Time To Schedule Mammogram

●Screening mammography in research studies has consistently been found to decrease breast cancer-related death, and we need to plan when to get the next mammogram. Various organizations can help determine how many you need. We prefer to discuss at your appointment. The latest organization to decrease mammogram frequency recommendation can be found http:// https://annals.org/aim/fullarticle/2730520/screening-breast-cancer-average-risk-women-guidance-statement-from-american

.●You will get two views of each breast (top to bottom, and side to side.) and the better the breast compression is the better the image will be. The compression may be uncomfortable, so some women like to schedule when they have the least amount of breast tenderness in their cycle.

●You can help direct the amount of breast compression during the exam and you can take a mild anesthetic such as ibuprofen or Tylenol prior to the exam.

●Generally mammograms are as accurate in women with large breasts as in women with small breasts.

●Mammograms are more accurate in older women than in younger women.

●When to have your first mammogram and how often to repeat should be determined individually with your gyno. Generally most recommend your first at 40 and then every 1-2 years after, stopping when you are too old to be treated for an early cancer.

●The mammogram will expose you to radiation but it is not much. The radiation dose received from a routine screening mammogram is equivalent to the dose received from natural background radiation we get from the earth’s atmosphere over three months. Women with genetic abnormalities are at greater risk for radiation-induced cancer and could discuss with their gyno what is the best strategy for them.

●Digital mammography is current considered the best test for image quality in the average women, but 3D mammograms are indicated in many cases, these are called a variety of terms, clarify at your appointment.

●Most radiology departments also now have mammography with computer-aided detection (CAD), but due to finding more suspicious areas CAD may increase need for recall or follow up examinations

●Diagnostic mammograms are performed for women with symptoms, or a mass or a known history of cancer. Diagnostic mammograms usually have additional views are obtained, such as oblique views rather than just a view from top or side, and magnification may be used as well.  

●Increased breast density both increases the risk of breast cancer and decreases the sensitivity of mammography to detect small lesions, and this is the setting that most often calls for that 3D screening breast tomosynthesis.

●Women with implants can have safe and regularly performed mammograms. If you have no breasts, because you have had all your breast tissue removed, you no longer need mammograms.. Standard imaging technique in women with breast implants involves four views.

●You can expect a report that will both describe your results in words as well as give you a BI-RADS score. A score of 1 is normal, and the best, a score of 5 indicates a test that appears to be cancerous.

●Ultrasound and be used to help  distinguish solid and cystic breast masses and have no radiation so are very safe to use in young women with breast symptoms. It also doesn’t use compression and is thus very comfortable

Remember that Mammography is safe, appropriate as a screening tool for many women, and has saved many lives according to most studies, in generally the Breast Cancer Detection Demonstration Project showed that cancers that cannot be felt can be detected even those less than 1 cm. At least 89% of cancers will be accurately found, and of those about half would not be felt by the woman or her health care provider. There are those studies which question whether it really saves lives. When and how often, and now even what type of mammogram to get  is an important decision for each women. Individualized evaluation and risk assessment for your risk of breast cancer should occur on an annual basis, and an important reason for women to continue yearly visits. Factors that we should consider will include: your personal history, lifestyle, do you smoke or consume alcohol, your family history of breast disease or breast cancer, your personal genetics if you have been tested, hormone, cancer prevention treatments and medication history, whether you have had children or breast fed your children, nipple discharge, breast pain, cysts or masses, or prior breast surgery.

As a Board Certified Obstetrician and Gynecologist the organization I belong to called the American Congress of Obstetrics and Gynecology (ACOG). They are studying the new guidelines, but they have not yet changed their current guidelines.

Insurance coverage for medical exams are based both on medical necessity and on recommendations of organizations such as these. Insurance coverage you may have had in the past may be affected by these changes, but most insurance plans will cover screening mammograms well, virtually all plans cover diagnostic mammograms (meaning done to check a problem) well.


Suzanne Trupin, MD, Board Certified Obstetrician and Gynecologist and owner of Women's Health Practice, Hada Cosmetic Medicine, and Hatha Yoga and Fitness

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