Breast Cancer and Breast Health
Maintaining good breast health
involves a combination of three very important steps:
- Monthly breast self-examination (BSE) beginning at age 20.
- Clinical breast examination (CBE) by a healthcare provider at least every 2-3 years through a womanís 20s and 30s.
- Annual mammography after age 40.
None of these steps alone are adequate;
but in combination, they are our best chance at early detection. Mammography is the best tool we have
for the early detection of breast cancer. It is acceptable for women to choose not to do BSE or to do BSE occasionally; however, women who choose not to do BSE should still know how their breasts normally look and feel and report any changes to their doctor right away.
There are many risk factors for developing breast cancer. The biggest risk factor for breast cancer is just being a female.
Mammography is the gold standard
for screening for breast cancer in women age 40 and older. There has been a lot of controversy in the news
regarding the use of mammography, but the facts are:
- Mammography has helped reduce mortality rates due to breast cancer in the U.S. by nearly 1/3 since 1990.
- For those that a mammogram helped save a life, 40% were in their 40s. One in 5 breast cancers occur in women aged 40-49.
- 3 in 4 women diagnosed with breast cancer have no family history.
- For women over 50, skipping a mammogram every other year can miss up to 30% of cancers.
At age 40, women should begin having annual screening mammograms. Screening mammography is a very low dose X-ray examination of the breast. It is currently the best available screening method and is considered the gold standard for detecting breast cancer when no symptoms are present. A woman must be without any symptoms or breast complaints to have a screening mammogram. She must have a primary care provider to whom results can be sent. An order from your health care provider is not required for a screening mammogram; however, the report will be sent to the patientís primary care provider.
The screening mammogram procedure involves at least two images of each breast. The breast is positioned to ensure as much of the breast tissue is included and then compressed. Compression of the breast tissue can be somewhat uncomfortable, but it will only last a few seconds in each position. The compression holds the breast in place, minimizes radiation, motion and tissue overlap. We understand that compression can be uncomfortable, but we compress because we care, and we want you to have the best images.
Diagnostic mammography is used when a woman is experiencing symptoms. These symptoms must first be evaluated clinically by a health care provider, so they can order a diagnostic mammogram, if it is indicated.
Diagnostic mammography involves the same two images of each breast as in a screening mammogram, but also may include additional images as directed by a radiologist to best show the area or areas of concern. The diagnostic mammogram may be followed by additional imaging studies, such as an ultrasound of the breast or a breast MRI.
Diagnostic mammography is also done as follow up to an abnormal screening exam.
Thermography is study of the breast measuring abnormal blood flow or heat (increase in temperature) in the breast. The FDA has approved thermography as an additional diagnostic tool for detecting breast cancer.
The American College of Radiology (ACR), Society of Breast Imaging (SBI), FDA, and the Academy of Clinical Thermology all agree that thermography is not a replacement for mammography; and it should not be used alone to diagnose breast cancer.
Florence Gin, MD
Inland Imaging board-certified breast imaging radiologist
- In Spokane County in 2013, among women 40 years of age or older, 58% had a mammogram in the last year. Women having a mammogram increased as age increased, and was significantly less likely among the lowest income group. (2015 Spokane Counts, Spokane Regional Health District)
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