There are 3 types of prevention:
-Primary prevention is when the disease can be prevented by not being exposed to the causative agent. A classic example is asbestosis. If you haven't had exposure to asbestos, you won't get asbestosis.
-Screening for any disease is an example of secondary prevention. You look for the disease early in order to improve survival.
-Tertiary prevention is about prevention of the complications of a disease. For example, if diabetes is treated effectively, there is less chance of going blind.
|The mammogram room at the clinic|
One sobering fact remains. Cancer can be missed by both mammograms and ultrasound.
|Sr Louw in the reception area of the clinic|
Lobular cancer is less likely to show up on a mammogram. The woman may be reassured by a "normal mammogram" and so may present at a later stage. Lobular cancers are often easier to feel than to image.
To have breast screening done properly, all women should have an examination as well as a mammogram. At the Well Woman Clinic, in Harare, I was really impressed to see that they combine clinical examination with a mammogram. There are 2 radiologists who work there: the founding partner, Dr Nancy Jonker, and Dr Maita Mvere. There are 4 clinicians (Dr Landman, Dr Mhlaba, Dr Cowper and Dr W Samaneka) who see all women prior to mammographic screening and determine whether/not they should have a mammogram. Although they work in the same building, they are independent and so will not refer a woman for a mammogram if they feel it is inappropriate. The atmosphere is relaxed and the ambience appropriate.
The other health practitioners who are there include Miss Allaart (dietician). Ms Petra Mesu (psychologist), Ms Kathy Harter (social worker) and Sr Georgie du Plessis (SRN). Many thanks to Sr Riana Louw (practice manager) for taking me to the clinic.
|Sr Louw, Dr Jonker, Dr Mvere, Dr Landman and Mr Machingauta (accounts)|