Employee & Community Health

Raise your mammogram IQ

10/23/2017 by Jennifer Frank, APRN, CNP

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Breast Cancer is the second most common cancer of women in the United States, and mammograms are the screening tools used to detect it. Here are six things you should know about mammograms:

Should I have a screening mammogram?

Mammograms have been shown to reduce deaths from breast cancer by about 30%. In general, Mayo Clinic recommends annual mammograms for women at average risk of breast cancer beginning at age 40. However, the benefit of a screening mammogram is smaller for women in their 40s than for women 50 and older, primarily because breast cancer is less common at this age. The risk of false-positive findings is also higher, which may lead to further imaging and possible biopsy.

For this reason, you and your health care team may decide that an every-other-year mammogram may be more appropriate for you during the ages of 40-45 or 40-50. If you have a family history of breast cancer, the age to begin mammograms and intervals also may vary, which you should discuss with your health care provider.  

Why can’t I wear deodorant on the day of my mammogram?

Avoid using deodorants, antiperspirants, powders, lotions, creams or perfumes under your arms or on your breasts. Metallic particles in powders and deodorants could be visible on your mammogram and lead to confusion when your images are interpreted.  

When and how will I find out the results from my recent screening mammogram?

Most of the time, women getting a routine mammogram will receive a letter mailed to their home within seven to 10 days reporting normal results. At Mayo Clinic, Patient Online Service results are available within three to five days of the mammogram.

If something suspicious is found, your care team or the radiology team will contact you within the week, and you may be asked to return for additional images or tests. This discussion can be scary, but a suspicious finding does not mean you have cancer.

More than likely, you will have a diagnostic mammogram, which will take more-detailed pictures of the area of concern. You also may have an ultrasound of your breasts. Based on the results of the diagnostic imaging, the radiologist usually is able to resolve questions or decide if a biopsy or short-term follow-up is needed, which may be a repeat mammogram in six months. If a biopsy is recommended, this can be scary but does not mean you have cancer.  

Recently, I found a lump when examining my breasts. My mammogram is due in the next few months. Should I wait for the scheduled mammogram to have the lump evaluated?

Not necessarily. Your annual screening mammogram is recommended for an overall view of the breast. If a specific area of concern is identified, a diagnostic mammogram may be better suited to further evaluate it. Discuss breast changes with your health care provider, especially if they persist throughout your menstrual cycle if you are premenopausal.  

At my last mammogram, the report suggested my breasts were dense. What does this mean and should I be concerned?

Dense breast tissue is common, and refers to how the breast looks on the mammogram, not how it feels. Women with dense breasts have less fatty tissue and more non-fatty tissue. Areas of dense breast tissue can mask cancer on a mammogram, making it more difficult to detect. Women with dense breasts have a higher risk of developing breast cancer compared to women with less-dense breasts.

Routine mammograms remain very important and should be continued for women with dense breasts according to their screening schedule. Even with dense breast tissue, tumors have been seen on mammograms.

Supplemental screening tests could be added to your next screening mammogram, if desired. These tests, such as Molecular Breast Imaging (MBI), may find cancers not seen on mammograms. MBI also may detect cancers at an earlier stage when treatment options tend to be less invasive.

There is no current consensus on whether more testing is necessary for women with dense breasts. Supplemental screening may lead to additional testing, breast biopsy or false positives. Also, it is important to check with your insurance company about coverage if you are interested in these tests. 

For more information in MBI and breast density, please review these videos from the Mayo Clinic Breast Clinic. If you have questions, discuss them with your health care team.

My last mammogram was painful. Are there things I can do to reduce the discomfort?

Compression is important for clear mammogram images, but may be uncomfortable. If you have not gone through menopause, it may help to schedule your mammogram seven to 14 days after the start of your period, when your breasts are less likely to be tender. Eliminating caffeine-containing products (chocolate, coffee, soda, tea) or excess salt around your mammogram may help, too. Taking a mild over-the-counter pain medication, such as acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®) an hour before your mammogram is another option.

It also is important to speak up and talk with your mammogram technician because they will be able to help position you and suggest breathing and distraction techniques to make your experience more tolerable.

Jennifer M. Frank, APRN, CNP, is a certified nurse practitioner in Employee and Community Health’s (ECH) Division of Family Medicine and works at the Northwest Clinic. She has a special interest in women’s health and also provides care at the ECH Gynecology Clinic.