Who Should Be Getting a Mammogram and When?

We have all heard the recommendations for early breast cancer screening with the use of mammograms.  Maybe we know someone or have heard about a celebrity that was lucky to detect breast cancer early because they had a mammogram and caught it in an early stage that was more treatable.  But, if you are under 40 and are relatively healthy, you may be wondering if you are really a candidate for a mammogram and when you will need to worry about having a mammogram.  Not everyone needs to run right out and get a mammogram but there are certain people that could benefit from having a mammogram.

To discuss the use of mammogram in the early detection of cancer, it is important to first understand what exactly a mammogram is.  The Office of Women’s Health explains what a mammogram is and how exactly it works, “A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. The results are recorded on x-ray film or directly into a computer for a doctor called a radiologist to examine.  A mammogram allows the doctor to have a closer look for changes in breast tissue that cannot be felt during a breast exam. It is used for women who have no breast complaints and for women who have breast symptoms, such as a change in the shape or size of a breast, a lump, nipple discharge, or pain. Breast changes occur in almost all women. In fact, most of these changes are not cancer and are called “benign,” but only a doctor can know for sure. Breast changes can also happen monthly, due to your menstrual period… You stand in front of a special x-ray machine. The person who takes the x-rays, called a radiologic technician, places your breasts, one at a time, between an x-ray plate and a plastic plate. These plates are attached to the x-ray machine and compress the breasts to flatten them. This spreads the breast tissue out to obtain a clearer picture. You will feel pressure on your breast for a few seconds. It may cause you some discomfort; you might feel squeezed or pinched. This feeling only lasts for a few seconds, and the flatter your breast, the better the picture. Most often, two pictures are taken of each breast — one from the side and one from above. A screening mammogram takes about 20 minutes from start to finish.”  Generally speaking, the recommendation is that women over the age of 40 should get a regular mammogram.  The American Cancer Society recommends over 40, while the United States Preventive Task Force recommends over the age of 50.  But, while we see the majority of women with breast cancer being diagnosed over the age of 40, more and more it seems, we hear about women in their 20s and 30s being diagnosed with breast cancer.  So, should you wait or are you someone that could benefit from earlier screening?  If you have a close family history of breast cancer, you may need more regular monitoring.  It is important for every woman, regardless of age, to check their breasts often to feel for lumps or suspicious changes.  In addition to having a strong family history of breast cancer, women with dense breasts may benefit from regular mammograms.  NPR explains some of the recent research regarding who needs to be getting a mammogram, “The study found that the women under 50 who benefit from annual mammograms are the 12 to 15 percent who have extremely dense breasts. That is, the test is more likely to find dangerous tumors that are larger or more advanced at diagnosis. For the other 85 percent of under-50 women, there’s no added benefit. Annual mammograms don’t find more late-stage tumors or those that are larger at diagnosis. But annual screening doubles their already high risk of false-positive tests and biopsies that seem to find cancers that aren’t really there.  “I want to be clear,” Kerlikowske says. “This study does not say women in their 40s should undergo screening mammography.” But for those who want to, the study supports the idea of annual mammograms for those with extremely dense breasts.  Among women over 50, Kerlikowske thinks there’s been a slow shift away from annual mammograms since the federal task force issued its controversial guidelines in 2009.  “Our data reinforce the idea that women can be reassured they can be screened every two years, even if they’re at high risk” by virtue of having dense breasts or having been on hormone replacement therapy, the University of California, San Francisco researcher says.”  If you have any concerns, it is important to consult yoru physician right away and if you find yourself in one of the higher risk groups discussed above, you could benefit from more regular mammograms.

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