Give Yourself the Gift of a Mammogram
By David Gruen, MD, MBA, Director of Women’s Imaging & Co-Director, Breast Center and Helen Pass, MD, Director of Breast Surgery and Co-Director, Breast Center
Everyone has a different excuse for avoiding their yearly mammogram. Here are our thoughts on some of the most common ones.
1. “I’m too busy!”
Well, Stamford Hospital has evening and weekend appointments available. Certainly, we can help you find a time that works!
2. “I’m afraid of what we might find.”
Surgical treatment today is very different than a relative or friend may have received in the past. The cosmetic results from lumpectomies and mastectomies are much better as the techniques of cancer surgery are combined with those of plastic surgery (onco-plastic) to achieve the best cosmetic outcome without sacrificing the treatment of the cancer itself. Nipple and skin sparing mastectomies are routine. We no longer remove all the lymph nodes unless medically necessary to minimize the risk of lymphedema (arm swelling).
At Stamford Health, we also try to minimize anxiety by providing same day mammography results during standard business hours.
3. “I think I’ll skip it this year. I’ve heard I don’t really need one every single year.”
Some breast cancers grow and spread quickly, and others more slowly—no one can predict how one specific cancer will behave. The largest and longest running breast cancer screening trials found that annual mammography decreases the risk of dying from breast cancer by roughly a third in all women age 40 and over. Since the best hope for cure is early detection, it’s in your best interest to start getting yearly mammograms at age 40.
4. “I think I’ll wait until I’m 50 years old to get my mammogram.”
A recent study showed that more than 70% of the women who died from breast cancer in their 40’s- were among the 20% who were not getting mammography. In addition, the best and most extensive studies show that women who start screening at age 40 have the most lives saved from mammography. The harms of screening are negligible, compared to dying from breast cancer, and there is no scientific or biological reason to delay screening until age 50.
Many major American medical organizations with expertise in breast cancer care agree that starting annual mammography at age 40 saves the most lives.
5. “I’m afraid of radiation and chemotherapy.”
Yes mammograms use low dose radiation, but one fact remains irrefutable: mammography has helped reduce breast cancer mortality in the U.S. by 30% since 1990.
A woman's lifetime risk of getting breast cancer is 1/8 (12%). The risk of dying from cancer due to the radiation exposure from mammography in a woman aged 40 years is 1/70,000 and this risk declines rapidly with age.
To be even more specific (feel free to skip this section if you do not like numbers), mammography exposes people to 0.4 mSv. That is the same amount of radiation a person living in Denver receives in about 1/3 of a year (133 days to be exact). The average yearly radiation dose from food is 0.3 mSv. The average yearly background radiation dose is 3.1 mSv (that is almost eight fold the dose of a mammogram). Radiation workers are allowed to receive 50 mSv per year. Sooooo, compared to everything else, mammography exposes a person to a very small amount of radiation.
Chemotherapy has come a long way, too. The decision to have chemotherapy is now based on individualized tumor characteristics rather than deciding based on general population factors. Significant advances in anti-nausea medication, support of white blood cell counts to prevent infection, and even the use of cold caps like DigniCap® Scalp Cooling System to prevent hair loss have revolutionized chemotherapy.
Yearly mammography is recommended because finding early stage breast cancer allows more treatment options and a better opportunity for long-term survival.
6. “I can’t afford it!”
Do not let financial concerns keep you from getting your mammogram. Stamford Hospital offers free mammography for those who are uninsured or whose insurance does not cover breast cancer screening. Our Breast Center team works closely with the Connecticut Department of Public Health’s Breast and Cervical Cancer Early Detection Program (CBCCEDP) to increase the number of women who receive screening, diagnosis and treatment. Certain eligibility criteria must be met.
This holiday season, give yourself the best present and make sure you and your loved ones have had a recent mammogram—no more excuses! And as always, use these guidelines when talking with your doctor.