October is National Breast Cancer Awareness Month—the perfect time to discuss the importance of mammography. Because breast cancer is often detectable in its early stages when there’s a good chance for a cure, breast cancer screening is essential to early detection.
Most significantly, mammography is an important line of defense against breast cancer because it can identify tumors even before they can be felt.
According to the Centers for Disease Control and Prevention, aside from non-melanoma skin cancer, breast cancer is the most common cancer among women in the United States. It is also one of the leading causes of cancer death among women of all races. In 2008, 210,203 women in the United States were diagnosed with breast cancer, and 40,589 women died from the disease.
The National Cancer Institute recommends that women age 40 or older have screening mammograms every 1 to 2 years. If a woman is at high risk for developing breast cancer, her doctor may recommend screening at a younger age, along with additional imaging studies.
Screening and Diagnostics
A conventional screening mammogram is a low-dose X-ray test that creates images of breast tissue so doctors can check for lesions or other abnormalities. The x-ray images make it possible to detect tumors that cannot be felt, and can find microcalcifications (tiny deposits of calcium) that sometimes indicate the presence of breast cancer.
A mammogram used to check for breast cancer after a lump or other sign or symptom of the disease is called a diagnostic mammogram. Besides a lump, signs of breast cancer can include breast pain, thickening of the skin of the breast, nipple discharge, or a change in breast size or shape; however, these signs may also be signs of benign or non-cancerous breast conditions.
While digital imaging feels almost identical to conventional mammography, its benefits are a shorter exam time than traditional mammograms, and less chance that patients will be called back for repeat exams.
Digital images tend to provide doctors with better visibility of the breast, chest wall and dense breast tissue. Through computer-aided technology, radiologists are able to enhance certain areas of the digital images to get a more precise picture of a patient’s condition. The digital images can also be stored electronically, and later retrieved to share with other doctors if needed in the future.
To minimize any discomfort of the mammogram, many women’s imaging facilities offer soft foam pads which serve as a cushion between a woman’s breast and the mammography machine, resulting in a warmer and more comfortable mammogram. Although compression is still required, the pads provide an extra level of cushion for the patient.
Breast-specific Gamma Imaging
If mammogram results are inconclusive, the latest tool in diagnostic testing is breast-specific gamma imaging (BSGI). This tool can help find any hidden problems in the breast tissue and can help doctors identify cancer lesions that weren’t seen in the original mammogram.
During a BSGI test, the woman receives a pharmaceutical tracing agent that is absorbed by all the cells in the body. Due to their increased rate of metabolic activity, cancerous cells in the breast absorb a greater amount of the tracing agent than normal, while healthy cells generally appear as dark spots on the BSGI image. BSGI is also recommended for women who have dense breasts, scar tissue from a previous surgery, or breast implants that may make it difficult to detect breast abnormalities.
Magnetic resonance imaging (MRI) of the breast is a test often used to detect breast cancer and other abnormalities in the breast. It’s intended to be used in addition to a mammogram or another breast-imaging test. The MRI can capture multiple pictures of the breasts and once computer combines those images, it generates very detailed pictures.
A breast MRI is performed when a doctor needs more information than a mammogram, ultrasound or clinical breast exam can provide. It’s often used for a woman who has a high risk of breast cancer, has a suspicious area on her mammogram, or when a lump can be felt in the breast, but it’s undetectable on a mammogram or ultrasound.
For women with private insurance, the cost of screening mammograms is usually covered without copayments or deductibles, but women should contact their mammography facility or health insurance company for confirmation. In addition, Medicare pays for annual screening mammograms for all female Medicare beneficiaries age 40 or older.
Gary Wood, M.D. is the Medical Director at Northwest Women’s Imaging (NWI), part of Northwest Medical Center. NWI is designated as a Breast Imaging Center of Excellence. The office can be reached at 877-4180.