According to experts, a mammogram is the best screening tool for detecting breast cancer at its earliest, most treatable stages. Using special x-ray imaging, a mammogram can reveal both harmless and cancerous growths even when they are too small to be felt through a breast self-exam or clinical breast exam.
An annual mammogram is recommended for women age 40 and over. If you have a family or personal history of breast cancer, your doctor may recommend beginning annual mammograms earlier.
What to Expect of a Mammogram
A mammogram can be performed in a variety of settings, including hospital clinics, mobile vans or your doctor’s office. It involves standing or sitting in front of a specialized x-ray machine. A technician will position your breast on a platform. A clear plastic plate will press the breast flat, enabling the maximum amount of breast tissue to be examined with the least radiation possible.
The compression of the plates may cause some minor discomfort, but no significant pain. If you feel pain, you should inform the technician immediately. If you are menstruating, you may want to schedule your mammogram appointment a week after your period ends when your breasts are not swollen or tender. And if you have breast implants, you should tell your doctor so extra care can be taken to prevent rupturing the implant.
During the mammogram procedure, you will need to remove your clothes from the waist up. For this reason, you may want to wear loose clothing and a shirt that you can take off easily. You will also want to refrain from wearing any deodorant, lotions or powders. These substances can alter the x-ray quality.
Many mammogram facilities now use skin markers to help identify areas of concern or normal breast variations such as surgical scars and raised moles. These adhesive markers are placed on the breast skin and develop on the x-ray to pin point specific spots. This alerts the radiologist and enables a fast accurate reading of the mammogram film.
After your mammogram is completed, a radiologist will examine the films and determine if there are breast abnormalities that need further exploration. If your mammogram results are not back within 10 days, contact your doctor or the mammogram facility. Don’t assume that the results are normal just because you haven’t received them. If the mammogram does show a breast abnormality, talk with your doctor about the appropriate next steps.
There are two basic types of mammograms, screening and diagnostic.
This type of mammogram is used for women who are asymptomatic, meaning they have no complaints or symptoms of breast cancer. Its purpose is to identify breast abnormalities before they can be detected through breast self-exams or clinical breast exams. Screening mammograms generally involve taking x-rays from two views of each breast and can be completed in less than 15 minutes. According to the FDA, screening mammograms can detect 85% to 90% of all breast cancers.
A diagnostic mammogram is administered to women who are experiencing symptoms of breast cancer or have detected a breast abnormality. It involves a more thorough examination and is used to determine the exact size and location of the breast abnormality. Diagnostic mammograms generally take several x-ray views of the breast and require approximately 30 minutes to complete. Women with breast implants or a personal history of breast cancer will usually require a diagnostic mammogram.
While the causes of breast cancer are largely unknown, medical researchers have identified a number of risk factors that can increase a woman’s chance of developing the disease. It’s important to note that risk factors do not cause breast cancer, nor do they predict whether an individual will get the disease. Some women may have many breast cancer risk factors and never get the disease, while others who have no risk factors get the disease. However, understanding your risks for breast cancer will help you actively monitor your breast health to detect potential problems at an early stage.
Age: An Increasing Risk
Your risk for developing breast cancer increases dramatically with age. Only 1 in 8 invasive breast cancers are found in women under the age of 45, while 2 out of 3 invasive breast cancers are found in women age 55 or older. *
* Source: American Cancer Society, 2015
Controllable Breast Cancer Risk Factors
- Having more than one drink of alcohol per day
- Not getting regular exercise
- Using combined hormone therapy after menopause
- Being overweight
Source: American Cancer Society, 2015
Uncontrollable Breast Cancer Risk Factors
- Being a women
- Getting older
- Family history of breast cancer
- Having the mutated breast cancer genes BRCA1 or BRCA2
- Personal history of breast cancer
- Starting your period before age 12
- Starting menopause after age 55
Source: American Cancer Society, 2015
Breast Cancer Myths
Because the causes of breast cancer are not completely known, many people have misconceptions about the disease. Here are 10 common beliefs about breast cancer that are NOT true.
- Only women get breast cancer
- If a woman is diagnosed with breast cancer, she will likely die from it
- Only women with a family history of breast cancer are at risk
- Small-breasted women cannot get breast cancer
- Breast-feeding causes breast cancer
- Large-breasted women are at greater risk for breast cancer
- Breast implants increase the risk of developing breast cancer
- A discharge from the nipple indicates breast cancer
- Using birth control pills causes cancer
- Antiperspirants increase the risk of breast cancer
Breast Health Habits
Good breast health starts by following good breast health habits. Medical professionals recommend the following:
- 1. Performing monthly breast self-exams (BSE)
- 2. Receiving an annual clinical breast exam (CBE) from your doctor
- 3. Receiving annual mammograms beginning at age 40
The best defense against breast cancer is early detection. To reduce your risk of developing the disease, you need to routinely check your breasts for breast cancer signs and symptoms.
A breast self-exam (BSE) will help you learn the normal feel and shape of your breasts, making it easier to notice any changes. This breast care procedure should be performed monthly. Breast self-exams are best done a few days after your period ends, when your breasts are not tender or swollen. If you no longer get your period, you should perform a breast self-exam on the same day of each month.
How To Perform a Breast Self-Exam (BSE)
Examining your breasts involves feeling for lumps or thickenings as well as looking for visible changes.
While showering, raise one arm over your head. With the fingers of your opposite hand, gently feel your breast for any abnormalities. Repeat this process by raising your other arm and inspecting the other breast with the opposite hand.
When inspecting your breast, keep your fingers flat and together. Gently press the pads of your fingers to the surface of your breast in small, circular motions. Rotate around the entire breast starting from the outermost part and spiral in toward the nipple. Use this circular method to inspect under your armpit and across your collarbone as well.
After you shower, visually examine your breasts in a mirror. Look for any dimpling, puckering, redness or swelling. Raise your arms over your head and check for any changes in size, shape or contour. Gently squeeze both nipples and look for any discharge.
If you feel a breast lump or notice any changes in size or color, be sure to contact your doctor.
Clinical Breast Exam
In addition to regular breast self-exams, a clinical breast exam (CBE) performed by a health professional, such as a physician, nurse or nurse practitioner, is recommended for women starting at age 20. Clinical breast exams are vital for early detection of breast disease and are typically performed once a year.
A clinical breast exam may resemble the self-breast exam. Using the pads of the fingers, the examiner will apply slight pressure to feel for breast lumps in the outside, middle and around the nipple of the breast. He or she also will examine under the armpit and check for any discharge coming from the nipple. A trained health professional can often detect a breast abnormality before a woman feels something irregular through a self-breast exam.
Ultrasound Breast Imaging
Although a mammogram remains the most common and effective screening device for detecting early stage breast cancer, there are occasions where it may not reveal a breast lump or other abnormality. There are also times when a mammogram may not provide enough detailed information about a breast abnormality. In these cases, your doctor may recommend a breast ultrasound.
An ultrasound of the breast uses high-frequency sound waves to create a detailed computer image of the breast tissue. From this, your doctor can distinguish between cysts and solid masses to determine the size, shape, texture and density of a breast lump.
Breast MRI is a special test, used in select high-risk women, to find small lesions invisible to traditional imaging methods such as mammography or breast ultrasound. This provides patients with the earliest and most accurate and complete diagnosis possible.
MRI, or magnetic resonance imaging, is a non-invasive procedure that uses powerful magnets and radio waves to construct pictures of the body. Unlike radiography and computed tomographic (CT) imaging, MRI does not use radiation to look inside the body. For a breast MRI, the patient lies facedown, with the breast hanging freely into a cushioned recess that contains the coil. The bed then moves into the magnet, a giant, tube-like machine, where the patient must remain still while the scans are produced. MRI is a more sensitive procedure — that is, MRI can reveal additional lesions early on and help identify lesions that warrant biopsy in high-risk women. The procedure is used as an additional test in patients most likely not to have a lesion detected by mammography alone. They include women who have a family history of breast cancer, a genetic predisposition to breast cancer or a firm area in the breast from a scar or recurrent tumor, those who have had breast surgery, and those who show residual tumors near the surgical site that require additional tissue removal.