Mammography, Bone Density and Women Health Examinations | Virtus Medical

Virtus Women Health Centre

 

We are dedicated to providing comprehensive preventive, therapeutic,and rehabilitative services to women of all ages. The Centre is equipped with advanced medical equipment, including X-ray, 2D/3D mammography, and dual-energy X-ray absorptiometry (DEXA), making it possible to oer our clients convenient, one-stop physical assessment and imaging examination. Healthcare services that are specific to women, are provided by our multi-disciplinary team of doctors and specialists, including Mammogram, Osteoporosis Treatment, Hormonal Replacement Therapy, Urinary Incontinence Treatment, and the following:

FOCUS AND SERVICES

  • Breast and Gynaecology Examination
  • 2D or 3D Mammography X-ray Imaging
  • Breast Ultrasound Scan
  • Ultrasound, 2D or 3D Guided Fine or Core Needle Biopsy of Breast
  • 3D Tomo guided Vacuum-Assisted Biopsy of Breast
  • Gynaecological Ultrasound Examination
  • X-ray Bone Mass Density Determination
  • Menopause and Osteoporosis Consultation and Treatment
  • Blood Test
  • Administration of 9-Valent HPV Vaccine
  • Administration of Herpes Zoster Vaccine and Hepatitis Vaccine

 


Mammography

Breast Cancer
Breast cancer is the most common cancer among women in Hong Kong, 1 out of 15 women suffers from this disease. Early detection allows doctors to diagnose and treat patients in the early and more treatable stages.
The U.S. Food and Drug Administration deems mammogram the best tool for breast cancer screening. A mammogram is a low-dose X-ray picture of the breast. Traditional 2D mammogram, as the name suggests, renders a 2D representation of the breast. While 2D mammogram is generally effective in detecting breast cancer, it has its limitations – small cancers masked by normal breast tissues may result in a false negative interpretation, alternatively overlapping breast tissues mimic a mass may result in a false positive interpretation. 3D mammogram, an upgrade from the traditional 2D mammogram, takes multiple images of the breast from different angles and produces a 3D image of the breast in one-millimetre slices, making it easier for radiologists to identify abnormalities, and as a result reducing the need for follow-up imaging. 3D mammogram provides a more accurate assessment of breast health while exposing women to a lower dose of radiation.
While mammography is considered the best screening tool for breast cancer available today, mammograms do not detect all breast cancers. Breast cancer screening is a collaborative effort from professionals across multiple disciplines–Doctors conduct clinical breast examination, specially trained technicians perform the mammogram procedure and radiologists interpret the diagnostic images.
To improve diagnostic accuracy, additional examinations such as ultrasound, magnetic resonance imaging and biopsy may be required. If image presents asymmetric density, breast tissues overlapping or microcalcifications, patient will be invited back to have images retaken, which is fairly common and no need to panic.
The radiation risk of mammography is extremely low. The total radiation dose for a screening mammogram is about 0.36 mSv. To put that number in perspective, it is equivalent to one-eighth of the total radiation dose a person is exposed to from his natural surroundings, or the total radiation dose a person is exposed to while
making 4 return flight journeys between Hong Kong and London. (Data source: Radiation Health Unit, Department of Health)

We use BI-RADS (Breast Imaging Reporting & Data System), a classification system
developed by the American College of Radiology.
Category Definition Likelihood of Cancer Recommendations
0 Incomplete N/A Further examniation needed
1 Negative Essentially 0% Routine examination
2 Benign Essentially 0% Routine examination
3 Probably benign >0%, but <2% Early follow-up visits or biopsy
4a Low suspicion >2%, but <10% Biopsy
4b Moderate suspicion >10% , but <50% Biopsy
4c High suspicion >50%, but <95% Biopsy
5 Highly suggestive of malignancy >95% Biopsy
6 Known biopsy - proven malignancy 100% Surgical treatment

 


 

Female Menopause

Menopause refers to the changes a woman goes through just before and after she stops menstruating, marking the end of her reproductive years. All women experience menopause as they age. In Hong Kong, the average age for a woman to reach menopause is 51.

Common Symptoms and Treatments of Menopause:
1. Hot flushes:
Sudden feeling of heat on the face and in the upper body. May also experience flushing of the face, sweating and elevated heartbeat. Relax, avoid spicy foods, and avoid wearing tight clothing or clothing made from unbreathable fabrics (e.g. nylon).
2. Estrogen depletion:
As estrogen levels decline in a woman, her breasts, ovaries and uterus begin to shrink. Her vagina also loses elasticity and she may experience vaginal dryness, which tends to lead to itching and may cause atrophic vaginitis. Vaginal lubricant or estrogen cream can be used to treat this condition and reduce discomfort during sexual intercourse.
3. Incontinence:
As the bladder and pelvic floor muscles weaken, women become more susceptible to incontinence. Some women may experience urine leakage with physical activities such as coughing, running and laughing. Kegel exercises, also known as pelvic floor exercises, can prevent or control urinary incontinence. Seek profesional advice from a Urologist would be recommended.
4. Osteoporosis:
As women age, estrogen levels decline, aecting calcium absorption and retention, resulting in drop in bone density and potentially leading to osteoporosis. Prevent osteoporosis by regularly performing weight-bearing exercises such as speed walking, jogging, tai chi and yoga, by always maintaining a good posture, by eating a calcium-rich diet (good sources of calcium include milk, cheese, tofu, sardines etc.) and by reducing tea and coee intake.
5. Psychological changes:
Menopausal women may experience insomnia, impatience, irritability, emotional instability, anxiety, fatigue, and paranoia. Manage these emotional changes by talking to trusted friends or healthcare professionals or by participating in social activities that help reduce stress.

Hormonal Replacement Therapy (HRT):
Always consult a doctor before starting on any medication to treat menopausal symptoms and to prevent osteoporosis. Find out if the medication is right for you, understand its side eects and special instructions for how it should be taken. There are many types of Hormone Replacement Therapy in many dierent forms and the best type depends on the patient’s health, symptoms and needs. Must consult a doctor before deciding on which type to take. Hormone Replacement Therapy is not recommended for women suering from severe liver disease, breast cancer, endometrial cancer, stroke or thrombosis. Before taking any medication, consult a doctor to confirm breasts and reproductive parts are tumor-free, and liver and renal functions are normal. Patients undergoing HRT should schedule regular follow-up visits with the doctor to monitor body’s response to the medication. Long-term use of HRT (5 years) may increase the risk of breast cancer, stroke, heart diseases and venous thrombosis.

 


Osteoporosis

 

Hong Kong has the highest life expectancy in the world with its men living, on average,up to 81.7 years and its women, 87.6 years. With the increased life expectancy, we oftenask – How do we make our extended years quality years?
Statistics shows 1 out of 4 elderly women, who are 10 years post-menopausal, suffer from osteoporosis and half of them do not know they have it until they break a bone.

Diagnosis of Osteoporosis
Ultrasound: Fast and convenient, but inaccurate
Bone Densitometry, also known as Dual-Energy X-Ray Absorptiometry (DEXA): The current gold standard for measuring bone mineral density (BMD)

 

World Health Organization Diagnostic Criteria
T-score of Spine or Hips Category for Diagnosis   
-1.0 and above Normal
Between -1.0 and -2.5 Low Bone Mass
-2.5 and below Osteoporosis
-2.5 and below with history of fracture    Severe Osteoporosis

 

Risk Factors of Osteoporosis
1. Family history of osteoporosis
2. Being underweight
3. Menopause before age of 45
4. Being over age of 65 for women and 70 for men
5. Inactive lifestyle
6. Long-term steroid use
7. Not getting enough calcium
8. Smoking
9. Parathyroid and thyroid problems

Prevention and Treatment of Osteoporosis
1. Weight-bearing exercises, such as speed walking, jogging, tai chi and yoga
2. Diet rich in calcium (good sources of calcium include milk, cheese, tofu, sardines etc.), or take calcium supplements (500 to 1,200 mg per day)
3. Quit smoking and alcohol drinking
4. Drug Therapy
Hormone Replacement Therapy (HRT):
Can only be administered to patients who are free of tumors in their breasts and reproductive parts, and are with normal-functioning liver and kidneys. Patients undergoing HRT should schedule regular follow-up visits with your doctor, because HRT may increase the risk of breast cancer, stroke and heart diseases.
Selective Estrogen Receptor Modulator (SERM): May increase the risk of deep vein thrombosis (DVT).
Bisphosphonate Therapy:
Could cause osteonecrosis of jaw or hip and unusual fractures. Oral bisphosphonates can cause stomach discomfort. You must inform your dentist of the bisphosphonate therapy you are receiving before any surgical dental procedures such as extraction and implant placement.
Calcitonin: Can be delivered as a nasal spray or injected subcutaneously. Can cause an allergic reaction and an increased heart rate. 

Symptoms of Osteoporosis
1. No symptoms in the early stages
2. Bone fractures
3. Height loss and hunched posture
4. Bone pain in the later stages


Common Places for Bone Fractures
1. Wrists
2. Spine
3. Hips