By Patricia Ferguson
Breast cancer is the most common cancer in women. In 2019, more than 58,000 cases were diagnosed in Michigan. Mammograms are critical for early detection.
Who needs a mammogram?
Women in their mid-40s and older need regular breast cancer screenings.
- Women in their 30s: Due to family history, younger women may inquire about mammograms. Discuss the need for an earlier exam with a primary care physician. Some health plans don’t cover mammograms for patients who don’t meet age requirements.
- Women in their 40s: For women ages 40 to 44, breast cancer screenings are optional. By age 45, mammograms should be performed during their annual physical.
- Women age 55 and older: Individuals can continue annual screenings based on their medical history and physician’s instruction. The recommendation for a mammogram is every two years.
Types of mammograms
Prior to the first screening, ask about the available mammograms. Discuss their benefits and risks, including over-diagnosis and radiation exposure.
- 3D mammography: Tomosynthesis, called 3D mammography, is advanced digital imaging. It captures the breast from multiple angles giving doctors a comprehensive view of the tissue. It has a higher detection rate than 2D imaging and requires less recalls for additional photography.
- Film/digital mammography: Conventional mammograms consist of low-dose X-ray images of both breasts. Digital mammograms allow doctors to store images in a computer where they can enlarge, manipulate and examine specific areas. This improves the ability to identify abnormalities or areas of concern.
- Screening/diagnostic mammography: A screening is for individuals with no previous signs of breast cancer. It’s often used to detect new lumps, tumors or other suspicious developments. A diagnostic mammogram is for those who’ve already found cancerous tissue. It requires more photos and usually takes longer to perform. For most health care providers, screenings are considered preventive care, meaning little to no additional cost. Yet, diagnostic mammograms may come with certain restrictions or payment conditions.
- Thermography: Thermography, or thermal imaging, uses infrared technology to measure the temperature on the breast’s surface. Cancer cells grow at an accelerated rate, leading to increased blood flow and inflammation. With thermography, the machine detects the warmer temperature, isolating the affected tissue. The FDA says thermography works best alongside traditional mammograms. It shouldn’t be used as a primary screening method.
What happens during a mammogram?
A technician places the breast on an X-ray machine, where a plastic plate is lowered to flatten the tissue. If it’s extremely painful, the technician can adjust settings. The process takes about 20 minutes, producing two photos per breast. Occasionally, more views are necessary, but that’s not always cause for alarm.
If a woman has had breast augmentation, inform the doctor and technician before the appointment. Implants can impede the view of the breast, making it difficult to note serious issues. The technician should know how to maneuver tissue to capture the best images. These patients should expect a longer exam, as additional photos will be required.
About the author: Patricia Ferguson, M.D., is a physician consultant at Blue Cross Blue Shield of Michigan. Visit AHealthierMichigan.org for more health tips.