As a mammography technologist, I’m often asked questions concerning the need for breast imaging as well as breast health in general.
Myth #1: I don’t need to worry about mammograms because I don’t have any symptoms of breast cancer, my mammogram was normal last year, and/or there is no history of breast cancer in my family.
Fact: 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. However, if you have a strong family history, your screenings should start sooner.
Why is early detection 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 percent of women having breast cancer, have no family history.
Myth #2: A mammogram is painful and will only expose me to unnecessary radiation.
Fact: 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.
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 is 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 (A mSv is a measure of radiation dose). To put the dose into perspective, people are normally exposed to an average of about 3 mSv of 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 radiation a woman would get from her natural surroundings over about seven weeks.
Myth #3: There is no difference between 2-D and 3-D mammograms.
Fact: While the positioning of tomosynthesis 3-D mammogram is the same as a conventional 2-D mammogram, the images are much different. Tomosynthesis 3-D mammography is much more advanced and may find cancers possibly missed by conventional 2-D mammography.
Tomosynthesis allows the radiologist to look at the breast tissue in 1 millimeter slices for optimal viewing. With conventional 2-D 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 call backs for additional imaging.
Myth #4: A screening mammogram is guaranteed to find all cancers. And if a lump is found, it is cancerous.
Fact: 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.
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 3-D 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 a more testing. That doesn’t mean you have cancer. That simply means it needs to be determined if those changes or normal for you.
Myth #5: My doctor didn’t tell me I needed a mammogram, so I cannot schedule an exam.
Fact: 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 25 years old depending upon your provider and facilities protocols.