Mammograms & Self Exams
It has been said time and time again, in ads and articles and Web sites like this one, a yearly mammogram combined with monthly self-checks lead to early detection of breast cancer, and early detection is the key to saving a woman’s life.
Yet statistics reveal that 44% of women in the prime breast cancer risk years of 40 to 50, do not get a yearly mammogram. Even fewer do self-checks on any regular basis.
When asked why they do not follow these vital preventative tips, women cite everything from forgetfulness or lack of time to fear of radiation or pain with mammograms. And while some early equipment did require more intense breast compression, the small amounts of radiation were never a health risk.
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In general, women are so good at taking care of everyone around them that it’s often hard to get them to take a step back and take care of themselves.
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In addition, recent advances in mammography have made the imaging simpler, easier and far less unpleasant (
click here for how to prepare for a mammogram). These have included adjustments in radiation which allows less breast compression and contour designs that more closely follow the natural curve of a woman’s breast for more comfortable imaging.
Make time for yourself
Regarding lack of time, Dr. Jennifer Johnson, an internist with Advanced Healthcare, note that women are so good at taking care of friends and family that they often shortchange their own health needs.
"When trying to get a woman to remember to do her breast exams on a monthly basis, I ask, ‘Who is the favorite female over 40 in your life? I want you to take responsibility to call them and remind them to do their monthly breast exam then go and do one yourself. They say, ‘Yes, I can do that,’ but if it were just for themselves, they would be too busy," Dr. Johnson said.
Dr. Johnson said that while self-exams are important for women of all ages, they are particularly vital for younger women, because that’s when cancer strikes hardest and fastest. "In premenopausal women, breast cancer tends to be more aggressive and a woman is more likely to feel changes in the calendar year between mammograms. As women get older they tend to get less aggressive tumors, but have less dense breasts so it easier for an older patient to actually feel a breast lump."
She added, "If you want to catch the smallest tumor possible, mammography is much better, but clearly the combination (of mammography plus self-check) gives the best protection." In addition, the more familiar women become with their own breasts, the more likely they are to detect changes.
Mammograms
Scientists are working to create mammography equipment that can detect smaller, more easily treated, lumps. One of the new technologies is digital mammography available at the Van Dyke-Haebler Center at Columbia-St. Mary’s.
Digital mammography does not use film. Instead, the X-ray data is fed into a computer to become three dimensional, giving radiologists a far better look at breast tissue. (
click here to find out more about digital mammography).
Other recent innovations used at the center include contour mammography, which minimizes discomfort and photographs more breast tissue than standard mammograms, and breast imaging ultrasound.
Ultrasound is used to further evaluate a breast abnormality or lump discovered with mammography. The painless and non-invasive technique is the same one used to obtain pictures of developing infants in their mothers’ wombs. Ultrasound uses sound waves to locate and measure abnormalities found in mammograms.
Radiologists’ role
The Mammography Quality Standards Act is a federal law that makes certain every mammography facility meets quality standards. It assures this through thorough training of the X-ray technicians who take the mammograms, the radiologists who read them and the medical physicists who test mammography equipment.
After radiologists take their first look at the mammogram pictures, the data is fed into a computerized reading program called an ImageChecker that scans the images and issues a report. This computer aided detection allows for much more accurate reading of the data and focuses the radiologist’s attention on areas which need the most study.
The result is impressive. Radiologists alone are able to detect 87% of breast abnormalities. With the addition of an ImageChecker, the detection rate of visible cancer rises to 98%. With better, earlier detection, comes more effective – and less invasive – treatment.
