October is the month in which breast cancer and the need for prevention are traditionally talked about more. But behind the campaigns and appeals, one important question remains - how many women actually get to a quality examination on time and what "quality" diagnostics means. Dr. Alexandrina Percheva, a specialist mammologist at the Clinic for Imaging Diagnostics at Acibadem City Clinic UMBAL Mladost, spoke to FACTI. Dr. Percheva was a lecturer at the 25th national meeting of the "Media Society Family Traditions" (MOST) Foundation, held in "Albena", which was under the title "Life as a Value".
– Doctor Percheva, we are in the month of October, which is generally associated with greater attention to breast cancer, the month of prevention. And in this vein, let's start like this. What proportion of Bulgarian women turn to a mammogram to monitor their health?
– More and more women are now coming, which is very good. It strikes me that these are middle-aged women. We are talking about people around 35-40 years old. When they go through an examination and see that it is not so scary, they tell their mothers and mothers-in-law and take them with them. So this is a useful contact. Bulgarian women are paying attention. They are slowly waking up, I can say.
– What will you pay attention to this year, with what appeal?
– We use the word “quality” because the better the examination, the greater the possibility of preventing breast cancer. But by quality I mean a quality device, a quality doctor, quality diagnostics, quality interpretation of everything. We are imaging diagnosticians and that is why I appeal to people to come to those who are qualified and who do this every day.
– How do you judge whether a woman's examination should be an ultrasound, a mammogram, or a 3D mammogram?
– There is a globally accepted standard. This standard states that we should invite women after the age of 25 for an ultrasound examination. This is a quick, cheap and harmless method to examine the breast. The standard includes starting to do quality mammograms after the age of 40. Mammography should be repeated every second year, regardless of whether the woman has a problem or not. And what is rarely talked about is the first step of the standard - teaching women to do self-examination, which we train them on when they visit our offices. We show them how to do self-examination in the shower, in bed and in front of the mirror, in the hope that if there is something that has changed and is bothering them, they will see it. It is simply important for a woman to be prepared, to know what to look for when she looks in the mirror, because this is her life.
– Let's get back to that. Are more and more women paying attention and taking care of themselves?
– With us, the schedule is full weeks in advance. And that means that people are showing interest in themselves. We provide 12 hours of a specialist doctor in breast diagnostics. There is an awakening among women, for which I thank you - the media, for raising these questions and for people having more information.
– What does early detection of breast cancer mean?
– That breast cancer is diagnosed as less than 2 cm. This is the critical size of the tumor and means that the woman will survive. She probably will not have metastases, which will make it easier for the surgeon and oncologist who will treat her. For us too, because the diagnosed woman comes for periodic check-ups on time and it is much easier to monitor her.
– You are talking about quality. If we are talking about Bulgaria in general, is it possible to get a quality examination everywhere in the larger cities? And what is happening, is the so-called mother mobile working at all, which can travel around the country?
– In the large cities there is equipment and good devices purchased. Now, not all of them are of the latest generation, but they are extremely good digital devices and I can safely say that in every large city, regional city, there is one.
The mammography mobile is a minibus in which a mammography machine is installed. These are my memories from the past, when this mammography machine was used. Where is it now? Does it exist? Most likely there are far more modern such mobile stations. But unfortunately in our country this seems not to be used.
– Do many people from the countryside come to Sofia, or are things well organized in places such as examinations…
– It is very different, because there are provincial towns where there are extremely well-qualified colleagues of ours who work wonderfully, comply with world standards, and from these towns usually no patients come, because they do not need them. Or people who are difficult and complicated patients come. But there are small settlements where there is no quality hospital care. Women come from the western outskirts, from the edge of Bulgaria, towards the Turkish border. There cannot be the same medicine everywhere.
– How do silicone implants affect such an examination - do they interfere with mammography?
– We “push” them, so to speak, in order to see and examine the tissues well. A woman with breast implants also suffers from breast cancer, just like a woman without implants. This is not a problem for us. I say again that we “push the implant“, figuratively speaking, so that we can photograph all the tissues that we want to examine well, and in this sense, the presence of an implant is not a problem for us at all in our work.
– If you have to address women this month?
– Ladies, wake up and give yourself time, but give yourself this time on time. This is important so that we can help you too.