Skip to main content Skip to home page

Your Health Blog

    What All Women Should Know About Mammograms and Their Breast Health

    Michael Daugherty, MD Breast Radiologist, Deaconess Breast Services 09/16/2020
    Breast cancer will develop in 1 in 8 American women during their lifetime. For 2020, it is estimated greater than 276,000 women will be diagnosed with invasive breast cancer, and over 42,000 will die from breast cancer.

    What is a mammogram and when should I have one?
    A mammogram is a low-dose x-ray picture of the breast used to look for changes in breast tissue. Mammograms can often detect breast cancer in women who have no signs or symptoms of disease, also called a screening mammogram. Annual screening mammograms are still the best way to find breast cancer early, which typically includes 2 images of each breast. The x-ray images often make it possible to detect tumors that are small, and often before a lump is felt. 

    The American College of Radiology (ACR) and Society of Breast Imaging (SBI) recommend that women start getting annual mammograms at age 40. The ACR, SBI, American Cancer Society (ACS) and the U.S. Preventative Services Task Force (USPSTF) all agree this saves the MOST lives.  

    By not getting annual mammograms starting at age 40, your chances of needing more extensive treatment for any cancers found will increase, plus your chances of dying from breast cancer will also increase. Following other guidelines (i.e. USPSTF) could miss 1/3 of cancers and result in 6,500 - 10,000 additional cancer deaths.  

    Are there specific reasons to have a mammogram before age 40?
    Women who have a history of breast cancer in their family (mother, sister, grandmother, daughter) may be at an increased risk for breast cancer.

    If you have this kind of family history, talk with your primary care doctor and/or your OB/GYN about what screenings may be right for you. Sometimes a woman with a family history of breast cancer should begin annual screening mammograms as early as age 30. Some women may benefit from breast MRI screenings. Any screening outside the general guidelines will require a physician order, and potentially a consultation with a genetic counselor. 

    Finally, any woman who notices something abnormal about her breasts upon examination (such as a lump, dimple/puckering, leaking from the nipple, etc.) should notify her doctor immediately. A diagnostic mammogram may be needed to closely look at breast abnormalities with additional images; it is not the same as a screening mammogram. Plus, a focused ultrasound is often required.  


    What are the risk factors for breast cancer?  
    The list below from the CDC is a comprehensive list of risk factors for breast cancer.  

    The two main factors that influence your risk include being a woman and getting older. Most women diagnosed with breast cancer have no family history (only about 15% have family history). 

    Having a risk factor does not mean you will get the disease, and not all risk factors have the same effect. Most women have some risk factors, but most women do not get breast cancer. If you have breast cancer risk factors, talk with your doctor about ways you can lower your risk and about screening for breast cancer.

    Risk factors include
    • Being born female. Men can get it too, but much more common in women.
    • Getting older. The risk for breast cancer increases with age; most breast cancers are diagnosed after age 50.
    • Genetic mutations. Inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2. Women who have inherited these genetic changes are at higher risk of breast and ovarian cancer.
    • Early menstrual period. Women who start their periods before age 12 are exposed to hormones longer over their lifetime, increasing their risk.
    • Late or no pregnancy. Having the first pregnancy after age 30 and never having children can raise breast cancer risk.
    • Starting menopause after age 55. Like starting one’s period early, being exposed to estrogen hormones for a longer time later in life also raises the risk of breast cancer.
    • Not being physically active. Women who are not physically active have a higher risk of getting breast cancer, especially if post-menopausal. American Cancer Society (ACS) recommends 150-300 minutes of moderate activity each week.
    • Being overweight or obese after menopause. Older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight. More fat tissue can increase estrogen levels and increase breast cancer risk.
    • Having dense breasts. Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get breast cancer.
    • Hormone replacement therapy. While beneficial in treating symptoms of menopause (hot flashes, etc.) and helping to prevent osteoporosis, taking hormones to replace missing estrogen and progesterone in menopause for more than five years raises the risk for breast cancer. The hormones that have been shown to increase risk are estrogen and progestin when taken together.
    • Taking oral contraceptives (birth control pills). Certain forms of oral contraceptive pills have been found to raise breast cancer risk.
    • Personal history of breast cancer. Women who have had breast cancer are more likely to get breast cancer a second time versus someone who has never been diagnosed.
    • Personal history of certain non-cancerous breast diseases. Some non-cancerous breast diseases such as atypical hyperplasia or lobular carcinoma in situ are associated with a higher risk of getting breast cancer.
    • Family history of breast cancer. A woman’s risk for breast cancer is higher if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who have had breast cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk.
    • Previous treatment using radiation therapy. Women who had radiation therapy to the chest or breasts (like for treatment of Hodgkin’s lymphoma) have a higher risk of getting breast cancer.
    • Women who took the drug diethylstilbestrol (DES), which was given to some pregnant women in the United States between 1940 and 1971 to prevent miscarriage, have a higher risk. Women whose mothers took DES while pregnant with them are also at risk.
    • Drinking alcohol. Studies show that a woman’s risk for breast cancer increases with the more alcohol she drinks.
    What is 3D mammography?
    Mammography, and in particular, 3D digital mammography, is the gold standard in breast cancer screening.
    In 2D imaging, cancerous tumors can be hidden behind normal breast structures. 

    3D mammography, also called tomosynthesis, helps radiologists see clearer, more detailed photos of the breasts. The mammography machine takes images of the breasts in layers, helping us see the breast in clearer, more precise views. 

    A 3D mammogram catches more cancers- and it catches them earlier! Earlier cancer detection results in better clinical outcomes. 
     
    Deaconess Breast Services received designation as a Breast Imaging Center of Excellence by the American College of Radiology (ACR).  We’re very proud of this designation, as it means that our breast imaging centers have earned accreditation in mammography, stereotactic breast biopsy, and breast ultrasound (including ultrasound-guided breast biopsy), and breast MRI.

    We offer 3D mammography at all three of our screening locations, including:
    • Deaconess Breast Center at Deaconess Midtown
    • The Breast Center at The Women’s Hospital
    • The Mobile Breast Center

    There are additional Deaconess services related to breast cancer that we believe women should know about below:

    Genetic counseling
    If you have a family history of breast cancer, you may benefit from oncology genetic counseling.  The Women’s Cancer Center, located in the Chancellor Center for Oncology, offers the expertise of the only oncology genetic counselor in the entire region. 

    Contact The Women’s Cancer Center to learn more. 
     
    Multidisciplinary Breast Cancer Clinic
    When a woman is diagnosed with breast cancer, having a team of cancer experts can improve outcomes. The Multidisciplinary Breast Cancer Clinic involves multiple physicians and experts to create a personalized treatment plan for each patient.

    Mobile Breast Center
    We’re proud to be able to bring 3D mammograms to women throughout the region via the Deaconess Mobile Breast Center.
     
    Convenient mammogram scheduling
    When you make the decision to have your annual screening mammogram, you don’t need to wait for an appointment!  Schedule your mammogram online--right now--or simply call 812-450-6266.  
Top Back to top