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Mammogram Screening Guide

Breast cancer is the singular most common form of cancer among women in the United States, but it is also one of the most treatable forms of cancer with early detection. Mammography is a key screening tool for early detection and treatment, and it offers doctors a safe, reliable way to make an informed diagnosis and develop an appropriate treatment plan. Because of the small amount of radiation, an annual mammogram is not routinely undertaken until age 50, but doctors may recommend it earlier for patients with genetic histories of breast cancer. Regardless of age, it is important for every woman to understand this basic screening tool that can assist with their future breast health.

When to Prepare

All women of reproductive age should engage in routine self breast exams, as well as annual manual breast exams by an OB-GYN. Mammograms rely on a small amount of radiation to create an internal image of your breast. Mammography typically yield 70 millirems of radiation, about roughly the dose women receive normally from their environments over two and a half months. Because of this small amount of radiation, annual mammogram screening isn’t typically ordered until women turn 50, but women who have a family history of cancer or who have detected a breast lump may wish to undertake screening earlier.

What to Expect

A typical mammogram takes two x-ray pictures of the breast: one from the front and one from the side. This allows doctors to detect problem areas that may not be able to be felt during a routine breast exam, and also functions as a diagnostic tool if a lump has already been identified. Each breast must be compressed to achieve an accurate x-ray. Most women find this compression uncomfortable but not painful, and it only lasts a few seconds; most procedures only take 15 minutes from start to finish. Whether the images are recorded digitally or via film, results are instantaneous, but still require a trained radiologist to read and interpret them. This typically takes 1-2 days.

Mammography, Ultrasounds, and MRIs

Mammography is one tool out of several for breast cancer detection and diagnosis. Doctors may also order a breast ultrasound and/or a breast MRI, depending on a patient’s unique circumstance. A breast ultrasound uses radio waves instead of x-rays to create a picture of the breast. Ultrasounds may be ordered as a screening measure in young women who are still of child-bearing age, simply as a best medical practice to spare their body unnecessary radiation. A breast MRI is a slightly more involved process which uses powerful imagining technology to create extremely detailed pictures of the breast. Because a breast MRI is so detailed, it may display many lesions and areas that are not cancerous, and therefore must be read very carefully and paired with other tools of evaluation. A breast MRI may be ordered if a patient has a notable family history of breast cancer, has a known BRCA1 or BRCA2 gene mutation, or has a syndrome related to breast cancer risk. Neither an ultrasound or a breast MRI is a replacement or substitute for mammography; they are used in conjunction with the standard mammogram process to get as much information as possible.

Mammogram Costs

Most private insurance companies cover an annual screening without copay for women over forty, and Medicare covers one baseline mammogram screening between age 35-39 and one annual screening each year beginning at age 40. In addition, many states and local municipalities offer free or low-cost services to low-income women. For more information about these programs, check with your local health department or hospital.

Sources:

• University of Maryland Breast Center, http://www.umm.edu/breastcenter/
• Center for Disease Control, National Breast and Cervical Cancer Early Detection Program, http://www.cdc.gov/cancer/nbccedp/
• National Cancer Institute, http://www.cancer.gov/cancertopics/factsheet/detection/mammograms