This is a dangerous time for women! This is an unprecedented situation, but it did not cause any noise. For several days, it was not possible to perform mammograms anywhere on the island of Mayotte, neither at the Center Hospitalier de Mayotte (CHM), where the Technical Medical Center states that it “does not have mammograms,” nor at the Médicale de Image Center. Mayotte announces that its machines are “broken” and that the parts needed for this repair will arrive in April 2024.
However, Mammography is a powerful and essential tool for breast cancer screeningBecause it makes it possible to detect potential cancer that may be developing, and its early detection enhances the patient's chances of recovery. This screening targets all women at risk of breast cancer regardless of age, due to genetic predisposition or family history, but especially to all women over the age of 50, as 80% of breast cancers affect women aged 50 and over.
This Wednesday morning, all the centers we met with agreed! In the absence of mammography in the territory, the Mayotte Regional Center for Coordination of Cancer Screening (CRCDC-Mayotte), the Mayotte Hospital Center (CHM), and the Mayotte Medical Imaging Centre, We recommend that all patients who need a mammogram go to Reunion Island.
But this response is interesting because it requires this basic examination to be performed on women who can afford to pay for a plane ticket to go to Reunion and organize their own course of treatment.
The inability to benefit from mammograms for several months complicates an already tense care pathway, as in the face of breast cancer screening, only chemotherapy can be performed in Mayotte, while complementary radiology and surgeries can only be performed on Reunion Island. This situation may raise concerns about loss of care, as some women who need mammograms may refuse to undergo screening for social, logistical, or financial reasons.
Breast self-palpation remains essential in breast cancer screening
Currently, before considering mammograms, there is an essential tool that costs nothing and requires no equipment: breast cancer screening by “self-palpation.” In fact, if breasts change throughout a woman's life, any changes noticed should be the subject of increased vigilance. Self-palpation of the breasts, that is, the fact of feeling the chest yourself regularly, allows you to know the appearance and consistency of your breasts and possibly detect unusual changes that are likely to be symptoms of breast cancer. Any change in color or appearance, possible sagging of the breast, or the detection of a lump, lump or lump, should prompt a woman to consult a doctor or midwife, for in-depth examinations.
In the face of this absolutely unsatisfactory situation, when we know that cancer represents the second cause of death in Mayotte, the health authorities nevertheless want to reassure and assure that “to ensure continuity of care, patients who need mammograms will be able to benefit from this situation.” . From MRI* in CHM.”
This support plan will certainly be clarified later. But we can actually ask ourselves the question of what classification of patients will be accepted for MRI? Will all patients at risk of breast cancer be able to benefit from it? All patients aged 50 years or older for their semi-annual (every 2 years) check-up? With or without a prescription? Will new equipment be considered for delivery to allow the clearinghouse to be better equipped and to enable the radiology center to perform mammograms sooner than 4 months?
Work is currently underway between the clearing-house mechanism and the Dispute Review Commission to provide concrete solutions to this situation.
In the meantime, just one piece of advice: Breast cancer can be detected at any age, feel your breasts regularly and, if in doubt, consult a health professional!
Mathilde Hangard
*MRI: Magnetic resonance imaging
