Mammogram Must Haves

None — Breast Cancer Incidence

Breast cancer is the most commonly diagnosed cancer among American women and the second leading cause of cancer death. In 2009, the American Cancer Society estimated about 192,370 cases of female breast cancer would be diagnosed in the U.S. In addition, 62,280 new cases of breast carcinoma in situ (the earliest form of breast cancer) were expected to be diagnosed. More than 40,000 women were expected to die of breast cancer in 2009.

Breast Cancer Screening: Mammography

Mammography can detect tumors that are too small to be felt during a physical exam. The goal of the procedure is to catch breast cancer or abnormalities before symptoms occur and/or the cancer has spread. Breast cancer that is detected in the earliest stages (while it is still confined to a small area) is more likely to have a successful treatment outcome.

Traditionally, mammograms are taken using X-ray films. However, more mammography facilities are now using digital techniques. With digital mammography, doctors can manipulate or magnify breast images to obtain clearer pictures of suspicious areas. The digital images can be stored in a computer and sent over the internet to other physicians for analysis and consultation.

Researchers estimate more than 27 million screening mammograms are performed annually in the U.S. If a suspicious area is found during a screening mammogram, a women may be asked to come back for more thorough imaging, called a diagnostic mammogram. Diagnostic mammography can provide more information about a suspicious breast lesion. However the only way to determine if the area is cancerous is to perform a breast biopsy.

Mammograms are considered the gold standard for breast cancer screening. However, they aren't perfect. According to the American Cancer Society, mammography may miss up to 20 percent of breast cancers (called a false negative report). There is also a chance a mammogram may falsely indicate the presence of cancer (called a false positive report). The American College of Radiology reports up to 15 percent of screening mammograms yield false-positive results, requiring further imaging. About 8 to 10 percent of women who have a diagnostic mammogram end up needing a biopsy. However, among those who have a biopsy, only 20 percent turn out to be cancer.

Getting the Most from Your Mammogram

There are many factors that can influence the quality and reading of a mammogram. To get the best mammogram, experts offer several tips:

• Choose an accredited facility. The American College of Radiology awards accreditation to facilities that meet the organization's high standards for image quality, physician expertise and safety. (To search for a mammography facility accredited by the American College of Radiology, go to http://www.acr.org/accreditation/AccreditedFacilitySearch.aspx.) Facilities should also be certified by the Food and Drug Administration.

• Film or digital? Overall, film and digital mammograms produce similar findings. However, Belinda Barclay-White, M.D., Radiologist with Breastnet in Scottsdale, AZ, says digital mammography appears to be better at detecting cancer in women with dense breasts, those who are pre – or perimenopausal and in women under 50. If you are uncertain which technique is best for you, speak with a physician or radiologist.

• Time your mammogram. For clear images, each breast must be compressed between two plates, which can cause some discomfort. For women who are still menstruating, the breasts are less tender the week after period onset. Timing is less of an issue for women taking hormone replacement therapy or who have reached menopause because hormone levels don't fluctuate.

• Come prepared. Be ready to provide information on family/personal medical history, current breast symptoms, past breast surgery and any concerns you may have about breast symptoms or health. If you are having your first mammogram ever, let the technician know so she can tell you what to expect. If you are going to a new facility, bring copies of past mammograms with you.

• Get your results. Some facilities will give you the results of your readings the same day. If the mammograms are read off-site, it can take longer for the results get back to the physician. The American College of Radiology says a high-quality mammography facility will get the results to your physician within 24 hours to a few days. If you don't hear from your doctor within two weeks, don't assume the results were negative. Call to confirm the findings.

Barclay-White says the most important thing to remember is to get screened. She says 75 percent of breast cancer deaths are in women who have not had breast cancer screening. She also advises women to talk to their health care providers about what age to start getting mammograms.

Last year, the US Preventive Services Task Force changed the recommendations for mammogram screening, urging routine screenings every other year for women 50 to 74. But some experts still recommend yearly mammograms starting at 40, or earlier for women who are at high risk for breast cancer. In fact, Barclay-White says researchers have found women with a family history of breast cancer tend to develop the cancer about ten years earlier than women of previous generations.

To search for a mammography facility accredited by the American College of Radiology, click here.

For general information on breast cancer and mammography:

American Cancer Society American College of Radiology National Cancer Institute Susan G. Komen for the Cure

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