According to the National Cancer Institute, breast cancer is the second most common cancer in women after skin cancer. The key to early detection of breast cancer is screening mammograms.
Q. When should a patient start annual screening mammograms?
A. In general, women should begin annual screening mammograms at the age of 40.
Q. Does that recommendation change if the patient has a family history of breast cancer?
A. If you have a family history of breast cancer, it’s recommended to begin screenings at the age of 40 or 10 years before the incident case – meaning if a patient’s mother was 45 when she was diagnosed with breast cancer, we would begin screening at the age of 35. In general, however, we don’t do mammograms on anyone younger than the age of 30.
Q. How is 3D mammography different than traditional mammography?
A. It’s really an exciting development to have 3D mammography. With 3D, you get a three-dimensional picture of the breast, and that helps detect things like masses. A 3D mammogram actually reduces the callback rate for mammograms, because we can more easily determine what is a mass vs. overlapping tissue.
Q. If a breast assessment indicates a high risk of developing breast cancer, what are the next steps that you offer your patients?
A. At MidMichigan, we do a breast cancer risk assessment when you get your mammogram. When you walk in the door, we ask questions about your personal and family history, and through computer models, are able to estimate your risk for developing breast cancer in the near future and over your lifetime. If you fall into the high-risk category, we’ll discuss any ways that you can reduce your risk and any potential additional screening or testing.
Q. What is dense breast tissue?
A. Breasts are glands that make milk. The milk is made in ducts and lobules and there is fibrous tissue that helps support it. Some people have more of this fibrous and glandular tissue, and other people have more fatty tissue. The fatty tissue is easier to mammogram because there is nothing to hinder us from seeing anything. Dense breast tissue shows up white on a mammogram, and so do lumps and masses.
We can miss cancers in a dense breast more frequently than we would in a breast with more fatty tissue. We want to identify people with dense breasts, so that we can be more proactive and talk about other ways to screen those breasts. In Michigan, it’s the law to notify patients who have dense breast tissue showing up on a mammogram, so patients will receive a letter if that’s the case.
Q. Are people with dense breast tissue more likely to have breast cancer?
A. People with dense breast tissue have a slightly higher risk of breast cancer than those with non-dense breasts.
Tari Stull, M.D., is a breast surgeon at MidMichigan Health.
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June 28, 2021 at 04:04PM
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