Medically reviewed by Noel Phipps, MD Florence Radiological Associates
“When it comes to discovering breast cancer, a woman can do a self-exam, looking for lumps or changes in the size or shape of the breast,” says Radiologist Dr. Noel Phipps, Medical Director of McLeod Breast Imaging. “Also, a physician or nurse can perform a clinical breast exam, feeling for lumps or other changes. Or the gold standard for diagnosing breast cancer is the mammogram.* But the questions many women face are 1) when should I start getting mammograms and 2) how often should I get a mammogram?”
WHEN SHOULD YOU HAVE A MAMMOGRAM?
The questions when to start and how often became even more clouded with the announcement in late 2015 by the American Cancer Society that women with “average” risk of breast cancer can wait until they’re age 45 to a first mammogram. Then have on every year until age 55, when they can have one every other year.
Then, there was the 2009 report by the United States Preventive Services Task Force confused a lot of women when it said regular mammograms for women should start after age 50. After criticism from the American College of Radiologists, among others, the Task Force backed off its recommendations.
The National Cancer Institute recommends that women aged 40 or older have a regular screening mammogram every 1 or 2 years. Authors of a recent study of more than 7,000 breast cancer patients concluded: “the best method for women to avoid death from breast cancer is to participate in regular mammography screening.”
WHAT SHOULD YOU DO?
You likely have a relationship with a primary care doctor, family physician or GYN specialist. And you have that relationship because you trust them.
So ask your personal physician what they recommend. If you are still unsure, get a second opinion. Also, check with your health insurer to determine when they will cover a mammogram.
*WHAT IS A MAMMOGRAM?
At the simplest, a mammogram is an X-ray of a woman’s breast. A screening mammogram is used for women who have no signs of breast cancer. It involves several pictures of each breast. A diagnostic mammogram is conducted on women when cancer is suspected. It involves more images from different angles. Close-up images of suspicious areas may be captured as well to help the doctor provide a better diagnosis.
Experts advise avoiding a mammogram the week before your period. Your breasts will be more swollen and tender, making the process more uncomfortable for you.
Women with breast implants should continue to have mammograms but should tell the mammogram technician before the screening.
NEW TECHNOLOGY FOR MAMMOGRAMS
Women have had breast X-rays since the World War II era. Yet, special technology specifically for mammograms wasn’t introduced until the late 1960s. Today’s units use low levels of radiation, as well as other enhancements.
Digital. Just as still photography has moved from using film to a digital format, many hospitals are now capturing breast images as digital files. There’s no development time. Files can be sent instantaneously to the radiologist for interpreting and then to the primary care physician or specialist for review with the patient.
For most women, there is no difference between digital and film X-rays’ ability to detect breast cancer. However, for women with dense breasts, digital mammography appears to be more accurate than film.
3D Images. One of the newest developments is “Tomography.? The machine moves around the breast taking numerous images, which are then computerized into a 3D image. It uses a bit more radiation than a 2D mammogram, but the doctor can see problems more clearly. It may eliminate a patient being called back for another mammogram if the doctor needs more detail.
LIMITATIONS OF A MAMMOGRAM
A mammogram can’t tell whether a mass is cancerous. If the image shows a mass, a biopsy (small tissues sample) may be taken and sent to the lab for analysis.
ACTION YOU CAN TAKE
Have a question? Ask a Cancer Specialist.
Find a Family Medicine Physician near you.
Find a Gynecologist near you.
Sources: McLeod Health, Cancer Online, JAMA Internal Medicine, US Food & Drug Administration, American Cancer Society, Breast Cancer Foundation, Centers for Disease Control & Prevention, Cancer Research UK, National Institutes of Health