x-ray mammography machine

Do I really need an annual screening mammogram?

As a mammography technologist, I’m often asked questions concerning the need for breast imaging, as well as breast health in general. The simple fact is that screening mammograms every year are necessary for people age 40 or older and for younger people with a family history of breast cancer.

Early cancer detection is important

Early detection increases a patient’s survival rate. At the first sign of any symptom or change in the breast, it is imperative to contact your physician. Keep in mind not all changes in the breast lead to cancer, however, all changes should be addressed.

According to the American Cancer Society, early-stage breast cancers have a five-year survival rate of almost 100 percent. Later-stage cancers have survival rates of 24 percent. Breast cancer is not always an inherited gene, meaning just because you do not have a family history does not mean you have no chance of getting breast cancer. In fact, 90-95% of women who have breast cancer have no family history.

That seems clear, but I still encounter popular myths about mammograms. So, let’s look at why mammograms are important and what to expect when you get one.

Why do I need a mammogram screening every year?

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You have no symptoms, your mammogram was normal last year and there is no history of breast cancer in your family. So, a screening mammogram every year is unnecessary, right? Wrong. Although there are some disagreements among the health experts about when to start your screening mammograms, most all agree that you should start your annual screenings at age 40.

If you have a strong family history – especially if you’ve had a member of your close family diagnosed within the last 10 years – your annual screenings should start sooner than age 40.

Is a mammogram painful?

Do I really need a mammogram? 40 or older? Yes, every year No family history of breast cancer? Still yes, if 40 or older Family history of breast cancer? Yes, start sooner than 40 Survival rate of nearly 100% for early-stage cancer drops to 24% later on. Squeeze into your schedule a quick, simple mammogram. It may just save your life. While you might experience a little discomfort due to your breast being compressed, you should not experience pain. Your breast will be imaged one breast at a time and will be compressed to a degree that is tolerable for you. Keep in mind, compression is important because it spreads out the tissue, making the structures of the breast more visible.

Compression also smooths out areas that if not compressed could require you to have another mammogram. But you should only feel some pressure. Remember, in the grand scheme of things, compressing the breast for a few seconds could save your life.

Will I be exposed to unnecessary mammogram radiation?

Modern machines use low radiation doses to obtain high-quality breast images. The radiation exposure is well within medical guidelines. The radiation exposure and exam procedure are also regulated by the Food and Drug Administration and inspected by the American College of Radiology.

According to the American Cancer Society, the average dose for a typical mammogram with two views of each breast is about 0.4 millisieverts, or mSv, which is a measure of radiation dosage.

To put the dose into perspective, people are normally exposed to an average of about 3 mSv of background radiation each year just from their natural surroundings.

The dose of radiation used for a screening mammogram of both breasts is about the same amount of background radiation a woman would get from her natural surroundings over about seven weeks.

2D vs 3D mammograms

While the positioning of a tomosynthesis 3D mammogram is the same as a conventional 2D mammogram, the images are much different. Tomosynthesis 3D mammography is much more advanced and may find cancers possibly missed by conventional 2D mammography.

Tomosynthesis allows the radiologist to look at the breast tissue in 1-millimeter slices for optimal viewing. With conventional 2D mammography, the radiologist is viewing all the complexities of your breast tissue in one flat image making it much more difficult to see possible abnormalities.

Tomosynthesis reduces the chance of false positives, thus reducing patient callbacks for additional imaging.

Mammography is effective, but not the only tool

While screening mammograms are highly recommended, there are limitations. Not all breast cancers will be found with mammography, however, screening is essential. Also, stay vigilant with your monthly breast exams and be aware of any changes, even if you recently had a negative mammogram. Contact your physician right away if there are any changes in your breast.

If a lump is found, it isn’t always cancerous

Non-cancerous breast conditions are common. Sometimes these benign breast conditions cause symptoms that mimic cancer, making it hard to tell the difference. If your mammogram shows a suspicious area, your providers will take additional steps to identify the suspicious area. This might require additional images in mammography, ultrasound, or MRI.

Women with dense breast tissue can take advantage of 3D mammography, breast MRI or breast ultrasound, to obtain additional images. Be aware that if there are any changes in your breast structure, you may get called back for more testing. That doesn’t mean you have cancer. That simply means it needs to be determined if those changes or normal for you.

Do I need a doctor’s referral to schedule an exam?

If you are of age 40 or older, many places you may go for your screening mammogram do not require your doctor to write you a prescription or complete an order form. Be sure to check with the facility that you schedule with as those requirements may vary from facility to facility.

Your first mammogram, typically at age 40, will determine your “baseline.” A baseline simply outlines what is your normal.

If your mother, sister or daughter has been diagnosed with breast cancer, discuss with your health care provider when to start screening mammograms. You may be advised to start having mammograms 10 years earlier than the age that your relative was diagnosed with breast cancer. Mammograms may start as early as age 25 depending upon your provider and facilities protocols.

Last Updated: May 24, 2023

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About Author: Shelley Wesley

Shelley Wesley is a radiology graduate from Southwestern Illinois College. Shortly after completing her studies, OSF Healthcare Saint Anthony’s Health Center welcomed her as a Mission Partner where she works as a mammography technologist. Her and her husband, Brandon, share three wonderful children - Brooke, Dawson, and Allison.

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Categories: Cancer, Preventive Health, Women's Health