Board-Certified Plastic Surgeons Serving Denver & Lone Tree, Colorado
The majority of doctors and experts say that early detection of breast cancer saves thousands of women each year, and that more lives could be saved if more women participated in early detection methods like mammograms and breast self-exams. Even when you have breast implants, mammograms and self-exams remain important and highly effective.
Check with your doctor to see if your age, background or other factors mean you should get regular mammograms. Learn more about these detection methods below.
Importance of the Mammogram to Screen for Breast Cancer
Screening mammograms are important because they can detect breast cancer in its early stages. Early detection improves your chances of successful treatment, according to the American Cancer Society. Furthermore, mammograms are important for the following reasons:
- Screening mammograms provide a baseline for your doctor. Your doctor can then compare your mammograms each year to see patterns and evaluate changes in your breasts.
- Screening mammograms may show lumps when they are too small to be felt by you or your doctor.
- Diagnostic mammograms provide a way for your doctor to evaluate a lump, growth or breast change to decide if further evaluation is needed.
How Often Do I Need Mammograms?
Health experts have different recommendations for mammogram frequency. Some recommend getting a mammogram every one to two years beginning at age 40. Others suggest waiting until age 45 and scheduling annual breast screenings.
Your doctor can help you choose when and how often to get mammograms. If you have a personal or family history of breast cancer, you may be advised to start having mammograms earlier and more often than average. In that case, additional diagnostic tools may also be used.
Is There a Risk of Radiation Exposure From Having Regular Mammograms?
Mammograms expose the breasts to low levels of radiation. It helps to put these levels of radiation into perspective. Generally speaking, a woman will get the same amount of radiation from her natural surroundings over about seven weeks as she will when receiving a screening mammogram on both breasts. The former is something known as background radiation.
Radiation can have some possible health effects. However, the important thing to remember is that the benefits of mammography far outweigh any of the potential risks of radiation exposure.
What Should a Woman Expect When Having a Mammogram?
You will begin your mammogram standing in front of an X-ray machine. A technologist will then place your breast on a plastic plate attached to the device. At that point, another plate will firmly press down on your breast from above to flatten it and hold it still. It is normal to feel pressure.
To take a side view of the breast, these steps are repeated. They are then repeated on the other breast. This entire process creates four X-rays. Additional X-rays are sometimes necessary.
Be aware that the technologist will not tell you your results. Your mammogram will be sent to a radiologist who can read it. You will usually hear back within a few weeks, sometimes sooner.
Are Mammograms Painful?
Most women find mammograms uncomfortable, and some find them painful. Fortunately, mammograms are over quickly, and that means the discomfort is very short-lived.
What you feel during a mammogram can depend on:
- The size of your breasts
- The skill of your technologist
- Your menstrual cycle
How Long Is a Mammogram?
Most mammograms take about 15-30 minutes from check-in to completion. Women typically spend just a few minutes actually getting the X-rays. The fact that mammograms are so quick means that they are very accessible. You can accommodate one no matter your schedule.
What Should I Wear to a Mammogram?
You will need to undress from the waist up when you receive a mammogram. For that reason, many women choose to wear a top with a skirt or pants. If you wear a dress, romper, or jumpsuit, you will likely need to undress completely. However, robes will be provided for privacy.
There are certain personal care products that you should not wear to a mammogram. These include deodorant, perfume, and powder, which can show up as white spots on the X-ray.
The goal of a screening mammogram is to find cancer early, before it can be felt by touch and before there are symptoms. When you can feel the cancer or have other symptoms, it is more likely that the breast cancer is larger and has spread beyond the breast, whereas cancer found during breast cancer screening is more likely to be smaller and contained within the breast. The outlook of your diagnosis (the prognosis), is heavily influenced by the size of cancer and how far it has spread.
The mammogram is an X-ray of your breasts. Two images are taken of each breast. Some imaging centers now offer 3D breast mammograms, called breast tomosynthesis. The 3D mammogram takes multiple images of each breast, moving over it in an arc. Not all health insurance policies cover the cost of 3D mammograms. The Affordable Health Care Act requires all health insurance companies to cover the cost of a traditional screening mammogram. Medicaid and Medicare does as well.
Women with breast implants can have mammograms, just make sure you tell the technologist performing the screening. Your technologist will likely take 4 additional X-ray images of your breasts and push the implant against your chest wall so that the breast tissue can be isolated.
The goal of the Breast Self-Exam (BSE) and Breast Awareness methods are to look and feel for changes in the breasts that may be signs of breast cancer. If you familiarize yourself with how your breasts look and feel normally, then changes in the breasts are easier to identify. You then have the changes evaluated by a doctor.
Just because you have felt a change, that does not mean you have breast cancer. An appointment with your doctor is needed to determine the cause of any changes. Two methods for self-exam are:
- Breast Awareness: Knowing how your breasts look and feel normally, and feeling breasts for any changes from the norm.
- Breast Self-Exam: A scheduled, step-by-step self exam to feel changes in the breasts.
Please see the American Cancer Society's instructions for performing a breast self-exam. If you have breast implants, you can still perform a BSE. Our plastic surgeons can show you how to identify the edges of your implants so that you don't confuse them with tissue changes.
Even if you choose not to perform BSEs, you should schedule a doctor's appointment if you notice any changes in your breasts just from looking at and feeling them.
How To Do a Breast Self-Exam
If you have risk factors for breast cancer like a BRCA gene mutation, monthly self-checks could help you detect new lumps early and give you peace of mind. To perform a BSE, you should:
- Choose a day each month. Your breasts are less likely to feel sore or swollen about a week after your period has ended, making it a good time for a BSE. If you’re not menstruating, simply schedule a reminder for the same day each month.
- Check your breasts while standing. You can use the flats of your fingers to lightly press around both breasts and armpits with light, medium, and firm pressure. You’re feeling for any thickening, hard knots, pea or marble-sized lumps, and other changes.
- Repeat while lying down. You may catch changes you missed before when your breast tissue is spread evenly along the chest wall.
- Perform a visual inspection. Check your breasts in the mirror with your arms at your sides and again with your arms overhead. You’re looking for any changes in the nipple or breast shape, skin dimpling, redness, or swelling.
If you notice any changes during your BSE, report back to your doctor. They can perform a physical exam, mammogram, or biopsy as needed.
I Found a Lump. Is It Breast Cancer?
If you find a new mass in your breast, it’s always best to see your doctor. That said, it’s also important to stay calm. Several benign conditions cause breast lumps. Fibroadenomas are solid breast lumps that typically grow slowly to about an inch. They’re usually firm or rubbery, round with distinct borders, and easily moved.
Fibrocystic breast changes (FBC) can cause thickening, pain and tenderness, nipple discharge, and lumpy nodules that change in size with your menstrual cycle. These changes typically occur in both breasts. FBC is an extremely common condition, affecting about 50% of women in their lifetimes, usually between the ages of 20 and 50.
Many other harmless conditions cause breast lumps. However, any new growth should be checked by your doctor, who can order a mammogram if needed.
Do I Need More Mammograms if I Have a BRCA Gene Mutation?
If you have a BRCA gene mutation, which raises your breast cancer risk to about 50% to 85% in your lifetime, mammograms are essential. The American Cancer Society recommends an annual screening for breast cancer starting at age 30 if you have a BRCA mutation. In addition to screening with mammography, they recommend a yearly MRI.
You might also need more frequent breast cancer screenings if you have other risk factors, including:
- A family history of breast cancer and an estimated risk of 20% or greater according to risk assessment tools
- A first-degree relative with a BRCA1 or BRCA2 gene mutation and you haven’t been tested yet
- Radiation therapy to the chest between ages ten and 30
- Li-Faumeni syndrome, Cowden syndrome, or Bannayan-Riley Ruvalcaba syndrome
Your doctor can recommend an appropriate screening schedule based on your unique breast cancer risk factors.