Let’s be honest, scheduling a mammogram isn’t exactly something most women look forward to. With the conflicting information many of us hear about what age we should be screened, how often we should be screened, and what type of mammogram to get, it’s no wonder it’s a task that all too often falls to the bottom of the to-do list.
At Mount Nittany Health Breast Care Center, we find that a patient’s reluctance to get a mammogram often stems from a lack of answers to some common questions about the procedure. Myself and my colleague, Allison Yingling, MD, as well as our patient care coordinator, Sara Marker, LPN, understand and are always happy to answer any questions or address concerns or issues relating to breast health. Below are some of the most commonly asked questions we hear, along with comprehensive answers to help you make the best decision for your health.
Q: When should I start screening and how often should I go?
A: At Mount Nittany Health Breast Care Center, we recommend yearly mammograms starting at age 40 and continuing yearly for as long as the patient is in good health, expects to live 5 to 10 years, and would seek treatment if cancer was found. These recommendations are backed by the American College of Radiology and Society of Breast Imaging, and research has shown mammography performed annually starting at 40 provides the greatest benefit to women. While most women should start at 40, some high-risk women should start screening before age 40.
Q: Why do the breasts have to be compressed during mammograms and does the exam hurt?
A: Unfortunately mammograms are not comfortable exams, because the breasts need to be compressed as thin as possible. The compression spreads out the breast tissue and therefore helps us to see through the breast tissue better by reducing overlap of tissues. Additionally, the compression reduces the amount of radiation to the breast; the thinner the breast is compressed, the less radiation is needed to get an adequate image.
It’s important to remember that every patient is different and some people have more discomfort than others. You should inform the technologist if mammograms are especially uncomfortable for you, and she can work with you to make the exam as comfortable as possible. Some other measures to reduce discomfort include timing the exam to be performed in the first week after the menstrual period or taking an over-the-counter pain reliever before the exam.
Q: How much radiation am I getting from screening mammograms?
A: Mammograms expose the breast to small amounts of radiation, but the risk of causing breast cancer from the radiation of mammography is far lower than the likelihood of mammography detecting breast cancer for women ages 40 and over. The dose from an average mammogram is comparable to a few months of natural background radiation (such as cosmic rays and radon), which we are all exposed to every day.
Q: What are 3D mammograms and are they better than the traditional 2D mammogram?
A: Digital breast tomosynthesis, also called “3D mammography,” is an advanced form of imaging where multiple images are obtained of the breast at different angles. The images are reconstructed into thin slices similar to a CT scan, which decreases the overlap of tissue and allows the radiologist to get a better view of the breast tissue. The compression is the same as with a 2D mammogram. At Mount Nittany Health Breast Care Center, we now offer 3D mammograms to all patients. When comparing 3D mammograms to standard 2D mammograms, studies have shown a reduction in callbacks and an increased cancer detection rate.
Q: The letter I received after my mammogram says I have dense breasts. What is dense breast tissue?
A: Breast density describes how a breast looks on a mammogram. Breasts are made up of fat and fibroglandular tissue, and dense breasts are breasts that have more fibroglandular tissue compared to fat. Having dense breasts is normal; about half of all women have them. Having dense breasts can make it harder to find cancers on a mammogram, with some studies showing a slight increased risk of breast cancer. The use of 3D mammography, however, can help us see through dense breast tissue better than a 2D mammogram and is recommended for women with dense breasts.
Q: If I get called back from a screening mammogram, does that mean I likely have cancer?
A: About 10 percent of women who get a screening mammogram will be called back for additional imaging, which may involve additional mammogram images or an ultrasound. Many times the findings are benign and could represent an overlap of normal tissue or findings such as cysts. Some women will also need a biopsy to further evaluate an area, but the majority of biopsies are also benign.
To learn more about Mount Nittany Health Breast Care Center, breast health and other women’s healthy living topics, visit mountnittany.org.
Anna Hood, MD, Mount Nittany Health Breast Care Center, is a board-certified radiologist with specialized fellowship training in breast imaging.
This article orginially appeared in Town & Gown