By now, all women should know the basics: Breast cancer is a serious threat to your health, and regular screening for breast cancer can save your life. A cancerous lesion, caught early, can be treated with amazingly successful results. The important part is to make sure you take advantage of the opportunity for early detection.
MyLifeStages checked in with two physicians whose practices are dedicated to breast cancer detection, to find out what women should be aware of at the end of 2010.
We talked with Linda Gordon, M.D., Imaging Director at the Carol Ann Read Breast Health Center at Alta Bates Summit Medical CenterOpens new window in Oakland – and also with Jessica Leung, M.D., a radiologist with the Breast Health Center for California Pacific Medical CenterOpens new window in San Francisco.
You may remember some controversy in the media over recommended intervals for breast cancer screening exams. Both Dr. Gordon and Dr. Leung recommend following the American Cancer Society screening guidelines:
Annual screening mammography for all women aged 40 and over.
That means you begin regular mammograms when you turn 40, and schedule one every year after that. “Women make much more frequent appointments to have their hair done, or their nails painted, even in their very busy lives.” Says Dr. Gordon. “I’d like to see women consider their screening mammogram another way of caring for their bodies – absolutely essential and never to be missed.”
Women with a family history of breast cancer may want to start exams even earlier. If you have had a close family member – mother or sister – with breast cancer detected before menopause, it is recommended that you begin screening mammography 10 years before your relative was diagnosed. A woman with known risk factors should consult with her primary care physician about other types of screening that may be warranted.
Mammography is the “gold standard” for routine breast cancer screening. According to Dr. Leung, “Mammography is one of the few areas of medicine in which true reduction in mortality has been demonstrated – with large scale clinical trials, over decades of time.” In other words: It has been proven that mammography saves lives.
Screening mammography is the term used for a routine exam, when no lumps or problems have been identified. For most women, the annual mammogram is a screening exam.
Diagnostic mammography is the term used for an exam that studies the breast in more detail, following the discovery of a lump, nipple discharge or any other area of concern. A radiologist will be present for a diagnostic mammography, looking at the images as they are created and guiding the technician if more views are needed.
In some cases, a women may go in for a screening mammogram, to be “called back” later for the more extensive diagnostic exam. The second exam will focus in on any suspicious area that the screening exam might have detected.
Mammography uses x-rays to create images of the breast. Standard mammography creates those images on film that is developed (like a picture), while digital mammography creates its images within a computer.
Digital mammography provides a lower dose of radiation to the breast, is a bit faster to perform, and may provide a better view of dense breast tissue. Many breast centers have made the conversion to using digital mammography for all exams. However, a screening exam by traditional mammography is still a vital tool for detecting cancer.
Ultrasound uses sound waves, rather than radiation, to view breast tissue. Ultrasound is not a traditional screening technique, but may be used if the screening mammogram detects a mass or irregularity in the breast tissue. The masses seen in younger women are often fluid-filled cysts associated with the menstrual cycle – not a cancer. Ultrasound can ‘see’ whether the irregularity is a solid mass, or a simple cyst.
MRI of the breast uses yet another diagnostic technique – radiofrequency waves, instead of sound waves or radiation. An MRI may be used to examine a breast more carefully before biopsy or surgery is performed. “MRI can pick up any additional areas of concern, and better determine the size and location of a lesion,” says Dr. Gordon.
MRI is not, however, a standard screening technique. In certain high-risk patients, such as those with a genetic risk for breast cancer, or other risk factors, such as previous chest radiation, health plans may authorize the use of MRI for screening.
Women who are in certain high-risk groups may also be recommended for genetic screening, to determine if they carry either the BRCA-1 or BRCA-2 gene mutation. These genetic mutations can increase the risk of developing breast cancer. Talk with your primary care physician about your own risk factors – as a physician referral is needed for genetic screening. Many breast health centers now include a genetic counselor, who can work with women who face a higher known risk for developing breast cancer.
Breast cancer screening is effective. And it can almost be convenient. Many breast health centers now accommodate women with busy schedules, offering appointments in the evening or on weekends.
Full service screening centers work hard to make your appointment convenient, efficient and pleasant, offering quick check-in, pleasant surroundings, skilled technicians and the presence of multiple diagnostic tools, should any further examination be needed.
“As women, we often have a host of other people depending on us,” says Dr. Gordon. “You might say that the busier you are, the more important it is to stay on top of your health. Mammography – once a year – is one of the most simple and wonderful gifts you can give yourself.” Consider using a significant marker – like your birthday – as an annual reminder to schedule that mammogram.