By Linda Bren
If you're a woman over 40 and you can't remember the last time you had a mammogram, you may be overdue.
The National Cancer Institute (NCI) estimates that 1 in 8 women will be diagnosed with breast cancer at some time in their lives. But the good news is that mammograms--X-ray pictures of the breast--can detect breast cancer early, when it's most treatable.
According to the Centers for Disease Control and Prevention (CDC), a mammogram can show a lump in the breast an average of one to three years earlier than a woman can feel it.
"Mammograms are our best tool for early detection," says Marsha Henderson, Health Programs Director in the Food and Drug Administration's Office of Women's Health. "Early detection gives a woman more treatment options and a better chance of successful treatment and survival."
In short, a mammogram can save your life.
How Often?
The NCI recommends that women in their 40s and older have mammograms every one to two years. Some women who are at higher-than-average risk of breast cancer may need to get them at a younger age and more often. Talk to your doctor about when you should get a mammogram.
Safety and Quality of Mammograms
A federal law, the Mammography Quality Standards Act (MQSA), ensures that mammography is safe and reliable. Under the MQSA, all mammography personnel and facilities, including mobile units, in the United States must be accredited, be FDA-certified, and pass annual inspections. Mammography facilities are required to display their FDA certificate where patients can see it. The certificate indicates that the facilities have met stringent standards and can provide quality mammography.
In addition, the law requires all mammography facilities to
- Provide patients with an easy-to-understand report on the results of their mammogram
- Provide a way for consumers to voice a complaint and a process for addressing their concerns
- Give patients their original mammograms when they are needed. A patient needs her original mammograms if she decides to change mammography facilities or makes an appointment for a second opinion or with a specialist for treatment.
Just Do It
Some women just don't take the time to go get a mammogram, says Cheryl Kidd, M.P.H., Director of Education for the Susan G. Komen Breast Cancer Foundation. Or they give other reasons for not going. Here are some common reasons they may avoid mammograms.
It hurts. Some women experience pain during a mammogram. "It can be painful, but it only hurts for a few seconds," says Kidd. In order to have a good sharp image, the technologist has to compress the breast between two plates.
"And if it really hurts, tell the technologist," says Henderson. "She may be able to reposition the breast so it's more comfortable."
Women with sensitive breasts may want to schedule a mammogram one week after their period, when the breasts are usually the least tender.
I'm too old to get breast cancer. "This is a big myth," says Henderson. "Some women think as they get older, they don't need to go as often." But the older you are, the greater your chances of getting breast cancer, according to the NCI.
I can't remember to go. "Go around a time that's easy to remember," advises Kidd. "Like the month of your birthday." Or get it around the time of your annual checkup or Pap smear.
I'm afraid that the radiation can harm me. A federal law has established a maximum radiation dose limit that is very low and considered to be safe. And there have been such improvements in mammography that women receive 50 times less radiation than they received 20 years ago, says the FDA.
According to the American Cancer Society, one mammogram exposes a woman to roughly the same amount of radiation as flying from New York to California on a commercial jet.
It makes me nervous. It can be scary, says Kidd. "If you're afraid, take a friend or family member with you."
"You can make it an event," adds Kidd, who says she knows of families that schedule appointments around Mother's Day, and mothers, daughters, and aunts all go together.
After the mammogram, the technologist usually asks women to wait in the changing stall in case more pictures are needed. "This is when some women panic," says Henderson. "But you shouldn't be nervous." Even if the technologist wants to take more pictures, it doesn't mean something is wrong. It is usually just to get an additional view to get a clearer picture of a particular area.
I'm scared I'll have breast cancer. It's possible that you'll get some bad news, says Kidd. But most lumps are not cancerous. And if you do have breast cancer, treatment is more successful when caught early. Deaths from breast cancer have been steadily dropping since 1990, due to early detection with mammography and advances in treatment.
"You may be scared, but not knowing is worse," says Kidd. Finding cancer early makes it easier to treat, often without losing a breast.
It costs too much. Medicare and many private insurers provide coverage for screening mammograms.
The CDC coordinates the National Breast and Cervical Cancer Early Detection Program, which provides screening mammograms at low or no cost to women throughout the country who qualify based on income.
How to Get a Mammogram
- Ask your doctor or nurse to help you find an FDA-certified mammography facility. See www.fda.gov/cdrh/mammography/certified.html for a list.
- Call the facility to make an appointment.
- If you have breast implants, ask the facility before scheduling the mammogram whether their personnel are trained in X-raying women with implants. If not, ask to be referred to another facility. At the time of the mammogram, remind the technologist before the procedure is done that you have implants.
- When you go to the facility, look for the FDA certificate and make sure it has not expired.
- Do not wear deodorant, lotion, powder, or perfume the day of the mammogram. They can cause shadows on the X-ray pictures and can make them harder to read.
- Take your doctor's name and address with you so the facility can send the results to him or her. Under law, the facility must also provide the results to the patient within 30 days after the exam.
- If you do not receive the results within 30 days, call the facility or your doctor and ask for the results. Do not assume the mammogram is normal if you do not receive the results.
- If you are satisfied with the facility, go back to it every time you get a mammogram so that your X-rays can be compared from year to year.
Risk of Breast Cancer in American Women
The older a woman is, the greater her chance of developing breast cancer. A woman's chance of being diagnosed with breast cancer is:
Ages 20 to 30 .............. 1 in 2,000
Ages 30 to 39 .............. 1 in 229
Ages 40 to 49 .............. 1 in 68
Ages 50 to 59 .............. 1 in 37
Ages 60 to 69 .............. 1 in 26
Ages 70 to 79 .............. 1 in 24
Lifetime ...................... 1 in 8
National Cancer Institute
For More Information
National Cancer Institute
"Understanding Breast Changes: A Health Guide for All Women" and other information
(800) 4-CANCER (422-6237)
TTY/TTD: (800) 332-8615
Centers for Disease Control and Prevention
Free or Low-Cost Mammograms
American Cancer Society
(800) ACS-2345 (227-2345)
TTY: (866) 228-4327
Susan G. Komen Breast Cancer Foundation
(800) I'M-AWARE (462-9273)
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