Q and A: Breast Cancer Screening
Q: I’m in my early 40s, I don’t have a family history of breast cancer and I breastfed my kids. Do I really need a mammogram?
A: It’s still a very good idea to get screened. Three out of four women who are diagnosed with breast cancer have no family history of the disease, and at least one in six of all women diagnosed are in their 40s. About 40 percent of years of life lost from breast cancer are in women in their 40s because in younger women, breast cancer tends to be more aggressive. Don’t take chances. Get screened annually starting at age 40, or sooner depending on your risk factors.
Q: If I have a mammogram, do I need to self-examine my breasts?
A: I like to think of it more as self- awareness than self-examination. You should know what your breasts feel like in a normal state so that, if changes occur, you will be in a better position to recognize that change. If you have questions about what’s “normal” and what’s not, talk to your doctor for guidance.
Q: Should I be concerned about receiving too much radiation from getting an annual mammogram?
A: No. The radiation received during a mammogram is not a concern because it’s about the same as annual background radiation, which is the amount of radiation we’re all exposed to on a daily basis from things like buildings, food, the atmosphere, etc.
Q: I hate mammograms. Would an ultrasound or something else do?
A: A mammogram really is the gold standard when it comes to breast cancer screening. Over the last 30 years, there has been a 30 percent reduction in mortality rate and that’s in large part because of mammograms and their effectiveness in finding breast cancer in earlier stages, when it’s less likely to be deadly and is also more responsive to the great treatments the oncology team has to offer.
Other types of equipment, such as an MRI or an ultrasound, are used for various reasons but only in addition to a mammogram. For people with a high risk of breast cancer, an MRI and mammogram may be offered, while those who have dense breasts may get a mammogram and an ultrasound to be safer. Those with denser breasts are increasingly being offered a 3D mammogram (known as tomosynthesis), which is essentially a better mammogram. However, you may still need an ultrasound.
If you think you might need to consider these additional tests, talk to your doctor and be sure to check with your insurance company. For the most part, aside from tomosynthesis, these additional tests are not covered like your annual screening mammogram is, so there may be an out-of-pocket cost for you.
Q: How much will I pay for my screening mammogram?
A: If you’re age 40 or older, there is no “cost sharing” in an annual screening mammogram, meaning it’s fully covered by insurance and there won’t be a charge to you for getting one. Medicare and most insurance companies now cover tomosynthesis. You can call and book an appointment yourself and go virtually anywhere you’d like. For those who are uninsured or underinsured, help is available. Contact the UR Medicine Breast Imaging Outreach program at (585) 487-3304. Also, the Cancer Services Program of Monroe County is available at (585) 224-3070.
It’s important to explain that a screening mammogram means you currently have no problems. And it has to be at least one full year from your last one. But if you have a lump or other problem, you will need a diagnostic mammogram and your doctor will need to order it. When symptoms occur, it’s especially important you see your doctor. The benefit of screening is to find breast cancer before it can be detected clinically or before it’s displaying physical symptoms, when the cancer is often still in a much earlier stage.
Avice O’Connell, M.D., is professor of Imaging Sciences and director of UR Medicine Breast Imaging, which provides mammograms and other breast imaging, such as MRI and ultrasound. You can schedule a mammogram at on of UR Medicine’s many locations by calling (585) 487-3300.
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