MMaybe you've been putting off getting a mammogram because you're worried about what it might find. But experts encourage women to reframe getting a mammogram as empowering. “While breast cancer cannot be prevented, mammography can help provide some control,” says Dr. Nina S. Vinkov, director of breast imaging at Northwell Health in New York. “Mammography finds cancer when it is smallest and most treatable. Women who have mammography are less likely to die from breast cancer and need more aggressive treatment, such as mastectomy or chemotherapy.” less likely to occur.”
Dr. Laurie Margolies, professor and associate professor of breast imaging at the Icahn School of Medicine at Mount Sinai, puts it even more succinctly: Don't be scared!
but many women don't. That's true even if you have symptoms, Margolies says. “Some people pretend that nothing is going on and let the lump in their breast grow and grow, until it eats away at the skin and they find it's bleeding and come to the emergency room,” she says.
Screenings aren't as scary as you think. Binkov and Margolyes explain what you need to know about mammography and what the potentially life-saving test entails.
What is mammography?
Breast cancer is relatively common. In the United States, 1 in 8 women Someday in her life she will develop the disease. Mammography is an x-ray examination of the breasts used to detect breast cancer and other breast diseases.
“Some mammograms are performed on people who have breast problems, such as a lump or nipple discharge,” Margolies says, but others, known as screening mammograms, It is performed as part of well-care for people without breast problems.
Who should get tested?
It's important to know your risks. “The American College of Radiology recommends that all women have a risk assessment by age 30,” Margolies says. Should I ask my doctor for this? free online calculator We will ask you questions about your family history and past breast biopsies.
Women at average risk should get a mammogram every year starting at age 40, Binkov says. “These are the guidelines that will save the most lives.”
If you have a family history of breast cancer or a personal history that may increase your risk of breast cancer, talk to your doctor about early screening. In such high-risk cases, it may be recommended to start mammography before age 40 and/or to supplement mammography with other tests such as ultrasound or MRI, Binkov said. says. She added that because mammography uses very small amounts of radiation, it is safe during pregnancy and breastfeeding.
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“It's really important for women to know that young women can get breast cancer even during pregnancy, so if you think something is wrong, please speak up,” Margolies says. “Perhaps the saddest group is the very young women, often young mothers, who are affected by breast cancer. Unfortunately, there are far too many of them.”
When should women stop getting this annual exam? As long as you're healthy, Margolies says, “There's no absolute age limit for a mammogram.” One of her patients, who is in her late 70s, asked if she could forego mammograms given her age. “I quietly asked her if she thought she was healthy. [would] They live at least five years,” Margolies says. “She said, 'Of course.'” Her next mammogram revealed bilateral breast cancer. “The great news is that she's alive and well,” Margolies says eight years later. It might not have been the case if she had skipped the test.
The bottom line is that if you're in good health, you should continue to get annual mammograms into your 80s.
Men and transgender people have different considerations to keep in mind. Margolies said men sometimes get a mammogram because they feel something is wrong or have a gene that puts them at higher risk for breast cancer. Transgender people should follow the “screen what you have” mentality. The timing of screening depends on multiple factors, including how your breasts are formed and your hormone therapy, she says. Work with your doctor to develop a plan.
How should I prepare for my mammography test?
The best preparation for a mammogram is the most difficult: “Relax!” Margolies says.
If you're relaxed, the technician's job will be easier and the mammogram will be more accurate, she says. This is because when the pectoral muscles (or chest wall muscles) relax, the mammogram image becomes clearer for the radiologist because the technician is able to optimally image more breast tissue.
Other guidelines to follow before getting a mammogram, according to Margolies and Vinkov:
- Do not apply deodorants, creams, powders, etc. to your skin. on and around the chest. These products may look like calcifications and may require additional imaging tests to ensure they are harmless.
- If you are having a mammogram at a different facility or health care system than the one you have previously visited, Please bring a mammography exam from at least 3 years ago It is recorded on the CD as well as the mammography report (if applicable) so the radiologist can compare previous exams. This also reduces the chance of needing to return for further images.
- Consider scheduling a mammogram with a female friend Or plan lunch with a group of friends or do something celebratory after your mammogram. “Having a friend makes the whole mammography experience more enjoyable. It becomes a fun outing and not just a medical event,” Margolies says.
What should I expect during my mammography exam?
You'll likely spend more time checking in and undressing and changing for the exam than you will for the actual mammogram. The mammogram itself takes less than 10 minutes from start to finish.
A typical mammogram consists of two x-ray images of each breast. One shot from above and one from the side. To perform a mammogram, one breast is placed on a hard surface and a plastic compression paddle applies pressure to hold the breast in place, then automatically lifts it away from the breast. Repeat this on the other chest. Although a mammogram takes several minutes to perform, the compression needed to minimize radiation dose and obtain the clearest images takes just seconds, Margolies said.
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Will it hurt? That can't be true. Dr. Binkov says the test “may be somewhat uncomfortable, but not painful” while the breast is held in place and compressed with a clear plastic plate.
Are there alternatives to mammography?
The short and appealing answer is that there is no substitute for mammography.
“This is the only breast cancer screening tool that has been proven to save lives time and time again in older studies using older equipment. The results are even better,” Margolies says.
Breast ultrasound and breast MRI are the most common adjuncts to mammography. “These are often recommended for people with dense breasts,” says Margolies. “Dense breasts are normal and about half of women have them.”
Women with dense breasts may need these additional tests because dense breast tissue appears white on mammograms and can mask cancer even on 3D mammograms. “Ultrasound can find some of these hidden cancers, and breast MRI can find many more,” Margolies says.
What follow-up might be required?
According to research, about Something is found in 10% of mammograms. Additional evaluation required. (Advances in technology such as 3D mammography and artificial intelligence have further reduced the number of women being recalled.)
Margolies said most recalled patients had their areas of concern resolved with additional mammogram images using different compression paddles and ultrasound. In some cases, Vinkov adds, you may be asked to do additional imaging tests after six months to make sure nothing has grown or changed.
Finding out you need more testing can be scary, but women should know it, Binkov said. Only about 20 out of 1,000 mammograms Find out what needs a needle biopsy. “And mammograms only find cancer in about 5 out of 1,000 cases,” she says. So if you find that you need additional testing, don't assume the worst.
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Unfortunately, after mammograms and follow-up exams, some women will need biopsies, and some of those biopsies may be diagnosed with cancer, Margolies says. “That's why it's so important to follow up if you're asked to come back after your mammogram.”
You've probably heard about mammography many times, but it bears repeating: Mammography saves lives. In fact, since mammography screening began in the 1980s, Breast cancer death rates have decreased by 40% in the United States. “This is partly due to improved treatments, but early detection plays a big role,” Binkov said. “Mammography detects cancer when it's small and easy to treat,” she adds, adding that women who get a mammogram every year starting at age 40 40% lower risk of dying from breast cancer than women without breast cancer.
Additionally, women whose breast cancer is detected on a mammogram should not wait until the cancer is large enough to be palpable. Less likely to require aggressive treatment Such as a mastectomy, chemotherapy, or a complete axillary dissection (removal of all lymph nodes in the armpit).
Mammography is just the beginning
Mammograms are an essential part of many women's annual checkups, but they're just one part of a woman's preventive health routine. Binkov, a practicing radiologist, says she sees many women who get annual mammograms but neglect other parts of their health. “Heart disease remains the number one killer of women in the U.S., and it's important for women to get regular screenings for things like high blood pressure and diabetes, colonoscopies, and lung cancer screening if they're at risk. is important,” she says.
