St. Pete Life Sept/Oct 2023

Annual Mammograms: 30 Minutes a Year for Peace of Mind

BY TIFFINI THEISEN

Breast cancer is the most common cancer in women. About 1 in 8 women will be diagnosed with breast cancer sometime in their lives, the National Cancer Institute says. Early detection is crucial for treatment and survival. Proper screening — starting with self-exams at home, clinical breast exams and regular mammograms — lets health-care providers check for possible issues even before a woman notices any signs or symptoms.

For most women of average risk, an annual mammogram should become part of your self-care routine in your 40s.

“You can think of it like going to the dentist for your cleaning. It’s a routine screening, and not something to be anxious about,” says Dr. Michael Hwang, a board-certified radiologist who serves as director of breast imaging at Bayfront Health Medical Group in St. Petersburg.

The recommended age to begin mammograms has changed over the years, but Dr. Hwang says most experts agree 40 is the new standard. “The reason we want to start screening at age 40 is studies show the 40- to 50-year-old subset can develop breast cancers,” he says. “The smaller an in situ pre-cancer is, the easier the treatment is and the better the outcomes for the patient.”

Early detection is critical

“While the vast majority of mammograms are negative, if your mammogram can pick up on a small ‘in situ’ tumor — meaning one that is pre-invasive and has not spread into surrounding breast tissue — the survival rate is 99%,” Dr. Hwang says.

Five-year breast cancer-specific survival rates are excellent even for more localized breast cancer cases: 99% survival for Stage 1 and 9099% for Stage 2 if caught in time.

This is why a mammogram every year is so vital. Think of it as a 30-minute investment of time that can pay off in peace of mind for an entire year.

“If an undetected cancer developed two years ago, but you didn’t come in for three years, that’s a lost opportunity for the patient and for us” because the tumor will have grown over time, Dr. Hwang says. “We always want to catch cancers as early as possible.”

Anxiety over the mammogram procedure is a common reason why some women put them off, “but it’s important to keep in mind that even if you’re called back, it’s usually a benign finding,” Dr. Hwang says. “The benefits of catching and treating a cancer early far outweighs the ramifications of some women experiencing anxiety. It’s better to just come in.”

Some women also express concerns about radiation. But mammograms are very low-dose X-rays, and the risk of harm from their radiation is extremely low, experts say.

A typical mammogram exposes a woman to a miniscule amount of radiation compared with what we receive just from walking around living everyday life. The average annual radiation dose per person in the U.S. is about 6 millisieverts (mSv), much of that from natural sources in the environment. That’s fifteen times as much radiation as a mammogram (0.4 mSv).

Importance of self-exams

Although a self-exam at home is highly unlikely to detect the smallest of tumors, it’s still a good idea for women to examine their breasts monthly and alert their health-care providers if they notice any changes. Women should especially be aware of any new lumps, thickening, discharge in only one nipple, bloody or clear nipple leakage, or other changes in how the breasts feel.

But which breast changes tend to be less of a concern? Breast pain that is throughout both breasts or in line with one’s menstrual cycle, while unpleasant, typically isn’t a sign of a serious medical problem, Dr. Hwang says. “In some cases, pain can be caused by cysts, which are harmless. We see cysts all day long.”

Still, a self-exam doesn’t even come close to being a substitute for your annual mammogram. In the rare event that a mammogram detects a problem, treatment is not one size fits all at Bayfront Health Medical Group. Because each woman and each case is unique, the Bayfront oncology and surgical team create a customized plan of care each time. This may consist of some combination of surgery, radiation, chemotherapy and hormone therapy.

“It all depends on what type of cancer and how early you detect it,” Dr. Hwang says. “The earlier it’s detected, the less complex and involved the treatment will be.”

What about menopause? The end of a woman’s menstrual cycle does not mean the end of her annual mammogram.

With women living longer lives, most breast radiologists are on the same page: Keep doing it as long as you’re in good health — meaning that you would still be a good candidate for treatment in the event that anything is caught.

“I see lots of women in their 80s these days who are super healthy, and we want them to keep living their fantastic lives,” Dr. Hwang says.

October is Breast Cancer Awareness month. Each year in the United States, more than 250,000 women will be diagnosed with breast cancer, and roughly 42,000 women will die from the disease. Men can also get breast cancer, however not as common. About 1out of every 100 breast cancers diagnosed in the United States is found in a man.