THEY'RE fighting in the front line of the ongoing battle against one of the biggest, most frightening killers around.

Breast cancer is a formidable rival but the team of the breast imaging unit at the King Edward VII Memorial Hospital (KEMH) is using the best of modern technology to stop women falling victim to the disease.

The key to winning the war is early detection, as more than 95 per cent of sufferers, whose cancer is detected early and does not spread beyond the breast, survive.

And the four mammography technologists and three radiologists who make up the KEMH team believe they are getting that message across as increasing numbers of women come in for regular check-ups.

"If we compare ourselves to other countries then we are doing a better job than many other places," said Dr. Daniel Stovell, director of diagnostic imaging.

"Not everyone who should be getting a mammogram is doing so, but the percentage is very high. We are quite happy with our coverage. Probably 90-plus per cent of those who should be, are coming in."

Last year the hospital, which is not the only organisation on the island offering the service, carried out 3,024 mammograms. All women over 40 years of age are urged to get an annual mammogram. And that should start earlier if there is a family history of the disease.

A computerised registry at KEMH ensures that a notice is mailed to a patient when her annual mammography appointment is due.

Doctors recommend three components to maintaining good breast health ? having mammograms, having regular breast examinations by a medical professional and self-examination. Self-examination should start by the age of 20.

The importance of doing all three lies in the fact that some types of breast cancer can be detected by a clinical examination, but not by a mammogram. On the other hand, some types of cancer can be picked up by a mammogram two years before a physician could detect them.

Willams, manager of diagnostic imaging at KEMH, said: "Women are much better informed these days, largely through using the Internet."

The incidence of breast cancer in Bermuda, like most of the western world, is on the increase.

Dr. Stovell said: "Bermuda has about the same incidence as the US. Now about one in eight or nine women can expect to be affected by breast cancer at some point. It used to be one in 12. The reasons why you get increases here and there are largely unknown.

"Some cancers are linked to genes. In some cases scientists have managed to show that 'this is the gene causing cancer in this family'."

Technicians in the breast imaging department frequently have to deal with people who are nervous about having a mammogram done and fearful about what the scan might bring to light.

"Our staff are all trained to alleviate their fears," Ms Williams said.

One of those staff is senior mammographer Carla Cann, who said: "It's just a matter of calming them down. If we let them know exactly what's going to happen, then we can build their trust."

is less to fear than there used to be. A situation which would once have required exploratory surgery, on the discovery of a suspicious area within the breast, can now be dealt with more swiftly and painlessly by means of what is known as a stereotactic biopsy.

This process, which uses equipment obtained by KEMH in the spring of 2003, takes around an hour and allows the patient to be back at work within 24 hours.

It involves a needle being inserted into the area of concern, guided by a computer working from a three-dimensional scan.

Results of scans are usually processed and made available within five days, though if there is a suspicion that something may be wrong, the unit strives to get the job done inside 48 hours.

If there is bad news to give a patient, it's not usually the job of the mammographers to break it. That responsibility falls on the shoulders of the patient's physician, as he or she will have an established relationship with the subject.

The KEMH mammography programme last month received renewal of its accreditation from the American College of Radiology (ACR) for the period through June 2008.

Stovell said: "This is the third time we have received this accreditation for a three-year period and it shows we have reached the highest standards. The ACR radiologists look at images we send them and check we are doing everything correctly."

Every week, the unit checks its machines are working correctly by scanning what is known as a "phantom", a block of synthetic material implanted with features designed to show up on a scan like different types of suspicious areas in a breast.

The machines produce X-ray images of the breast, but at some time in the future, when the technology has been tried and tested, a digital mammography machine would be top of Dr. Stovell's wish list.

The major risk factors in the contraction of breast cancer are being female and getting older. A woman over 60 is more likely to develop the disease than a woman in her 40s. A far lower proportion of men than women suffer from breast cancer.

Some experts believe that a diet high in fruit, vegetables and grains can reduce the risk of the disease, which is the second leading cause of cancer death in women.

And there is evidence to show that regular exercise can lower your chances of getting breast cancer by about a third.

According to Cancer Research UK, a woman who breast feeds her child also has less chance of getting the disease. The reasons for this are unknown.