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The Importance of Mammography in Early Dectection
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October is Breast Cancer Awareness Month. During this month, efforts intensify to help women learn more about the disease that strikes 1 in 8 American women in their lifetime. In Bay Area communities, the incidence of breast cancer is among the highest in the nation. The good news is that early detection, regular use of screening mammography and appropriate treatment are making an impact. Since 1990, breast cancer mortality in California declined by more than 20 percent.
Who is at Risk?
"Every woman is at risk, and the risk increases as you age," explains Brenda Carlson, R.N., M.S., A.O.C.N., Executive Director, Oncology Service Line with John Muir Health. "It is important for each woman to be familiar with the physical characteristics of her own breasts so that she is aware of changes that might occur over time." Fortunately, most changes are normal and benign, but if there is a problem, early identification allows for rapid evaluation and increases the potential for successful treatment," she adds.
A Combined Approach is Still the Best Defense
"Most suspected risk factors aren't fully understood and therefore can't be controlled," adds Vicki Rocconi, R.N., O.C.N., nurse educator at John Muir Breast Health Center at John Muir Medical Center, Concord Campus's. "You can, however, take steps for early detection and appropriate treatment."
Why Should I Have a Mammogram?
"Mammography has proved to be the single most beneficial tool in detecting early and treatable cancer," says Howard Cohen, M.D., a radiologist with John Muir Health. "It has resulted in a 30 to 35 percent lower mortality rate over the last several years, according to the American College of Radiologists." While mammography may not be an exact science, a recent major study showed a 42 percent reduction in the rate of women diagnosed with stage II or higher breast cancer in those who practiced routine screening.
If it is caught early and hasn't spread to the lymph nodes, the five-year survival rate is 97 percent, dropping to 78 percent if it spreads locally, according to the American College of Radiology.
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." Information can be obtained by calling (925) 674-2001.
How is a Mammogram Done?
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.
What if a Lump is Found?
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 Revises 1997 Guidlines
In May 2003, The American Cancer Society (ACS) released its updated breast cancer screening guidelines. This is the first update since 1997. There are few differences, but the differences are important. The recommendations for mammography have not changed, in fact, their review of the literature and most recent study results confirmed the benefits of routine screening mammography. The ACS maintains that "women can feel confident about the benefits of regular screening mammography."
Current Breast Cancer Detection Guidlines
John Muir Health recommends following the ACS guidelines and reminds women that early detection is their best protection against breast cancer.
- 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.
Your 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. Staying on a regular schedule of clinical breast examinations and following the appropriate guidelines for mammograms are highly effective screening tools. Remember, if you find something abnormal, seek medical attention right away. Early diagnosis and treatment give the best chance of being "cured."