Mammograms 101



BY JAMIE LOBER

The American Cancer Society defined a mammogram as an x-ray of the breast that looks for changes that could be signs of breast cancer. While there are screening recommendations, the best strategy is to know your body, your risks, and talk to your gynecologist to learn what will be most effective for you. Early detection for any disease is always the key, though just how early you need to become more aware of your breast health is individualized.

In 2017 the American College of Obstetricians and Gynecologists revised their recommendations for mammograms to focus more on patient autonomy and shared decision-making with the doctor. They suggest women and their gynecologists have a conversation about the woman’s health history, benefits, and harms of screening, concerns, priorities, values, preferences, and potential benefits and harms of screening. They find that regular screening mammography starting at 40 years old reduces breast cancer mortality in women with average risk. The American College of Radiology and Society of Breast Imaging shared the recommendation that women start to get mammograms at 40 years old as it can be lifesaving. The American College of Obstetricians and Gynecologists do note that screening can also cause anxiety, false-positive reports, overdiagnosis, and overtreatment.

Be conscious of when you schedule your mammogram. It is not a good idea to schedule it the week before a menstrual period. The best time is actually a week after your period. Some basic tips to make sure the mammogram goes smoothly include:

  • Not wearing deodorant or lotion
  • Describing any symptoms or problems with your breasts
  • Share any personal or family history of breast cancer, prior surgeries or hormone use
  • Gathering prior mammograms if you had any so the doctor can compare findings
  • Find out when results will be available and follow up

Knowing what to expect can help you feel more at ease during the procedure. The x-ray machine gives off a little burst of radiation that goes through your body and creates a film. The mammogram is performed on an outpatient basis where a licensed radiologic technologist positions your breast on a platform and compresses it with a plastic paddle. Compressing the breast helps all of the tissue to be seen and a sharp picture to be taken electronically. Both breasts will be photographed and you may be asked to change positions in order for the doctor to get the greatest views. For example, women who have breast implants may need to have a few extra pictures taken to be sure all of the breast tissue is seen. Sometimes 2-D images are created from the 3-D ones due to the advances of technology. The entire procedure should not take more than half an hour.

If you are a Forsyth woman over 40 years old and have not had your first mammogram, do not worry. You want to be educated on the risks and benefits and screen every one or two years. Women with an average risk for breast cancer should continue screening until they are 75 years old. After age 75, you want to consider health status and longevity when making a decision about screening.

Consider the positive side to mammograms. The Radiological Society of North America listed benefits such as:

  • It helps the doctor detect tumors when they are small and easier to treat
  • Helps to detect all kinds of breast cancer
  • Increases detection of small abnormal tissue growths
  • There are usually no side effects
  • No radiation remains in the body

The medical community has revisited the guidelines as well as taken a close look at mammography over the years to make sure it is as effective and safe for patients as possible. Modern x-ray systems have very controlled beams that are different from the mammogram you may envisioned from the past. Remember that there are many non-cancerous breast conditions, and just because the mammogram detects something unusual does not mean that it is a problem. By having open dialogue and addressing questions and concerns with your doctor, you will be able to make educated and wise decisions about your breast health.

 


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