MammogramPromise

What about the radiation from a mammogram? Is it safe?

If you read much, you’re bound to run into articles that say yes, radiation causes cancer so it stands to reason that mammography would as well since it uses X-rays (radiation) to take images of the breast. Doctors have been looking at this assumption for years. That’s how the guidelines for what age mammograms should begin came about. The younger a person is the more sensitive they are to radiation damage, especially soft tissue like breast tissue. Therefore, it’s not recommended that women 25 to 39 get mammograms, unless there is a strong reason to do so, which your doctor will help you determine.

Like dental X-rays, mammograms use very small amounts of radiation to take images of the breast—images that can be life-saving. The risk of not getting a mammogram seems to be greater than getting them at this point in time. According to the National Cancer Institute, several large studies conducted around the world show that breast cancer screening with mammograms reduces the number of deaths from breast cancer for women ages 40 to 69, especially those over age 50. 

Breast cancer is the most common non-skin cancer and the second leading cause of cancer-related death in the United States among women. The great news is that death rates from breast cancer have been declining since 1990, and these decreases are believed to be the result, in part, of earlier detection and improved treatment. Early detection = getting a mammogram.

~Amy

Comfy and Cozy Mammography

 

For those of you still not feeling so comfy with the idea of mammography, check out this serene scene. I’m not sure I could pull off such elegance at any exam, but most centers go to extra lengths to create a spa-like environment and experience for women. And if that doesn’t quite make it, one of the best ideas I’ve heard for bolstering motivation is to schedule a pedicure, massage or some other personal indulgence to follow your breast health visit.

Wow! We’re moving into the second half of Make a Mammogram Promise with nearly 3000 promises! Way to share and care, and keep it rolling!

As we in the Northwest settle into the chillier rainy times, people are getting out their glassybabies, lighting some warm candle glow and cozying up. It’s a good feeling to reflect on those 3000 promises - that you’ve helped to gather - turning into 3000 women getting their mammogram. Think of the peace of mind these will generate, and have a comfy and cozy weekend!

~ Marian

 

What's the best age to start having mammograms?

How does a woman know when it’s the right time for the first time?

 

There are several professional organizations that support screening mammography beginning at age 40.  These include the American Cancer Society, the American Medical Association, the American College of Obstetricians and Gynecologists, the American College of Radiology, and the U.S. Preventive Services Task Force, an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services.

Now, these folks know quite a lot, and establish what are known as evidenced based guidelines for medical practice. 

Other folks who also know quite a lot, The Canadian Task Force on Preventive Health Care, the American Academy of Family Physicians, and the American College of Preventive Medicine, recommend beginning mammography for average-risk women at age 50.  So, it’s been tossed around a bit, and some women in that grey zone have felt confused. 

The American Academy of Family Physicians wisely recommends that all women aged 40 to 49 be counseled about the risks and benefits of mammography before making decisions about screening.  Additionally, women who are at higher than average risk for breast cancer should talk with their health care providers about whether to have mammograms before age 40 and how often to have them.

Forty is the magic age to begin screening mammograms because breast cancer is a disease that mostly affects people at older ages.  So, if you’ve achieved that magic age, it’s time for that conversation with your health care provider.  If you’re younger, but have a strong family history of breast cancer, you’ll want to talk about screening sooner.

~Marian

Your first time with mammography?

Amy let us know yesterday that mammograms should not cause pain – scientific evidence - proof!  But what if this will be your First Time?  What exactly do they do in that radiology suite?

Not that I precisely recall my First Time; it’s sort of blended in with a long series of mammograms over more years than I care to count.  But here’s the typical sequence:

1. Jot down a few health facts on the clipboard, and try to get the pen to go back in that clippy part on top.
2. Pick your favorite gown with the unfathomable ties that tie in the front (or was it back?) and those cute little patterns.
3. Choose a changing booth and experiment a bit with the cold wipes provided for people like me, who usually forget to not apply metallic antiperspirant.
4. Stash any fashionable chunky metal neckware you forgot to not wear.
5. Follow the tech who has just summoned you out of your changing booth down the halls, leaving crumbs behind you in hopes of finding the booth again.
6. Find yourself in awe of this tech who manages to be so casually pleasant while finessing logistical positioning maneuvers to align your body parts with the mobile arm of the mammography equipment.
7. Cold – does that count as pain?
8. Develop profound gratitude that the tech, now your best friend, seems to know that the second position is tricky for everyone, and she’s fine just swinging your left arm up there for you.
9. Think of your odd position as dancing with the equipment, or giving it a hug – everyday activities except your breast is on a shelf (and you’re hugging a machine…).
10. Automatic lowering of another little shelf thing for Adequate Compression – this might be the part people find uncomfortable.  I try to amuse myself by imagining being forever stuck in this shape (this does not actually happen, or our undergarment fashion industry would definitely need to retool).
11. Now hold your breath – oops, I already was (see #7) – for about 15 seconds, and smile!
12. Same little X-ray buzz/click that you hear at the dentist happens in a flash, and you can stop holding your breath now.
13. Your Wonder-Tech can usually tell you on the spot whether the images are good, and if you need any retakes (say, if you blinked), which can be done on the spot.
14. Find your way back to your changing booth, and have a little fun with the cute one-use antiperspirant amenities the thoughtful people have left for you.
15. Make your appointment for next year on your way out!

See – it’s not only easy, it’s kind of weird and even a little fun!

 

 ~ Marian

Do mammograms hurt?

In the February 2005 issue of the American Journal of Roentgenology, a study was published suggesting that most women do not experience pain or anxiety during mammography screening, which of course goes against the common belief that mammograms hurt.

 

The study consisted of 150 women divided into three groups for their screening mammograms. In one group, the women listened to a relaxation tape during the mammogram. Another group listened to music during their mammogram. The third group didn’t listen to anything. After their mammograms, the women filled out questionnaires about how much pain and anxiety they experienced during the mammogram. The study found no significant differences regarding pain or stress in either of the groups.

 

"Virtually none of the participants experienced pain or anxiety. We were quite surprised at the outcome," the study investigator said in a prepared statement.

 

There are those holdouts though who’ll swear that their breasts are so sensitive just the idea of a mammogram is painful. This may especially be true for women with large breasts. Be sure to let the technologist know when you’re experiencing pain so they can reposition you during the test.

 

Bottom line: Mammograms should not be a painful experience.

 

~Amy

Digital or film mammography, what's the difference?

There are two kinds of mammograms: digital and conventional film. Both use X-ray radiation to produce an image of the breast, but conventional mammograms are read and stored on film, where digital mammograms are read and stored in a computer so the data can be enhanced, magnified, or manipulated for further evaluation. There are no other differences between the two.

Studies show that in most cases, digital mammograms read by specialized radiologists are over 20 percent more accurate at detecting breast cancer than traditional mammograms read by generalists. Breast expert radiologists read thousands of mammograms a year.

According to the National Cancer Institute, women with dense breasts who are pre- or perimenopausal (women who had their last menstrual period within 12 months of their mammograms) or who are younger than age 50 may benefit from having a digital rather than a film mammogram because subtle differences between normal and abnormal tissue may be easier to see. Recent studies support this, showing that digital mammography detects up to 28 percent more cancers than film mammography in the population of women mentioned above.

A 28 percent increase in accuracy means earlier detection, and most importantly, a better chance of a cure.

Other advantages to digital mammography over film mammography include improved ease of image access, transmission, retrieval and storage, and lower average radiation dose without a compromise in diagnostic accuracy.

In addition, digital mammograms are less likely than film mammograms to be lost. Digital mammograms require about three quarters the radiation dose of film mammography. However, the dose in film mammography is quite low and poses no significant danger to patients.

~Amy

Avoid false positive mammograms with expert radiologists

If you were able to watch any of the Healthlinks about mammography (on KING TV), you would have heard that the more experienced a radiologist is at reading mammograms, the more accurate the results will be.

The doctors who read mammograms are all board-certified radiologists and the more experienced ones are likely to be fellowship-trained, which earned them the title of breast imaging specialist. As a specialist, all they do is read mammograms -- thousands of them a year. Lots of studies have shown that doctors who specialize in mammography are more accurate at interpreting the images when compared to physicians with less experience.

So, what does this mean for you? Well, when you schedule your appointment for a mammogram, you can now ask if the radiologist reading the image is a general radiologist or a breast imaging specialist so you can be confident with the results you receive.

~Amy

What is the difference between a screening mammogram and a diagnostic mammogram?

Well, a screening mammogram is a general X-ray that is taken of the breasts to look for any abnormalities. A woman doesn’t have to have any signs or symptoms of a problem to have a screening mammogram. This is what doctors recommend that women over 40 get every year. It'll help you keep in touch with your body so you and your doctor will know if something changes, before you may even feel a lump.

A diagnostic mammogram is performed when a patient has focal symptoms or a lump, or when the radiologist calls her back for something seen on the screening mammogram. It might be followed up with an ultrasound. If you're called in for a diagnostic mammogram, it does NOT mean you have cancer! But it means there is something there that the doctor wants to take a closer look at, and to rule out the possibility that it's something more serious.

~ Amy