An Annual Mammogram Could Save Your Life
October is Breast Cancer Awareness Month, which makes this a fitting time to talk about the annual mammogram.
Dr. Matthew Miller, director of breast imaging with AHN Department of Radiology and Imaging Services, has seen its impact firsthand. “Annual mammography has been shown to be the biggest factor in helping patients overcome a breast cancer diagnosis,” he said. When a mammogram catches cancer, he added, patients ave a far better chance of survival.
That pattern is not new. Mammograms became widely used in the 1990s, once doctors began recommending them starting at age 40. Around that same time, the breast cancer death rate dropped by half. “I don’t think it’s a coincidence,” Miller said.
Dr. Danika Hogan, a diagnostic radiologist at Butler Memorial Hospital, sees the same value in early detection. “The whole goal is to detect breast cancers earlier than later,” she said, catching it at stage one instead of stage four. That difference shapes treatment. Stage one is often treated with lumpectomy and radiation, while stage four focuses on controlling the spread.
So, when should screening start? Age 40 remains the standard, Hogan said, though a family history of breast cancer can push that earlier. A woman is deemed “high risk” for developing breast cancer when her lifetime risk is above 20%, Miller added. High-risk women should start earlier than 40, often at 30, with an annual breast MRI added alongside the mammogram.
Part of what makes mammograms so valuable is how early they can catch an issue. “You’re not going to feel a lump the size of a pea, but we can find it with a mammogram,” Miller said. Hogan has seen that play out, too. Her team has caught cancers three millimeters deep in breast tissue, far too small to notice by touch.
None of that means self-breast exams are pointless. Miller still recommends doing one every month, ideally midcycle when hormones sit at their lowest.
Even so, the appointment itself tends to worry women more than anything else. Much of that comes down to compression – the part patients dread most. It spreads out breast tissue, so a mass is easier to spot, and it only lasts three to five seconds. “It’s uncomfortable, but it’s not as painful as it used to be,” Miller said. Hogan sees it as a fair trade-off. “Temporary discomfort for life-saving measures,” she said.
Radiation worries come up often. Miller wants to set the record straight. Mammograms expose patients to a small amount of radiation, he said. However, a round-trip flight delivers a similar dose. “There’s been no documented cases of mammogram-induced breast cancer,” he said. Hogan backs that up, noting that cell phone use exposes people to more radiation than a mammogram does. She also pushes back on the myth that compression spreads cancer.
Thermograms come up a lot as well, since a tumor runs hotter than surrounding tissue. But no study has shown they reliably diagnose breast cancer, Miller said, so he steers patients away from them. Mammograms remain the only accurate way to detect the disease.
If a mammogram turns something up, that rarely means cancer. Out of 100 mammograms, 90 come back completely normal, Miller said. Ten women get asked back for more imaging, and only two will need a biopsy. Just a third of those biopsies turn out to be cancer. “If you get called back, it doesn’t mean you have breast cancer,” Miller said. “It means we see something that needs further examination.”
From there, Hogan said, radiologists compare the new mammogram with prior ones to track subtle changes over time. That’s why she urges patients to bring old mammograms along whenever they switch providers or hospitals.
Results can move fast these days – sometimes too fast. Miller said patients often see them in MyChart before a doctor calls. However, a professional always follows up. Hogan said that wait is rarely long. “As soon as the radiologist signs off, the patient gets it and the doctor gets it,” she said.
For women who have put off their mammogram for years, Miller and Hogan share the same message: don’t wait any longer.
Part of that urgency comes down to the numbers. One in eight women will be diagnosed with breast cancer during their lifetime, Miller said. That makes it the most common non-skin cancer among women worldwide. He hears the same reaction from patients repeatedly. “You never think it’s going to happen to you until it does.”
Hogan takes her own advice. She gets a mammogram every year and recommends the same for her patients. “You’re only hurting yourself by not doing it,” she said.
Cost shouldn’t stand in the way either, Miller said. AHN offers local programs to help uninsured women get mammograms and follow-up care. Patients with Highmark insurance now pay nothing for breast care, with no copays or deductibles. Hogan pointed to another option, too. Adagio Health covers mammograms for uninsured women through a voucher program. “There’s always ways to get your mammogram covered,” she said.
Screening doesn’t stop at the standard mammogram for everyone. Women with dense breast tissue may need supplemental screening, such as an ultrasound or MRI, Hogan said. Patients who are claustrophobic and cannot have an MRI now have another option, called contrast-enhanced mammography. That test combines a standard digital X-ray with an iodine-based dye injected into a vein.
This October, Miller and Hogan want women to take one simple step. Schedule a mammogram, even after years of putting it off. It could end up being the appointment that saves your life.
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