Treasure Your Chest

A Q&A About Mammograms And Breast Cancer Screenings

Every two minutes, a woman is diagnosed with breast cancer in this country. Even though treatments are better than ever, one person dies every 13 minutes from breast cancer. The good news is that there are 3.3 million breast cancer survivors in the United States. The best thing you can do is screen, catch, and treat breast cancer early. 

Dr. Lori Lilley, a board-certified surgeon with more than 20 years of experience, discusses the most frequently asked questions related to mammograms and breast cancer screenings. Dr. Lilley leads WakeMed’s Breast Services Program, dedicated to the management of breast health issues – from early diagnosis to surgical intervention and long-term treatment planning. Throughout her career, Dr. Lilley has focused much of her work on breast surgery, which is used to explore palpable shadows, spots, or tumors that may show up on imaging studies.

When should I start getting mammograms? Although there is some controversy regarding this subject, in general, women should start getting mammograms at age 40. One out of six breast cancers occur in women ages 40 to 49 – and a majority of these women had no family history of breast cancer. For women with a close relative who had breast cancer at a young age, breast screenings should start 10 years younger than the relative’s age at diagnosis. For women who have a mutation in BrCa 1 or 2, screenings should start in their mid-20s. 

Should I get a regular mammogram or a 3D mammogram? While traditional 2D screening mammography is a valuable tool in the early detection and diagnosis of breast cancer, a 3D mammogram is superior to a 2D one. 3D mammography has been shown to improve breast cancer detection by providing a more detailed, complete view of the breast tissue. In a 3D mammogram, also known as “breast tomosynthesis,” many slices are taken through the breast at 1 mm intervals, and they are put together in a three-dimensional way. It becomes easier to see masses, especially in dense breast tissue. There are also less callbacks for false positives.

Is there a lot more radiation for 3D mammogram? No, only a small amount more.

Is an ultrasound better? An ultrasound is helpful for some lumps, but the best screening tool is still an annual mammogram. If a mass is palpable (able to be touched/felt) and not seen on mammogram, an ultrasound is used to assess the breast tissue. An ultrasound can also tell us if a mass is solid or cystic.

Do I need genetic testing? Sometimes your family history raises suspicions, and we order genetic testing. If there is breast and ovarian cancer, early prostate cancer, or pancreatic cancer in your family, you may need testing. If you get breast cancer at a young age, you may need testing. If you develop a second or contralateral cancer, you may need testing. There may be other hints as well that you need genetic testing. Some insurance carriers require that you see a genetics counselor prior to having these tests.

Do mammograms cause cancer? No. Mammograms can save your life or the life of someone you love.