The old mammogram at the Kumanovo hospital is not functioning because it is outdated and defective. The female patients from Kumanovo and the five nearby municipalities are being redirected to the Skopje clinics for examination, Kumanovo hospital employees inform.
The 32-year-old K.M., a mother of two, says that she will have to go to the Skopje “8 Septemvri” hospital, despite having a recommendation and a reference letter from her gynecologist. This is her first examination and she came to obtain information from the Kumanovo doctors about the entire procedure.
“I am a bit scared of the examination, although I have read a lot about it on forums. I want to receive direct information from the doctors about whether this is a painful procedure. However, I was surprised to hear that the machine was old and not used for screening at all, but only for female patients with certain symptoms who were directed here”, the female Kumanovo resident says.
The X-Ray Diagnostics Department doctors say that the mammogram is more than two decades old. The mammogram was donated by a nongovernmental organization and it started to be used in the distant 1996, but it is unknow how long it had been used earlier.
“The mammogram stopped working because it is old, a permanent defect has been registered and the latest radiation measurements indicated that it had to be put out of use. This was the only mammogram used for the patients from Kumanovo, Kratovo, Kriva Palanka, Staro Nagorichane, Lipkovo and Rankovce”, Dr. Slavica Jakimovska, radiodiagnostic specialist, says.
She explains that they have not been doing any screening although it is compulsory and free of charge because the device is old and has been used exclusively for female patients with given symptoms who have been sent to be examined at the hospital. Only five-six female patients were checked in the hospital daily. Jakimovska says that they kept asking for a new mammogram and that they have asked the relevant institutions to provide a new mammogram immediately.
Kumanovo Hospital Director Snezhana Zaharieva has said that, right after her appointment, the hospital sent a request to the Health Ministry and the Macedonian Government.
“It is true that we have asked the Health Ministry to procure a digital mammogram and that this request has been submitted to the government, too, immediately after my appointment. However, elections had already been scheduled and there were unfortunately legal impediments to amending the annual public procurement plan”, Zaharieva says.
She informs that the amendments to the 2018 annual development plan give priority to the procurement of devices for a number of wards, but the procurement of a digital mammogram is of paramount importance.
“It is sad that Kumanovo has been asking for the procurement of new X-ray machines for a decade now because they are outdated and unsafe both for the patients and the medical staff, but the Ministry has been ignoring our requests. Much smaller medical institutions have received new machines, while Kumanovo has been neglected, even though we provide services to about 200,000 patients. We expect to receive assistance from the Ministry and the Government because the Kumanovo residents deserve the same rights as the remaining Macedonian citizens”, Zaharieva says.
The Kumanovo Hospital serves a large number of patients, but, because of the outdated mammogram, the female patients have been unable to use the free-of-charge screening for patients aged 50-69, which was first introduced in April 2016.
The Kumanovo Hospital, as well as other hospitals throughout Macedonia, have no record of the total number of women diagnosed with breast cancer. According to the statistical data of the Kumanovo Hospital, the youngest patient is 22 years old, while the oldest – 90. The youngest patient to die from breast cancer in Kumanovo was 28 years old and the oldest – 86.
“Breast cancer chooses no age, but it is a malignant disease with a high mortality rate, so it is important to diagnose it on time. Every woman older than 40 must be examined, while those who have a genetic predisposition to develop cancer should be examined earlier. From 5% to 15% of the women diagnosed with breast cancer at a global level have already had another member in the family with breast cancer”, Jakimovska says.
According to Jakimovska’s research, 12% of those diagnosed with breast cancer in this region had breast cancer in the family. She adds that this year the disease has recurred among a great number of patients a few years after they had a surgery.
“The regular control of the operated patients is very important”, Jakimovska says.
She explains that certain patients come from socially vulnerable categories and have no funds to pay for the mammography examination fee, which amounts to 80 denars. Most of these female patients come from the Roma ethnic community.
“Some of the patients cannot pay the examination fee because of their social status, so they come, ask and leave without scheduling an appointment because they have no money. The screening is free of charge, though”, Jakimovska says.
Last year, 1,200 women throughout the country were diagnosed with breast cancer during a screening. Macedonia is among the leading European countries in terms of breast cancer mortality.
Early detection of cancer is very important for the patients. The sooner it is diagnosed, the easier it can be treated, unlike when diagnosed at a later stage. Regular ultrasound and mammographic examinations are of exceptional importance for the female patients, and so is the breast self-exam.