Blog

While the recommendations for screening mammography vary among organizations, a plethora of research supports annual breast cancer screening starting at 40 years old. Currently, the American College of Radiology (ACR) and the Society of Breast Imaging (SBI) recommend annual screening beginning at 40 years old. The American Cancer Society and the US Preventative Services Task Force (USPSTF) support giving women the option to start annual mammograms at 40, but differ on guidelines for annual/biennial screening recommendations.

Research on the benefits of annual screening mammography beginning at age 40 (from the ACR’s mammography website):

• National Cancer Institute data shows that breast cancer death rates have dropped nearly 40 percent since the advancement of mammography in the 1980’s.
• The largest (Hellquist et al) and longest running (Tabar et al) breast cancer screening studies in history demonstrated that regular breast cancer screening reduced breast cancer deaths by approximately one-third in all women ages 40 and older.
• Research published in Cancer indicated that women who died in their 40’s from breast cancer were among the 20 percent who did not have annual screening mammograms.
• An analysis in the American Journal of Roentgenology found that approximately 6500 more women would die from breast cancer each year if the US Preventative Services Task Force guidelines for screening mammography starting at 50 years old were followed.

Additionally, the ACR and SBI are the first to recognize that African-American women have a higher breast cancer risk than other groups, and should be screened accordingly. The ACR and SBI now recommend that all women undergo risk assessments at age 30 to determine whether or not they should begin screening mammography before their 40^th birthday.

The benefits of mammography almost always outweigh the risks. In part two of our ‘Debunking Mammography Misinformation’ series, the radiologists weigh in.

Q: My doctor said I have dense breasts, will this increase my risk of getting breast cancer?

A: Having dense breasts may increase your risk for breast cancer. Dense breasts also make it harder to spot cancer on mammograms. Dense tissue appears white on mammograms, but so do cancers and other lumps. This means that mammography results may be less accurate in women with dense breasts. Debra Monticello, MD Radiologist

Q: I’ve heard that screening mammography contributes to overdiagnosis. What does that mean?

A: It’s when a test, such as a screening mammogram, finds a cancer that would not kill you before something else does. Only a few percent of cancers would fit this description, and medical science cannot yet tell which cancers will advance to kill and which won’t. The only way to know is to not treat the cancer and see what happens. Invasive breast cancers don’t go away or get smaller if left untreated. It’s only a matter of time before these cancers kill. –Nicole Saphier, MD Radiologist

Verdict: This year, more than 250,000 women will be diagnosed with invasive breast cancer, and at least 40,000 women will die from the disease. If not for life-saving mammography, tens of thousands more women would die. The relatively small risks associated with mammograms don’t even come close to outweighing the benefits. Mammograms continue to save lives.

*Adapted from the video “Balancing Mammography Benefit vs. Risk”, on the ACR’s Mammography Saves Lives YouTube playlist.

Related article: Debunking Mammography Misinformation: Risks & Benefits of Mammograms – Part 1

Honest answers from radiologists on the risks and benefits of mammography.

Q: Does getting a mammogram every year really help?

A: Regular mammography use has reduced breast cancer by nearly 40 percent since screening began in the mid 1980’s. But it’s more than that. Mammograms find tumors when they are small, before you can feel them, and when they can be better treated. This gives women a better chance for less surgery, less toxic chemotherapy, and less radiation treatment. – Debra Monticello, MD Radiologist

Q: Are there any risks to mammography?

A: Mammograms don’t find all cancers, and they do find things that turn out not to be cancer. Some women who get a mammogram will be asked to come back for another test to confirm or rule out that something is wrong. If those results rule out cancer, some people call the first results a false positive. – Debra Monticello, MD Radiologist

Mammography Math: For every 100 women who get a mammogram, 10 will be asked to come back for a closer look. Of those 10, two will be referred to have a needle biopsy. Fewer than one in every 100 women screened will be diagnosed with breast cancer.

Q: Every time I have a mammogram, I have such anxiety waiting for my results.

A: This is normal and will pass without lasting effects. The possibility of a cancer that kills thousands of people every year is of greater concern. Especially when breast cancer that is caught early can be effectively treated. –Katherine Hall, MD Radiologist

* Adapted from the video “Balancing Mammography Benefit vs. Risk”, on the ACR’s Mammography Saves Lives YouTube playlist.

Read more: Debunking Mammography Misinformation: Risks & Benefits of Mammograms – Part 2

Just because Breast Cancer Awareness Month 2018 is over doesn’t mean that active awareness should end. Before BCAM, we acknowledged that passive ‘awareness’ – such as retweeting a breast cancer statistic – doesn’t do much to help the cause  – but active awareness, like participating in a breast cancer walk or making a healthy change in our diet, does.

We encouraged you to indulge in mindful moments every day during BCAM, and

we hope you integrate those new positive habits into your life on a regular basis.

Here are some additional mindful actions you can take to lower your risk for developing breast cancer:

Know your normal –  While monthly breast self-exams are no longer recommended, it’s still important to check in with yourself, and make sure everything is ‘normal’.  If you find bumps, lumps,  or sore spots – on or near your breasts  – or experience abnormal nipple discharge, make sure to discuss it with your doctor.

Make time for movement – A sedentary lifestyle is associated with a higher risk for breast cancer and other diseases. Challenge yourself to do some form of exercise in 10 minute increments, two to three times a day, to establish a routine. Before you know it, working out will become the best habit you ever picked up. 

Plan for your mammogram –   Whether you and your doctor decide to start screening mammograms at age 45 – as recommended by the American Cancer Society – or at age 50 – as recommended by the American College of Radiology – pick and stick with it. Mammograms save lives by catching breast cancer in its earliest stages.

This Breast Cancer Awareness Month, take time out to love and celebrate your breasts by living mindfully.  Instead of focusing on negative breast cancer statistics, focus only on the factors you can control right now.   

Eat the rainbow – And we don’t mean Skittles! A diet high in fruits and veggies (5.5 servings per day) has been shown to lower breast cancer risk by as much as 11 percent. But instead of trying to overhaul your entire diet in a day, why not start with your next meal during Breast Cancer Awareness Month?  Since cruciferous vegetables – like broccoli and Brussels sprouts, as well as orange and yellow veggies, are most strongly associated with a lower risk, start there. Take time to savor each bite, while reflecting on the flavor and health benefits.

Move mindfully – Research shows that exercise lowers your risk. We know that finding the time – and motivation – to work out can feel like an uphill battle, but changing your mindset can help you to get moving.  Exercise is one of the few things in life that is 100 percent about you. Instead of dreading it, think about it as ‘me’ time – and focus on how good it feels to honor your body and put yourself first.

Meditate – Studies suggest that meditation helps breast cancer survivors cope with post-treatment symptoms like anxiety and depression. While we can’t say that meditation lowers breast cancer risk, we do know that a healthy body begins in the mind.  During  Breast Cancer Awareness Month aim to meditate for ten minutes every day.