Mammograms

Expert Quote

“Mammography plays a critical part in diagnosing breast cancer. In the past, we'd often find that a woman had breast cancer when she came in with a lump. Today, the cancers radiologists find on mammography are usually detected early, before they can be felt by the patient, are smaller than cancers felt by patients, and have much lower levels of lymph node involvement.”

Susan Orel, M.D.

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Mammograms are probably the most important tool doctors have to help them diagnose, evaluate, and follow women who've had breast cancer. Safe and highly accurate, a mammogram is an X-ray photograph of the breast. The technique has been in use for about thirty years.

Mammograms don't prevent breast cancer, but they can save lives by finding breast cancer as early as possible. For example, mammograms have been shown to lower the risk of dying from breast cancer by 35% in women over the age of 50; studies suggest for women between 40 and 50 they may lower the risk of dying from breast cancer by 25–35%.

Leading experts, the National Cancer Institute, the American Cancer Society, and the American College of Radiology now recommend annual mammograms for women over 40.

Finding breast cancers early with mammography has also meant that many more women being treated for breast cancer are able to keep their breasts. When caught early, localized cancers can be removed without resorting to breast removal (mastectomy).

Mammograms aren't perfect. Normal breast tissue can hide a breast cancer, so that it doesn't show up on the mammogram. This is called a false negative. And mammography can identify an abnormality that looks like a cancer, but turns out to be normal. This "false alarm" is called a false positive. To make up for these limitations, more than mammography is needed. Women also need to practice breast self-examination, get regular breast examination by an experienced health care professional, and, in some cases, also get another form of breast imaging, like ultrasound or MRI scanning.

4 Important Things to Know About Mammograms

1. They can save your life. Finding breast cancer early reduces your risk of dying from the disease by 25 - 30% or more. Women should begin having mammograms yearly at age 40, or earlier if they're at high risk.
2. Don't be afraid. It's a fast procedure (about 5 - 10 minutes), and discomfort is minimal. The procedure is safe: there's only a very tiny amount of radiation exposure from a mammogram. To relieve the anxiety of waiting for results, go to a center that will give you results before you leave.
3. Get the best quality you can.If you have dense breasts or are under age 50, try to get a digital mammogram.
   • Bring your old mammogram films with you for comparison.
   • Have more than one radiologist read your study.
   • Ask if your center has CAD—computer aided detection—which calls the radiologist's attention to any possible areas of concern.
   • Make sure the doctor who referred you for the mammogram includes an explicit note when ordering the study (providing clinical correlations—e.g. "palpable mass in the upper outer quadrant, rule out abnormality").
   • Correlate your results with other tests you've had done, like ultrasound or MRI.
   • Discuss your family history of breast and other cancers—from both your mother's AND father's side—with your doctor.
4. It is our most powerful breast cancer detection tool. However, mammograms can still miss 15—20% of breast cancers that are simply not visible using this technique. Other important tools—such as breast self-exam, clinical breast examination, ultrasound, and MRI—can and should be used as complementary tools, but there are no substitutes or replacements for a mammogram.

—Marisa Weiss, M.D.

When to get a mammogram

There's a lot of confusion out there about when and how often to get a mammogram. For now, the recommendation is that women get a mammogram once a year, beginning at age 40. If you're at high risk for breast cancer, with a strong family history of breast or ovarian cancer, or have had radiation treatment to the chest in the past, it's recommended that you start having annual mammograms at a younger age (often beginning around age 30). This, however, is something that you should discuss with your healthcare provider.