The radiographers from Morton and Partners requested a session with me, and it  took place a great location yesterday.  We talked about a variety of issues but the first hour was devoted to discussing the concept of holistic breast imaging.

I am based CBMH, a venerable institution, but there are plans afoot for the construction and design of  a brand new "state-of-the art" hospital.  Although the equipment in the radiology department is up to date, the layout is dated.  Cue the plans for the new hospital.

To begin with, we did a small survey whereby we asked patients to give us feedback about their experiences of having a mammogram. Sixty people completed the question and they were remarkably complimentary.  What became very clear was that the attitude of the person doing the mammogram was the most important factor in the experience of satisfaction.  The radiographers at CBMH were perceived as being the very best, certainly at the top of their game.

Doing the research for my talk, I read various blog sites about women's experiences of having mammograms.  There's no doubt that the procedure itself has become far less painful, with newer technology but, inevitably, there are still aspects that can be uncomfortable.  One women remarked on feeling how demeaning it was to walk around the department without a bra on.

We need fresh ideas. Your ideas. So, if it was you designing a new radiology department, what features  would you add to make the experience of having a mammogram more acceptable?  Please share your thoughts. I'm going to read all of them, and this is real chance to help me make inputs into the final design of the new generation of breast imaging setup.


Last week, a colleague who is premenopausal and in her late 40s complained about aching breasts and asked me what she could do about them.  It is a question that I am commonly asked.

There is no satisfactory explanation for mastalgia (aching breasts) and it is definitely something associated with normal breasts and particularly in women in their 40s.

Breast change with age.  During your 20s, your breasts are in the proliferative (busy) stage of development.  As you get older, the breasts start to age and by the time you get to your late 40s, your breasts have increased in size, may have undergone fibrocystic changes (dense tissue with small cysts), become fattier and so lost a lot of inbuilt support.  As a result, women in their 40s have breasts that tend to move around a lot more and may feel very lumpy and tender.

The question is what to do about it.  If you are over 40 and haven't had a mammogram for a year, you should have a screening mammogram to ensure the tissue looks normal.  After that, the best plan is to go to a specialist bra shop for a bra fitting (40% of women over the age of 40 wear the wrong size bra). Leave things for a month and if they are still uncomfortable, try a NSAID cream (available over the counter).  I think some women do get relief from Evening Primrose Oil but when it has been subjected to large trials, it hasn't been found to be useful.

No other dietary manipulation/drugs have been shown to work when they have been compared to sugar pills but please share your experience.  Let us know what worked for you.

In Cape Town, there are a number of good bra shops.  Two that consistently seem to give a good service are Inner Secrets and Storm in a G cup.