Oak Hills Womens Center

Should I get a mammogram or not?

Should I get a mammogram or not?

This is the question that women are asking all the time. Instead of getting answers, however, they are often hearing about the world-wide debate on this topic, as more studies that look at the benefits versus relative risks of mammography are reported. These conflicting reports may be leading to more confusion on the part of patients as they try to take a leading role in their healthcare and decision-making.

It is very clear that early detection of breast cancer is the key to its treatment. There is no question that one of the earliest signs of breast cancer is an abnormality that shows up on a mammogram, even before a lump can be felt by the patient or the physician. This is what makes the test such a valuable screening tool. Patients need to keep in mind, however, that like most medical tests, mammograms are not 100% accurate. In other words, they will not diagnose all breast cancers. Conversely, an abnormal mammogram doe not necessarily mean a woman has breast cancer.

A screening mammogram is done when the patient has no signs or symptoms of breast cancer, as opposed to a diagnostic mammogram, when the test is performed to evaluate signs and symptoms which might be associated with breast cancer. Women should sit down with their physicians to decide when it is reasonable to have a mammogram done.

The current guidelines set by the American College of Obstetricians and Gynecologists, based on limited scientific evidence are:

  • Women between the ages of 40-49 should be screened every one to two years.
  • Women over the age of 50 should be screened yearly.

Women younger than 40 may also be candidates for screening mammograms, depending on their family history, breast exams, or if factors exist that put them at high risk for breast cancer. Again, it is important to discuss this with their doctors. Another issue that has come up for debate is whether breast self exams should be recommended to patients. Despite lack of evidence for OR against breast self exam, there is no doubt that it does have the potential to detect a palpable breast tumor. Thus, it seems very reasonable to encourage patients to do monthly self exams. All women should have clinical breast exams annually as part of a thorough physical exam. What does a self breast exam look for? The following signs should be reported to a woman's physician immediately for further investigation:

  1. New, hard lump or thickening in the breast anywhere
  2. Change in breast size or shape
  3. Dimpling or puckering of the skin
  4. Swelling, redness, warmth that is persistent
  5. Pain in one spot that doesn't vary with monthly cycle
  6. Pulling of nipple
  7. Nipple discharge, especially in one breast only
  8. Itchy sore or scaly area

Since 1985, October has been recognized as National Breast Cancer Awareness Month, and its famous symbol, the "pink ribbon", was designed in 1992 by the Editor-in-Chief of SELF Magazine. NBCAM is actually a partnership of national public service organizations, professional medical associations, and government agencies which work together to promote breast cancer awareness, share information on the disease, and provide greater access to screening services. Its Web site, www.NBCAM.org is a year-round resource for breast cancer patients, survivors, relatives, caregivers, and the general public.

Let's all support the cause of "breast health awareness" every month of the year--not just in October. Now is the perfect time to start! Show off your "pink ribbon" and spread the word to your friends, relatives, and co-workers. Share your concern about this serious issue and do your part to promote "Early Detection".

American Cancer Society
American College of Obstetrics-Gynecology
The Susan G. Komen Foundation For the Cure
American Academy of Family Physicians

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