October is National Breast Cancer Awareness Month.
This year, more than 40,000 women will die from breast cancer. Early detection could save as many as 1/3 of them. Mammography plays an important role in saving lives because it can find a breast cancer tumor as early as two years before it can be felt. Far too many women die because they did not find their breast cancer soon enough. In fact, only about 2/3 of women aged 40 and up have had a mammogram in the last 2 years. One out of every eight American women will develop breast cancer in her life time. If breast cancer is diagnosed and treated early, the five year survival rate is more than 90%. Here are the most common reasons why women do not have regular screening mammograms (and why you should have one!)
1. The compression used for mammography is painful. While it is true compression used in mammography may cause some discomfort, it is rarely painful. Compression is necessary for mammography for several reasons. It thins the breast and spreads out the tissue, making it easier for the radiologist to find abnormalities. As well, compression decreases the radiation dose to the breast. It can help to schedule a mammogram at a time when the breasts are less sensitive, such as one week after a period.
2. The radiation to the breast is harmful. The radiation from a typical mammogram is small. The benefits of mammography far outweigh any theoretical risk due to radiation. In fact, the increased risk of death because of the radiation from one mammogram is equal to 60 miles of car travel, smoking three quarters of one cigarette, or being a man age 60 for 20 minutes.
3. No one in my family has ever had breast cancer; therefore, I do not need a mammogram. The fact is most women (75%) who develop breast cancer have absolutely no family history of breast cancer. Therefore, all women are at risk and should have yearly screening mammography by age 40.
4. I don’t have any lumps in my breasts. Therefore, I do not need a mammogram. The benefit of regular screening mammography is that small breast cancers can be found before they are able to be felt by the patient or her physician. If a breast cancer is found earlier, the chances for cure are much greater.
5. I have no time to get a mammogram. The average mammogram would only require a woman to be in the office for about 30 minutes. This is a small amount of time to spend once every year for a procedure that could save your life.
6. I can’t afford a mammogram. The median charge for a screening mammogram is around $100.00. This includes the technical component (images obtained by the technologist) and the professional component (radiologist consultation, review of previous images and full report with recommendations). This is a small investment for a procedure which could save your life. The National Breast and Cervical Cancer Early Detection Program. (NBCCEDP) provides breast and cervical cancer early detection testing to low-income, underserved, under-insured, and uninsured women in the US. Uninsured women who are diagnosed with cancer through the NBCCEDP can usually get treatment through their state’s Medicaid program.
7. I am afraid the mammogram might find something. This is a psychological barrier many women experience. However, it should be kept in mind that if an abnormality is found on a mammogram it is much more likely to be at a curable stage than if it is found later when the woman or doctor is able to feel it.
8. I am not sure which facility will provide high quality mammography. All facilities performing mammography must have accreditation from the FDA (Food and Drug Administration). Therefore, women can be assured that all facilities which currently perform mammography are of high quality. Accredited facilities can be found online by entering your zip code.
9. I am under 50; therefore, I do not need a mammogram. In fact, the current recommendations of the American College of Radiolgy (ACR), Society of Breast Imaging (SBI) and American College of Obstetricians and Gynecologists (ACOG) state that women should have screening mammography every year beginning at age 40. Sixteen percent of all breast cancers occur in women ages 40 to 49 and 25% of the years of life lost to breast cancer occur in this age group. Routine screening mammography in women age 40 to 49 can reduce the death rate from breast cancer by up to 40%.
10. I am afraid if cancer is found I will need to have my breast removed (mastectomy). In reality, women who have regular mammography are less likely to have a mastectomy than women who do not. Cancer can be found at an earlier stage, thus obviating the need for mastectomy. Most cancers which are found early can be treated with a lumpectomy and radiotherapy. This usually results in minimal or no cosmetic deformity to the breast.
Kevin M. Rice, MD serves as the Chair of the Radiology Department of Valley Presbyterian Hospital in Van Nuys, California and is a Member of Renaissance Imaging Medical Associates. Dr. Rice has made several media appearances as part of his ongoing commitment to public education. Dr. Rice's passion for state of the art radiology and teaching includes acting as a guest lecturer at UCLA. In 2015 Dr. Rice launched Global Radiology CME to provide innovative radiology education at exciting international destinations, with the world's foremost authorities in their field.
All posts by Kevin Rice, MD
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