Early detection offers the best chance for a cure.
1. Get screened regularly. Early detection offers the best chance for a cure. Screening guidelines vary; talk to your healthcare provider to determine what is right for you based on your individual risk factors. The Seattle Cancer Care Alliance supports the American Cancer Society’s recommendation that women begin annual mammography screening at age 40.
2. Choose a mammography expert. Numerous studies show that doctors who specialize in mammography are more accurate at interpreting the images when compared to physicians with less experience. Get your mammogram read by a doctor who specializes in reading them. The American College of Radiology offers an online search for accredited facilities and “Breast Imaging Centers of Excellence.”
3. Go digital. Centers that specialize in digital mammography are best for women with dense breast tissue and for women under age 50. Digital scans can do a better job of detecting cancer in these women than traditional film mammography.
4. Don’t put off screening because of discomfort. A mammogram should never be painful. Fear that the exam will be uncomfortable is one reason women put off scheduling a mammogram. To reduce discomfort, try to schedule the exam after your monthly period, when breast tissue is less sensitive. You may benefit by taking an over-the-counter anti-inflammatory such as ibuprofen or acetaminophen before your mammogram. Above all, tell the mammography technologist about any discomfort you may be experiencing.
5. Don’t put off screening because of fear. Most abnormalities found after a mammogram are not cancer. However, in some cases additional mammography or ultrasound is needed to confirm the area on the screening mammogram is normal. That’s why you may be asked to return for a follow-up exam.
6. Consider getting results while you wait. Particularly for your first mammogram, you may want to schedule your exam so you receive your results before you leave the imaging center. Or if you have found that you are frequently called back to your mammography center for a second scan, you can ask that your appointment include getting results to you while you wait.
7. Practice breast self-awareness. Know how your breasts feel normally. Your healthcare provider can show you how to do a breast self-exam. If you notice a change in your breasts, such as a lump or swelling, skin irritation, or dimpling, talk to your healthcare provider.
8. Have a clinical breast exam. The American Cancer Society recommends that women aged ≥40 years should receive annual clinical breast exams. Women in their 20s and 30s should have a clinical breast exam as part of a periodic health exam by a health professional at least every 3 years.
9. Know your risk. If you have family members who had breast cancer, especially a mother or sister, and if they had breast cancer before reaching menopause, tell your doctor, as your own risk of cancer may be higher than average. For example, a 20% increase in risk could mean that you should have an annual MRI in addition to a screening mammogram.
10. Try an online risk calculator. The Breast Cancer Risk Assessment Tool, designed by the National Cancer Institute, is a questionnaire to help women determine their chances of developing invasive breast cancer. You can find it online at www.seattlecca.org.
Dr Lehman is the director of Breast Imaging and the Medical Director of Radiology at the Seattle Cancer Care Alliance in Washington. Reprinted with permission from the Fred Hutchinson Cancer Research Center.