Mammogram

Mammograms save lives

You’re busy. With a to-do list as long as your arm, how can anyone expect you to find time for a mammogram appointment? Plus, your breast self exams have turned up nothing suspicious and there is no history in your family. Why bother?

The short answer is, mammograms save lives. According to randomized controlled trials, regular mammography screenings significantly reduces death from breast cancer in women between 40 and 74 years of age. (1) The American Cancer Society recommends that women between 40 and 44 get a mammogram if they wish to, that women age 45 to 54 get mammograms yearly, and that women 55 and older should get them every two years. (2)

What is a mammogram?

A mammogram is an x-ray of your breast tissue, using low levels of radiation which does not pass through breast tissue easily. The breast is therefore compressed between two plastic plates in the mammography machine to spread the tissue out and make the x-ray more accurate. (3) This is uncomfortable, and we are guessing it won’t be the best part of your day. So, close your eyes, suck it up and give yourself a mental pat on the back – you are being smart about protecting your health.

What is the mammogram looking for?

Technically, the mammogram isn’t looking for anything, it is just taking a picture so the radiologist can look for stuff. She looks for microcalcifications, or tiny specks of calcium-buildup, which when found in suspicious patterns, could be linked to cancer.

Radiologists also search for masses. Masses can be simple, fluid-filled cysts (totally benign), cysts that are at least partly solid (probably benign but may need some more investigation), and any masses that are not clearly a cyst (which would mean a biopsy to check for cancer cells). (3)

Remember that only 2 to 4 cancer cases are found in every 1,000 mammograms, so don’t let fear keep you from taking care of you. Go give yourself some peace of mind! (4)

A word about the latest research

A study that just came out this month suggests that mammograms cannot detect the fastest growing and deadliest cancers until it is too late, as diagnosis of these metastatic cancers did not rise with the advent of widespread mammography screening in the 1980’s. (All other kinds of breast cancer diagnosis increased by 30%.) Researchers also concluded that 81% of all tumors detected by mammograms over 10 years were overdiagnosis, or identification of non-progressive cancers that would never do any harm. Of course, 19% of tumors detected early did become life threatening – the very group that mammograms are meant to benefit. (5,6)

The bottom line is, you and your doctor should choose. You have the latest science and the best practices recommendations from ACS – do what makes you the most comfortable!

What to know before you go

  • When making your appointment, avoid the week before your period, when breasts may be tender and swollen.
  • Try to go to the same facility every year so that radiologists can view changes from year to year. If this is not possible, have previous mammogram results sent to your current mammogram provider.
  • Wear pants or a skirt rather than a dress so that removing your shirt and bra is easy.
  • Don’t wear deodorant or antiperspirant, as it can show up as white spots on the mammogram image and be confused for calcifications. Also, no lotion, powders, etc.on the breast or chest area.
  • The appointment should take about 20 minutes

[Primary source: American Cancer Society Website]

No insurance? No problem

The Centers for Disease Control run the National Breast and Cervical Cancer Early Detection Program, through which individuals can find a free or low-cost mammogram in their state. Click the link or call 1-800-CDC-INFO to find a facility near you.

References

  1. Mammograms. National Cancer Institute, National Institute of Health website. Accessed Oct. 11, 2016.
  2. American Cancer Society recommendations for early breast cancer detection in women without breast symptoms. American Cancer Society website, accessed Oct 12, 2016.
  3. Mammogram basics. American Cancer Society website. Accessed Oct. 11, 2016.
  4. Mammograms: What to know before you go. American Cancer Society website. Accessed Oct. 11, 2016.
  5. Park A. Even more evidence that mammograms have been oversold. FiveThirtyEight. Oct 12, 2016.
  6. Welch HG, Prorok PC, O’Malley J, Kramer BS. Breast-Cancer tumor size, overdiagnosis and mammography screening effectiveness. N Engl J Med. 2016;365:1438-1447.

More reading on mammograms

ACS guidelines
http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs

US Preventive Services Task Force 2015 guidelines
https://www.acponline.org/acp-newsroom/final-uspstf-recommendations-on-screening-for-breast-cancerpublished-in-annals-of-internal-medicine

Excellent YouTube explanation of recent research on mammograms
https://www.youtube.com/watch?v=IwoIBTJD1VQ

Dana Vaughan

About Dana Vaughan

Dana completed a Master of Public Health (MPH) and a Master of Social Work (MSW) at San Diego State University, and has worked in family planning education, prenatal counseling, and child development. She loves her mountain bike, her husband, her kids, and her faith—although possibly not in that order.

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