All women should know the look and feel of their bodies, including their breasts. If, for instance, you have always had an
inverted nipple your adult life, it should not be a source of worry. Acute onset, however, is something to bring to your health provider's attention. Knowing the look and feel of your
breasts is important in avoiding unnecessary procedures, too. All women should have their doctor do a clinical breast exam on a regular basis.
What's a mammogram? Simply, it's still the best way to screen for
breast cancer. Mammograms can help find tumours in women who don’t show any symptoms of cancer. But some doctors disagree about screening rules.
Considering having a mammogram? The current guidelines for mammogram screenings are as follows:
- American Medical Association: annual mammograms at age 40
- American College of Obstetricians and Gynecologists: annual mammograms at age 40
- American College of Radiology: annual mammograms at age 40
- National Cancer Institute: annual mammograms at age 40
- American Cancer Society: annual mammograms at age 45.
- American College of Obstetricians and Gynecologists: annual mammograms at age 40.
Most guidelines also say that if a woman doesn’t start having annual mammograms at age 40, annual mammogram screening should start at age 50. Still, there is no one right mammogram screening age.
When you receive your mammogram screening results, talk to your doctor about next steps if they are abnormal. A mammogram does not diagnose
breast cancer. Wondering where
to get a mammogram? Hospitals, mobile units, and
breast centres can all provide mammograms, but you can call ahead to ask about what equipment they use, whether they can
provide 3D mammograms or MBI, what insurances they take, and their certification.
3D Mammograms and Molecular Breast Imaging
There are special screening rules for people who are at a high risk for breast cancer or who have found a lump or other suspicious area in their breasts. Mammograms can help diagnose the issue, but a doctor may also suggest other tests, like a sonogram or an MRI, because having
dense breast tissue makes it harder for mammograms to spot cancer. Dense tissue and tumours both appear light on mammograms, unlike fatty tissue. Women with dense breast tissue may be told to have 3D tomosynthesis (3D mammograms) or molecular breast imaging (MBI), rather than normal mammograms.
3D-tomosynthesis takes multiple X-ray pictures of each breast from many angles and does not compress the breast as much as traditional mammograms. Molecular breast imaging uses a radioactive tracer, injected through a vein, to reveal cancer inside the breast.
Breast cancer cells absorb the radioactive substance more than normal cells, so they “light up,” making them easier to spot. A special scanner is used to locate high concentrations of the substance and thereby identify the location of cancer. Unfortunately, molecular breast imaging and 3-D tomosynthesis may not be covered by all health insurance providers. The cost may make them inaccessible to some groups of women, and they are not available in all care facilities. Before you pursue a screening plan, discuss it with your doctor and ask about risks and benefits.
A Note about Mammograms
Some studies and
doctors assert that mammograms can lead to overdiagnosis and false positives, which lead women to make difficult choices and engage in expensive and life-altering treatments that could have been avoided or delayed. “
Overdiagnosing” means diagnosing cancer that didn’t require immediate treatment
without any change to a
woman’s prognosis, or diagnosing cancer that never would have required treatment or affected a woman’s health.
False positives are suspicious findings that turn out to be normal; they are technically “good news” but can have significant psychological, physical, and economic tolls.
