When it comes to your list of favorite annual happenings, health screenings may not rank high. What they lack in enjoyment, they more than make up for in the knowledge and peace of mind they provide. Mammograms are no exception.
As we mark Breast Cancer Awareness Month, we’re checking in with two mammography specialists to share key facts around this important test. Tara Albrecht, RTRM, is a patient care coordinator, mammographer and team leader with ThedaCare. Bridget Frasheski, RTRM, is a breast imaging quality assurance specialist with the Froedtert & the Medical College of Wisconsin health network. Froedtert ThedaCare is an integrated healthcare system serving nearly all of Wisconsin’s population.
“Screening mammography is one of the most important tools we have for finding breast cancer before it causes symptoms,” Albrecht said. “Our goal is to make every patient feel informed, comfortable and cared for.”
Answering Common Mammogram Questions
What is a mammogram?
Mammograms are low-dose X-rays of the breast. Regular mammograms can often find breast changes that could be cancer years before physical symptoms develop, according to the American Cancer Society.
What are the screening recommendations?
Screening guidelines vary by organization. The Froedtert & MCW health network and ThedaCare both recommend annual mammograms for women of average risk beginning at age 40. For questions surrounding individualized recommendations based on health history and risk factors, women should speak with their primary care team.
What makes mammography an important screening tool?
Frasheski: Mammograms are important because they can detect breast cancer early. They find small abnormalities before they can be felt. Routine mammograms help the radiologist get a baseline of what your breast tissue looks like. They will then be able to compare imaging from year to year to spot subtle changes that may indicate a problem.
How does early detection make a difference?
Albrecht: One of our biggest goals is to detect breast cancer when it is very small. When breast cancer is found at an earlier stage, it is generally easier to treat. Treatment options and outcomes also are often more favorable.
When I first started working in breast imaging more than 30 years ago, many cancers were larger before they could be detected. Today, advances such as 3-D mammography allow us to detect many very small abnormalities that may not be palpable. I sometimes describe these findings as being as tiny as a grain of salt or sand.
What are some misconceptions about mammograms you would like to clear up?
Frasheski: Here are a few we hear most often.
- I’m concerned about radiation: The radiation dose from a mammogram is very low. Experts agree that early detection outweighs the small risk.
- Mammogram isn’t necessary because I have no family history or symptoms: About 75% to 90% of women diagnosed with breast cancer have no family history of the disease. Also, if you wait until you have symptoms, such as a lump, the cancer could be already in the advanced stages.
- Mammograms are painful: The test can cause mild discomfort or pressure. It is brief and should not be severe.
- Compression is harmful to the breast: This is not true. Compression is required to spread out the breast tissue, reduce the radiation dose and help produce clear images.
What can women expect at a mammogram?
Albrecht and Frasheski: Appointments usually last 20 to 30 minutes. We ask that you don’t wear deodorant, antiperspirant, lotion or powders on the day of your test. These products may contain metallic particles that can show up on the mammogram.
Our team will greet you and take a brief health history. You will change into a gown from the waist up, so it’s best to wear a two-piece outfit. Routine screening generally includes two images of each breast. Breast compression lasts only a few seconds for each image.
We will explain when and how you can expect your results and what a callback means if additional images are recommended. Coverage varies by insurance plan. Patients who are uninsured or have financial need may have access to programs that provide free or reduced-cost mammography. Our team can help explain available options.
Most patients having their first screening mammogram tell us afterward that it was much easier than they expected.
What guidance would you give women who are anxious about having a mammogram?
Albrecht: It is completely normal to feel anxious about your first mammogram. Compression is brief, and our team will talk you through each step. If you are worried about discomfort, tell your technologist so we can help make the experience as comfortable as possible.
You can also try to schedule your mammogram seven to 10 days after the start of your menstrual period, so your breasts won’t be as tender when you have the test, Frasheski said.
Who may need to begin mammograms earlier or require additional types of screening?
Albrecht: Women who are at increased risk for breast cancer may need to begin screening at a younger age or have additional screening. For example, a woman whose mother was diagnosed with breast cancer at age 40 may be advised to begin screening earlier than average. A common approach is to consider starting about 10 years before the age at which the relative was diagnosed. However, this is not appropriate for every person and should be individualized with a healthcare provider or high-risk breast specialist.
At Froedtert ThedaCare, risk-assessment tools can help identify patients who may benefit from a high-risk evaluation. Risk assessment takes into account factors such as family and personal history and breast density. A high-risk clinic may recommend additional testing. This may include breast MRI, supplemental ultrasound in selected patients, and/or genetic counseling and testing, depending on the individual’s risk profile.
How often do callbacks happen, and do they always mean something serious?
Frasheski: Major health organizations, including the American College of Radiology and the American Cancer Society, report that roughly one in 10 women receive a callback after a routine screening mammogram. Of those called back, fewer than one in 10 are found to have cancer. Most callbacks are due to benign (non-cancerous) findings such as dense breast tissue, normal variations or small calcium deposits.
Common callback reasons include:
- Unclear or incomplete images that need retaking
- Dense breast tissue, which can make images harder to read
- Calcifications (tiny calcium deposits) or other benign changes
- Asymmetry or areas that look different from surrounding tissue
- First-time (baseline) mammograms without prior images for comparison
Most follow-up imaging shows no cancer, and many women return to their normal screening schedule. If a finding remains concerning, the radiologist will explain the recommended next steps, Albrecht said.
Bottom Line
Mammography is an important, safe and effective test for detecting breast cancer early when it’s most treatable. Your care team is here to help you navigate any concerns you may have.
“If you have questions about when to begin screening, your breast density, your personal or family history, or whether you may benefit from additional screening, talk with your healthcare provider or breast imaging team,” Albrecht said.
Know Your Risk. Know When to Screen.
Talk with your Froedtert & MCW health network or ThedaCare primary care team to understand your personal risk factors and when you should begin screening.
To schedule a mammogram with ThedaCare, talk with your primary care team or make an appointment online via MyThedaCare.
To view locations and schedule a mammogram with the Froedtert & MCW health network, visit froedtert.com/mammogram.
