Breast Cancer Detection: How to Get a Better Mammogram

October is National Breast Cancer Awareness Month, making it the perfect time to schedule your yearly mammogram if you haven't already done so. According to the American Cancer Society, 1 in 8 women will be personally affected by breast cancer during their lifetime, and early detection can improve prognosis and survival.

“Mammograms are considered the gold-standard for detecting small, early stage breast cancers, and they remain the only screening modality that’s been proven to reduce mortality from breast cancer,” says Dr. Sara Fogarty, Associate Director and breast surgeon at the Sandra & Malcolm Berman Comprehensive Breast Care Center, part of the GBMC HealthCare system. “Effectiveness has markedly changed over time thanks to the advent of digital mammograms with computer-assisted detection and 3D capabilities.”

In tandem with monthly breast self-exams, mammography remains the first line of defense in early breast cancer detection.

“The sensitivity of mammography across the country is around 80 percent in finding breast cancers,” radiologist Dr. Judy Destouet points out. “The data at GBMC shows our sensitivity for finding breast cancer is between 92 and 95 percent. We’re very good at early detection.”

Different types of mammograms

By simplest definition, a mammogram is an X-ray that radiologists use to look for cancer in breast tissue.

The American College of Radiology recommends women begin yearly screening with mammograms at age 40, even if they’re not exhibiting any signs or symptoms of breast cancer. Women who are at higher risk due to previous cancers, extensive exposure to radiation, positive testing for the BRCA gene or a strong family history of breast cancer may want to start annual screenings at an earlier age. A physician referral isn’t necessary for a screening mammogram in women age 40 and over; women can make the appointment themselves at any time.

A more comprehensive evaluation, diagnostic mammograms, are ordered by physicians when a patient has a breast concern, such as a lump. The results are viewed by a radiologist at the time of the appointment so additional imaging can be performed immediately if needed.

Technological advances in 3D mammography now let radiologists view digital “slices” of the breast rather than one static image, improving cancer detection rates among women with dense tissue.

Annual screening mammograms after age 40 are usually covered by insurance plans and Medicare; a copay may sometimes be required if a 3D mammogram is completed (at GBMC, it’s $60).

How to prepare for your mammogram

There’s not much women need to do to get ready for mammograms beyond skipping their usual lotion and deodorant applications, both of which contain particles that can mimic cancer on an X-ray.

“You should also go to a facility that does mammograms all day long, every day and try to have your screening at the same facility every year for consistency,” Dr. Fogarty says.

Menstrual cycles don’t have any effect on mammogram results. Women can feel free to schedule their appointment at any time of the month.

“However, women would most likely benefit from planning to have their mammograms towards the end or after their cycle, as breast tenderness and swelling is usually at its worst the week before menstruation,” Dr. Fogarty suggests.

Don’t put it off

With work, family and busy lifestyles, it’s easy for women to forget about having an annual mammogram. Some want to avoid the radiation exposure (which is very minimal), and some complain that it hurts, but Dr. Destouet says the biggest reason women put it off is fear of getting bad news.

“Women are much more afraid of breast cancer than they are of other cancers,” she says. “They worry that breast cancer detection will lead to a mastectomy, impairing their appearance and damaging their self-image. But, if the cancer is found when it’s small, they usually have options for breast conservation that don’t involve radical surgery.”

If your mammogram does reveal an abnormality, try not to immediately leap to worst-case-scenario conclusions.

“If we find something suspicious, we’ll do additional imaging to better analyze what’s going on,” Dr. Destouet says. “Most of the time, it turns out to be normal tissue.”