Mammograms

Mammography

While, breast cancer is the second leading cause of cancer death for American women, there is good news. Early detection, regular use of screening mammography, and appropriate treatment are making an impact in helping to reduce the risk of women dying from breast cancer.

Risk factors

According to the American Cancer Society (ACS), factors that increase breast cancer risk include:

  • Age (65+)
  • Certain inherited genes
  • Age (30+) at first full-term pregnancy
  • Family history of breast cancer
  • Early first menstrual cycle
  • Late menopause
  • High breast tissue density
  • Obesity
  • Use of combined menopausal hormones
  • Alcohol consumption
  • Physical inactivity

"Every woman is at risk, and the risk increases as you age," explains Brenda Carlson, RN. MS, AOCN, executive director of cancer services at John Muir Health.

"Most suspected risk factors aren't fully understood and therefore can't be controlled," adds Vicki Rocconi, RN, OCN, nurse educator at John Muir Health. "You can, however, take steps for early detection and appropriate treatment."

Early detection

"Mammography has proved to be the single most beneficial tool in detecting early and treatable cancer," says Howard Cohen, MD, a radiologist with John Muir Health.

According to the American Cancer Society, mammography detects about 80-90 percent of breast cancers in women without symptoms. While mammography may not be an exact science, the ACS calls it the most effective method of early detection since it can identify cancer several years before physical symptoms develop.

If it is caught early and hasn't spread to the lymph nodes, the five-year survival rate is 98 percent, dropping to 84 percent if it spreads regionally, according to the ACS.

Low-income women in California without health insurance who are underinsured or without health insurance are eligible for free annual mammography screenings through "Every Woman Counts." For more information call (925) 674-2001.

Quick and easy

Mammograms are quick and easy. As you stand facing the X-ray equipment, the technologist places your breast between two plastic plates and compresses it. This process may cause slight discomfort, but it helps to get a clear picture. The entire procedure requires only 5 to 10 minutes. A mammogram can detect a lump before it is large enough to feel.

"The radiation dose is very low, and benefits far outweigh any potential risk," Carlson emphasizes.

If there is a lump

Your doctor will first carefully feel (palpate) the lump and tissue around it and in some cases perform an ultrasound test, to help identify the breast mass. A needle aspiration or needle biopsy of the mass can yield fluid or indicate a solid mass, giving additional information and evidence for lab testing.

ACS Guidelines

The American Cancer Society guidelines stress that early detection of breast cancer by mammography may lead to greater treatment options, including less aggressive surgery and medical treatment.

John Muir Health recommends following the ACS guidelines:

  • Breast Self Awareness: Women should know how their breasts normally feel and report any change promptly to their health care provider. Monthly Breast Self-Examination (BSE) is an option for women starting in their 20s.
  • Clinical Breast Examination: Performed by a health care provider. Women 20 - 39 should have a clinical breast exam every three years.
  • Mammography Screening: Asymptomatic women age 40 and over should receive a mammogram and clinical breast examination and discuss breast health with their physician yearly.

Women at increased risk (family history, genetic tendency or past breast cancer) should talk with their doctor about the benefits and limitations of starting mammography screening earlier, having additional tests such as breast ultrasound and MRI, or having more frequent exams.

Best Defense

Health care providers agree that no one method of detection is 100 percent accurate.

It is important that women become familiar with the normal feel and appearance of their breasts and be sensitive to any changes. Remember, if you find something abnormal, seek medical attention right away.

Staying on a regular schedule of clinical breast examinations and following the appropriate guidelines for mammograms are highly effective screening tools. Early diagnosis and treatment give the best chance of being "cured."