Most women have a love-hate relationship with screening mammograms. Breasts are not made to be compressed and squished flat like a pancake, even if it’s only for a few seconds. On the other hand, we embrace mammograms because they remain the best method of early breast cancer detection, and the earlier it’s detected, the better our chance for survival.
When it comes down to it, a couple of minutes of discomfort for a non-invasive, potentially life-saving test is a remarkably small price to pay. So if you’re due for a screening mammogram, don’t delay. It just might save your life!
Until the Food and Drug Administration approved the first digital mammography system in 2000, mammograms (breast X-rays) were recorded on film. Film-screen mammography, however, is limited in its ability to detect some cancers, especially those occurring in women with “dense” breast tissue.
Today, advanced imaging technologies are available and used for screening and diagnostic mammography. In addition, other tools are being researched, analyzed, and utilized, such as molecular breast imaging (nuclear medicine imaging of the breast).
FULL-FIELD DIGITAL MAMMOGRAPHY (FFDM)
Unlike traditional film-screen mammography, FFDM captures an electronic picture of the breast in digital format. The digital X-ray images, which are stored and analyzed using a computer, can be adjusted for image size, brightness, and contrast to see certain areas more clearly. Other advantages over traditional mammography include lower average radiation, reduced breast compression pressure, and improved breast cancer detection rates.
3-D MAMMOGRAPHY (BREAST TOMOSYNTHESIS)
Some state-of-the-art breast imaging centers offer 3D mammography in addition to FFDM. 3D mammography captures multiple slices (images) of the breast from several angles. This creates a layered 3D image that allows the radiologist to review your breast for suspicious features one thin slice at a time, almost like turning the pages of a book. Clinical studies have shown that 3D mammography may find cancers 40 percent earlier than FFDM. 3D may also reduce the chance that you will be called back for additional imaging.
Breast magnetic resonance imaging (MRI) creates detailed pictures of the inside of the breasts. It may be used in addition to a screening mammogram to help detect breast cancer in its earliest stage for some women who are at high risk for developing the disease. Breast MRI may also be used to help detect cancer in women who have breast implants or scar tissue that might jeopardize an accurate result from a mammogram. MRI should be in addition to, not instead of, a screening mammogram, because it may still miss some cancers that a mammogram would detect.
Breast ultrasound uses sound waves to make images of the breast. It is often used as a follow-up test after an abnormal finding on a mammogram, breast MRI or clinical breast exam.
WHEN TO GET SCREENING MAMMOGRAMS
Not all organizations agree on mammogram guidelines. If you have questions or concerns about screening mammograms, discuss them with your doctor. Together you can decide what’s best for you based on your individual breast cancer risk. The American Cancer Society and other organizations recommend screening begin at age 40 and continue annually for women who do not have breast disease symptoms and who are not at high risk for developing breast cancer.
Women age 40 and older should have a mammogram every year and should continue to do so for as long as they are in good health.
Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a periodic regular health exam by a health professional, preferably every three years. Starting at age 40, women should get a CBE from a health professional every year.
Breast self-exam (BSE) is an option for women starting in their 20s. Women should know how their breasts normally look and feel and report any breast changes to a health care provider right away.
Due to their family history, a genetic tendency (e.g., BRCA1 and BRCA2 gene mutations), or certain other factors, some women should be screened annually with MRIs along with a mammogram prior to age 40. Visit cancer.org/healthy/findcancerearly for more information on screening guidelines for early cancer detection.
By Annette Brooks