Breast Cancer Awareness: Your Questions Answered

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Question: I don’t have any symptoms and I check my breasts regularly. Why should I get a screening mammogram?

Answer: Breast cancer is most treatable when it is detected at the earliest 

• Many early-stage breast cancers cannot be felt.

• A screening mammogram is an X-ray that can find cancer long before it is large enough to be felt or cause symptoms.

• While being familiar with your breasts is good, unfortunately studies show that breast self-exams do not reliably improve cancer detection or survival rates. Relying only on a self-exam might create a false sense of security and cause a delay in detecting a problem.

• Breast cancer is very common - about 1 in 8 women in the United States will be diagnosed with breast cancer in her lifetime. It is the most common cancer in women, aside from skin cancer. 

• Imagine you are at work or at a party with 15 other women, two of you have the likelihood of being diagnosed with breast cancer in your lifetime. That is a very big risk you don’t want to take. This high probability means that breast cancer is not a distant threat but a reality that will likely touch the lives of your close friends, family, and colleagues.

Question: I don’t have a family history of breast cancer. Do I still need to get screened?

Answer: Yes, absolutely. While a family history does increase risk, the vast majority of women diagnosed with breast cancer have no family history of the disease. In fact, over 90% of breast cancer cases occur in women with no known genetic link. Screening is important for all women, regardless of family history.

Question: I am 75 years old. Do I still need mammograms?

Answer: It is an important conversation to have with your doctor.

• The risk of breast cancer does not disappear as you get older; in fact, the risk of breast cancer continues to rise with age.

• Guidelines often suggest stopping around age 75 because for older adults, the potential harms of screening (like overdiagnosis and unnecessary treatment for slow-growing cancers) must be weighed against the benefits.

• The best approach is to discuss your overall health, risk factors, and life expectancy with your doctor to make a shared decision that is right for you. 

• If you choose to continue, Medicare covers screening mammograms with no upper age limit.

Question: I'm worried about radiation from mammograms. Are they safe?

Answer: This is an understandable concern, but the risk is extremely small. The radiation dose from a modern mammogram is very low—about the same amount of natural background radiation you'd be exposed to over a few months. Decades of research have confirmed that the life-saving benefit of detecting breast cancer early far outweighs the minimal, theoretical risk from this low dose of radiation.

Question: If I get regular mammograms, do I also need a clinical breast exam from my doctor?

Answer: Yes, it is recommended. Think of them as two different tools that work together.

• A clinical breast exam allows your doctor to feel for lumps or abnormalities that might not be visible on an X-ray.

• A mammogram can detect tiny cancers or calcium deposits (microcalcifications) that are too small to be felt. Combining both methods provides the most complete picture of your breast health.

Question: I have dense breasts and always get called back for an ultrasound. Why don't they just do an ultrasound to begin with?

Answer: It can be frustrating to be called back, but it's a critical safety step for women with dense breasts.

• The "Snowstorm" Effect: On a mammogram, dense breast tissue appears white, and so do tumors. This can make it difficult to spot a cancer, like trying to find a polar bear in a snowstorm.

• Ultrasound Sees Differently: An ultrasound uses sound waves, not X-rays, and can see "through" that dense tissue to find cancers a mammogram might miss.

• Why Ultrasound Can't Replace a Mammogram: An ultrasound alone is not a good primary screening tool. It can miss tiny calcium deposits (microcalcifications), which are often the earliest sign of cancer, and it has a higher rate of false positives.

• For dense breasts, the mammogram and ultrasound work as a team. The mammogram provides the essential first look, and the ultrasound gives a necessary, more detailed second look.

Question: What changes should I look for in my breasts between mammograms?

Answer: You should contact your doctor if you notice any new or persistent changes in your breasts, including: 

• A new lump, mass, or thickening in the breast or underarm area.

• Changes in the size or shape of the breast.

• Dimpling or puckering of the skin.

• A newly inverted nipple, or nipple pain or discharge.

• Swelling, warmth, redness, or darkening of the breast skin.

Do not wait, do not hesitate to seek advice for anything suspicious. It is best to be safe!