Role of Mammography

Get the Picture? Mammography is a Key Tool in Fight Against Breast Cancer

Recent years have seen a number of stories questioning the value of mammography, confusing patients and practitioners alike. But experts at The Breast Center at Valley Medical Center believe that mammography remains the most effective, accessible tool for the detection of breast cancer at its earliest and most treatable stages.

A recent study published in the Journal of the American Medical Association confirms this view. The study found that women whose cancers were detected through screening mammography had better outcomes than those whose cancers were found through other methods.

The study was conducted by Finnish researchers who analyzed the records of women with unilateral breast carcinoma. The group found that tumors detected through screening mammography were typically smaller than those discovered with other methods—possibly indicating that the tumors were found earlier. Women whose cancers were found outside of mammography also required more invasive treatments such as mastectomy and axillary dissection, and they had higher rates of tumor recurrence away from the original cancer.

In large clinical studies, regular screening mammography has been shown to reduce breast cancer mortality by up to 44 percent.

The American Cancer Society and the American College of Radiology currently recommend yearly screening mammograms for women ages 40 and older. For women between ages 20 and 39, the ACS recommends a clinical breast examination by a health professional every 3 years, increasing to yearly at age 40. The ACS also recommends that women 20 years and over perform monthly breast self-examinations.

During mammography trained technologists use special x-ray machines to take two pictures of each breast, one from the top and one from the side. (This ensures that the largest possible volume of the breast is pictured.) Breast compression prevents breast motion, spreads out overlapping structures of the breast, and helps reduce the radiation dose required for proper development of the pictures. Although breast compression may be uncomfortable, it lasts only a few seconds. Polls indicate most women do not categorize a mammogram as painful. To lessen discomfort, a woman should avoid having a mammogram immediately before or during her menstrual period.

At The Breast Center at Valley Medical Center, strict federal guidelines are followed to ensure mammography equipment is safe. The radiation risk associated with screening mammography is extremely low and does not significantly increase the risk for breast cancer.

After the examination, a radiologist trained in interpreting mammograms reviews the images of the breasts. Questionable findings may include a mass (nodule), suspicious calcifications, distortion of breast tissue, skin retraction or skin thickening. One or more of these may be an indication of breast cancer. More and more often, mammograms are detecting breast cancers when they are only a few millimeters in size, before they can even be felt. Many of these cancers are said to be in the noninvasive, or in situ, stage.

Prior to the advent of modern mammography, less than 3 percent of newly diagnosed breast cancers were in situ. Now, approximately 16 percent are found at this early stage. Today women whose in situ breast cancers are properly diagnosed and treated have excellent prognoses and much higher long-term survival rates.

Following the initial screening mammogram, approximately 1 in 10 women will be called back for additional imaging. While this can be anxiety-provoking for the patient, sometimes a closer look at certain areas of the breast is necessary to rule out abnormalities. Upon further study, the majority of these cases turn out to be normal, or benign. Occasionally, the results will warrant a recommendation for a breast ultrasound and/or a breast biopsy.

To schedule your next mammogram, call The Breast Center at 425.656.5588.