alcohol intake to a low level, as excessive alcohol can raise the body’s oestrogen levels and increase the risk of cancer.
• Encourage your husband/partner to do regular self-examination and become aware of breast cancer in men.
Breast Cancer Awareness Month 2025 has concluded. Have you had your breast screening for 2025?
