Do I really have to get a mammogram?

MammogramBy Molly Lewindowski M.D.

Screening mammograms are the most important tool to diagnose early breast cancer. About 1 in 8 women will be diagnosed with breast cancer. While there’s no one answer why the rate has increased in the past 25 years, there are known risk factors. Some risk factors we don’t have any control over- getting older, family history, prior history of breast cancer. Another common issue is high breast density, which can complicate the reading of the mammogram. But others risks we can change: smoking, drinking alcohol, avoiding weight gain, lack of exercise, use of hormone replacement therapy.

There are several types of mammograms.  The screening starts for most women at age 40.

  • The digital  mammogram is the standard screening test. If you are told you have dense breasts, this is normal. About 50% of women have a larger proportion of fibrous and glandular tissue than fat. The only reason this is important to know is that it does make the images harder to interpret, and you may be called back for more testing.
    *Getting called back after the mammogram does not mean you have breast cancer.
  • The 3D mammogram is another type of x-ray that will allow the radiologist to look at the tissue in greater detail. Many times this type of mammogram gives the best detail in dense breast tissue. However, insurance frequently will not cover it 100%. Check with your insurance, as each one is different.
  • Breast ultrasound is usually ordered when trying to determine if an area is a cyst or a solid mass. It may be used during pregnancy as there is no x-ray exposure.
  • Breast MRI can provide other information when diagnosing and treating breast cancer.  This type is usually ordered in women who are at high risk for breast cancer, when there is a close family member diagnosed before age 50.

Two local sites for mammograms are the Breast Center at St Luke’s and The Diagnostic Imaging Center. You do not need an order, but we do ask that they send the report to us for your health record.

Even though mammograms and breast imaging have greatly advanced in recent years, it’s important to notify your primary care office of any breast lumps or skin changes. Checking your own breasts monthly is a healthy habit, and may save your life. We can provide instructions during your annual physical visit.

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