VOLUME 40 • NUMBER 44 • SEPTEMBER 29, 2022
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Why are mammograms so important? BY DR. KELLY MCALEESE MEDICAL DIRECTOR/RADIOLOGIST THE WOMEN’S IMAGING CENTER
Over the years, different kinds of imaging tools have been developed to increase the detection of breast cancer. Advances in mammography have proven to be the best first-line imaging tool for detecting breast cancer early. Current 3D mammograms use low-dose x-ray to detect very small abnormalities such as distortions, masses, and microcalcifications (cells as small as grains of sand). Mammography helps find abnormalities at their smallest size when the cancer is most easily treatable. Many of these mammographic findings may develop up to five years before a mass can be felt on your clinical or self-examination. Discovering a breast lump by self-exam alone depends on its size, how
close it is to the surface, and the size of the breast. In contrast, breast cancer found by mammograms have a better prognosis, require less aggressive treatment, and are less likely to have spread. The approximate average size of a cancerous nodule found by regular screening mammography is one centimeter compared to two centimeters by regular self exam versus three centimeters for cancers accidentally found. The American Cancer Society (ACS) recommends screening mammograms for women 40 years of age or older every one to two years. Women with an increased risk of breast cancer based on their family history or other personal factors may start mammography earlier. Since Mammography alone may not find all breast cancers, your clinician or radiologist can recommend additional tools that can help increase detection de-
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pending on what’s right for you. For example, ultrasound may be recommended for dense tissue or MRI for a strong family history. Colorado has made great strides in educating women about their breast tissue density. Colorado SB17-142 passed its Dense Breast Tissue Notification and Reporting Bill “...to raise your awareness and to inform your conversations with your doctor.. to decide which screening options are right for you.” This education and awareness helps you and your clinician to decide if whole breast ultrasound should be added to your imaging plan. While mammography may have limitations in detecting cancer in a dense breast, ultrasound excels at detecting cancers in these same women with dense tissue as the technology uses sound waves to show differences in normal tissue versus cancerous masses.
For women with a strong family history of breast cancer or personal risk factors, breast MRI may increase the detection of small cancers by using contrast technology to detect vascular tumors. The ACS recommends against surveillance MRI in women with a low risk of breast cancer because of the increase in false alarms. When MRI is added to the imaging recommendation, it is in addition, not as a substitute for mammograms. The American Cancer Society has changed the recommendations of breast self-examination to breast self-awareness. Being familiar with the way your breasts look and feel is important for several reasons: 1.) This is their primary means of finding cancer for women who are not yet screening mammogram age; 2.) Some masses are not seen on mammograms because of dense tissue or their position, and 3.) practicing self-awareness may help detect tumors between mammogram intervals.