Mammogram

One in nine women will be diagnosed with breast cancer in her lifetime, according to a New England Journal of Medicine study. Breast cancer risk increases with age. More than 75 percent of women diagnosed with breast cancer are age 50 or older.

More treatment options are available when cancer is detected early.

Medicare covers the cost of an annual mammography screening.

Free mammograms and other exams are available for uninsured women. Women over the age of 35 can receive free cervical cancer screenings, and women over the age of 40 can receive free mammograms and breast exams from the Illinois Breast and Cervical Cancer Program. Please call the Illinois Department of Public Health’s Women’s Health-Line at 1-888-522-1282.

Q: What are the basic breast health steps?

Screening guidelines are as follows:

• Mammograms every year starting at age 40.
• Women under 40 with a family history of breast cancer or other concerns should talk with a health care provider. Screening tests may be needed more often and/or started earlier.
• Clinical breast exams by a health care provider at least every three years starting at age 20, and every year after 40.
• Breast self-exams every month starting by age 20.
  

Q: When should I do a breast self-examination (BSE)?

The best time to do BSE is the same time each month, for menstruating women, it should be performed after the menstrual period has ended when breasts are less tender. For postmenopausal women, it should be performed the same time each month.

Q: What is a clinical breast exam (CBE)?

A clinical breast exam is performed by a healthcare provider. It includes visual examination and palpation (feeling) of the entire breast and underarm area, and is performed in both sitting and lying down positions.

Q: How often should I get a CBE?

You should get a CBE by a health care provider at least every three years beginning at age 20 and yearly after age 40.

Q: What is a mammogram?

A mammogram is an X-ray of the breast. This is the best screening tool widely available to detect breast cancer early.

Q: How often should I get a mammogram?

Starting at the age of 40, women should have annual screening mammograms. Women under age 40 with a family history of breast cancer and other concerns about their personal risk should consult with a health care provider about risk assessment and when to begin screening mammography.

Q: What is an ultrasound and when is it recommended?

Ultrasound is commonly used with pregnant women to look at a developing baby. When used on the breast, it can distinguish between different types of lumps, such as liquid-filled cysts and solid masses. Doctors use ultrasound to find out the size, shape, texture and density of a breast lump. An ultrasound is safe and painless, and uses no radiation.

A woman younger than age 40, who suspects there may be a lump or cyst in her breast would be undergo a breast ultrasound. If this is inconclusive, then she would undergo a limited view mammogram.

Q: Why are mammograms not recommended for women under 40?

Mammography is a very effective breast cancer screening tool overall. However, it may be more effective at detecting tumors in older women than in younger women. Images on mammograms appear in gradations of black, gray and white, depending on the density of the tissue. Bone shows up as white; fat appears dark gray and cancerous tumors appear a lighter shade of gray or white.

Unfortunately, dense normal breast tissue can also appear light gray on a mammogram, which can make mammograms harder to interpret in younger women, since they tend to have denser breasts. After menopause, though, breast density usually begins to decrease, making the mammograms of older women easier to read.

Q: Where can I get a free or low-cost mammogram?

The Illinois Breast and Cervical Cancer Program offers free mammograms, breast exams, pelvic exams and Pap tests. Uninsured women over the age of 35 can receive free cervical cancer screenings, and women over the age of 40 can receive free mammograms and breast exams.

If you need coverage for breast and cervical cancer, or if you know anyone who may be eligible for the program, please call the Illinois Department of Public Health’s Women’s Health-Line at 1-888-522-1282.

Q: Does the radiation from a mammogram cause cancer?

Today, mammography has little radiation risk. The amount of radiation that is used in mammography has been reduced greatly and is considered to be safe for women of the appropriate age.

Q: How effective are mammograms?

Mammography has the ability to detect breast cancers before they can be felt. However, a small percentage of breast cancers cannot be identified by mammography. For this reason, it is important to follow the guidelines for clinical breast examination (CBE) and to practice regular breast self-examination (BSE).

Q: What are calcifications?

Calcifications are deposits of calcium that appear on a mammogram. In older women especially, calcium may leave the bones and appear in other parts of the body, such as the joints or breasts. But, clusters of tiny calcifications (microcalcifications) can be indications of precancer or cancer.

Microcalcifications usually form as small, tight clusters in the ducts that can be seen on a mammogram. Although they are not themselves dangerous, they can be a warning sign of cancer and lead a doctor to perform follow-up tests to determine whether the area is cancerous or not.

What you should know about digital mammography?

Digital mammography uses computers and specially designed detectors to produce an image that can be displayed on a high-resolution computer monitor, and transmitted and stored just like computer files.

Having a digital mammogram is very much like having a conventional ‘film’ mammogram. Both file-based and digital mammogram use compression and x-rays to create clear images of the inside of the breast.

During all mammography exams, the specially trained technologist positions the individual to image the breast from different angles and compresses the breast with a paddle to obtain optimal image quality.

Digital mammograms produce images that appear on the technologist’s monitor in a matter of seconds. There is no waiting for film to develop, which can mean a shorter time spent in the breast-imaging suite.

With digital mammography, the radiologist reviews electronic images of the breast, using special high-resolution monitors. The physician can adjust the brightness, change contrast, and zoom in for close ups of specific areas of interest.

Digital mammography can greatly reduce the need for retakes due to over- or under-exposure. This can save time and reduce exposure to x-rays.

Digital images can be easily stored, copied without any loss of information, and transmitted and received in a more streamlined manner, eliminating dependence on only one set of ‘original’ films.

 

Breast cancer facts

(Source: American Cancer Society, 2007-2008 Breast Cancer Facts and Figures)

Excluding cancers of the skin, breast cancer is the most common cancer among women, accounting for more than 1 in 4 cancers diagnosed in U.S. women.

White women have a higher incidence of breast cancer than African American women after age 40. In contrast, African American women have a higher incidence rate before age 40 and are more likely to die from breast cancer at every age.

More than 240,000 new cases of breast cancers will be diagnosed this year.

The National Cancer Institute estimates that approximately 2.4 million breast cancer survivors are alive today.

More than 40,000 women are expected to die from breast cancer this year. Only lung cancer accounts for more cancer deaths in women.

Approximately 2,000 cases of breast cancer will be diagnosed in men. An estimated 450 men will die from breast cancer.

 

For more information, call Ron Shimonis, Medical Imaging director, at (708) 681-3200 ext. 4987.