Breast cancer often has no symptoms. That’s why regular screenings are so important. Getting a mammogram can be stressful, especially your first time, but it’s important to take care of yourself with regular preventive care. A mammogram is one of the best ways to find breast cancer early, when treatment is more likely to be successful. The chances of survival are higher, too.
What is breast cancer?
Breast cancer occurs when cells in the breast divide and grow out of control. Over time, the cells form a tumor that a mammogram may detect.
Apart from skin cancer, breast cancer is the most common type of cancer in women in the United States. In fact, about one in eight U.S. women will develop invasive breast cancer at some point in life.
The good news is that about 66 percent of cases are diagnosed before the cancer has spread outside the breast, when treatment tends to be more effective.
Types of breast cancer
Breast cancer can be invasive or non-invasive. Invasive means that the cancer has spread—or metastasized—to nearby tissue, lymph nodes, or other parts of the body, while non-invasive means that the cancer hasn’t spread.
Breasts are made up of three main parts:
- Lobules, the glands that produce milk
- Ducts, the tubes that carry milk to the nipple
- Connective tissue
Most breast cancers begin in the ducts or lobules.
Types of breast cancer include:
Invasive ductal carcinoma (IDC). As the most common type of breast cancer, IDC accounts for about 80 percent of all breast cancers. With this type of the disease, cancer cells grow outside the ducts into other parts of the breast. (Carcinoma is a common form of cancer.)
Invasive lobular carcinoma (ILC). With ILC, cancer cells spread from the lobules to nearby breast tissues. About 10 percent of all invasive breast cancers are ILCs.
Ductal carcinoma in situ (DCIS). With DCIS, abnormal cells grow inside the lining of the ducts but have not spread to nearby breast tissue. DCIS is a non-invasive breast cancer because it hasn’t spread beyond the ducts.
Risk factors for breast cancer
The biggest breast cancer risk factors are gender and age. Women have a far greater risk of developing breast cancer than men. (Less than one percent of all breast cancers occur in men.) And women are more likely to develop breast cancer as they grow older.
The risk of breast cancer rises if your mother, sister, or daughter has breast cancer. However, about 85 percent of breast cancers occur in patients who have no family history of the disease.
A small percentage of breast cancers can be linked to inherited mutations in the breast cancer genes, BRCA1 and BRCA2. On average, women with a BRCA1 mutation have a 55 to 65 percent risk of developing breast cancer before age 70. For women with a BRCA2 mutation, the risk is about 45 percent.
Early symptoms of breast cancer
Becoming familiar with your breasts can help you identify abnormalities or changes over time. However, the warning signs of breast cancer are not the same for everyone. The most common signs include:
- A change in the look or feel of the breast
- A change in the look or feel of the nipple
- Nipple discharge
Most lumps are not breast cancer. But be sure to talk to your doctor if you find a lump in your breast, have any warning signs, or notice changes in your breasts or underarm area.
What is a mammogram?
A mammogram is an X-ray image of your breasts. During the procedure, your breasts are compressed between two surfaces to spread out the tissue. Your doctor examines the images to look for signs of cancer.
Mammography is a common procedure. In fact, recent data indicate that screening mammography rates in the U.S. have increased over the past decade:
- 69 percent of women age 45 and older had a screening mammogram within the past year.
- 80 percent of women ages 50 to 74 had a screening mammogram in the past two years.
There are two types of mammograms, screening mammograms and diagnostic mammograms.
Screening mammograms can detect breast changes in patients who have no signs of cancer or breast abnormalities.
Diagnostic mammograms examine breast changes, lumps, pain, skin changes, or nipple discharge. They also evaluate abnormal findings on a screening mammogram.
Screening guidelines for breast cancer
Breast cancer screening guidelines vary by health organization:
The U.S. Preventive Services Task Force (USPSTF) mammogram guidelines recommend women ages 40 to 74 have a screening mammogram every two years.
The American Cancer Society mammogram guidelines recommend more frequent screenings for anyone with an average risk of breast cancer.
- Ages 40 to 44: Patients should have the option of getting a mammogram every year.
- Ages 45 to 54: Patients should get a mammogram every year.
- 55 and older: Patients can switch to a mammogram every other year or choose to continue yearly mammograms.
However, both organizations recognize that starting breast cancer screenings earlier may make sense for some patients.
For example, if you have a family history of breast cancer, you may need to begin screenings earlier and have them more often. Only you and your health care provider can decide what’s right for you.
How to prepare for your mammogram
Following a few tips can make the procedure less stressful:
- If you haven’t started menopause, schedule the screening for the week after your period, when your breasts are less tender.
- Don’t wear deodorant, powder, or lotion around your chest area as these items may interfere with the X-ray.
- Wear an outfit that allows you to easily remove the top. You will be able to wear a gown during the procedure.
- Bring the name and contact information of the doctor who ordered the mammogram so the facility can send your doctor a report.
Risks of mammograms
Mammography is an effective tool that can find breast cancer early and help save lives. However, it’s important to discuss the risks and limitations of mammograms with your doctor.
Mammograms can be wrong. A potential downside of mammograms are false-positive results, when the test shows signs of cancer even though there is no cancer in the breast. The accuracy of the procedure depends on the age of the patient and breast density, the technique used, the experience of the radiologist, and other factors.
Mammograms involve radiation exposure. In most cases, the benefits of breast cancer screenings offset the risks posed by exposure to very low doses of radiation.
Results can be hard to interpret. The dense breast tissue common in younger patients can hide signs of cancer. It’s often easier to detect changes in breast tissue and interpret mammograms as women age.
Additional testing may be required. If your radiologist finds something abnormal on your mammogram, you may need another test. This could involve an ultrasound or a breast biopsy, where a sample of breast tissue is removed for testing in a lab. A small percentage of mammograms require more testing, but most abnormal findings don’t turn out to be cancer.
Some cancers can’t be detected. While mammograms find most breast cancers, they can miss cancers that are too small or hidden in areas that are hard to view.
Talk to your doctor about getting a mammogram
If you’re not sure when to start breast cancer screening or how often to repeat it, talk to your doctor. Together, you can decide what’s best for you based on your personal risk of breast cancer and your medical history.
