JOHNSTOWN, Pa. — When it comes to detecting breast cancer, mammograms are still a vital tool in saving lives, health professionals say.
“A yearly mammogram is the gold standard of care for detecting breast cancer,” said Kimberly Knapp, registered nurse and site manager for research and genetics at Joyce Murtha Breast Care Center at Chan Soon-Shiong Medical Center at Windber, Pa.
The American Cancer Society recommends that women age 40 and older should have screening mammograms every year, and should continue to do so for as long as they are in good health.
“Sometimes women need to start a little bit earlier, depending on their family history of breast cancer,” Knapp said.
“Women who have a high-risk disposition, especially if they have a genetic mutation, should definitely be starting mammograms at age 35.”
When preparing for a mammogram, women are asked not to wear deodorant.
“The deodorant can show up in the images and look like little calcifications, and that could lead to reimaging,” Knapp said.
In the exam room, women will stand in front of the machine and a technologist will place each breast on a plate, where it will be compressed for X-ray pictures to be taken.
“We explain the test and tell the woman about the compression and that it’s going to be snug, but it’s not really painful,” said Tina Dibert, mammogram technologist at Joyce Murtha Breast Care Center. “New patients that I’ve seen expect it to be worse than it is, and after they get done, they say it wasn’t so bad.”
Joyce Murtha Breast Care Center has the capability of doing 3D mammography, offering screening and diagnostic mammograms.
“A screening is your annual mammogram, and it’s usually four views,” Dibert said. “A diagnostic mammogram happens when you come back for a follow-up if an area of concern is detected.”
A screening mammogram is not read while the patient is at the appointment.
‘Don’t be alarmed’
Dibert said if the radiologist reads the mammogram and sees something, the patient will receive a callback for further testing.
“Anybody who’s new, I usually tell them if they have to come back, don’t be alarmed, because it’s your first mammogram and one breast can look different than the other side and they may want some additional imaging,” she said.
“For women who have had mammograms and never had to come back and now do, they’re nervous, but it’s the same thing, with one breast looking a little different than the other one, or something showed that wasn’t there before. They just want more follow-up with pictures.”
Each patient will receive a letter telling them either that all is normal, or that there’s a finding that requires additional testing.
“The radiologist just wants to be sure that change is a normal change,” Dibert said.
“It could be different mammogram pictures or an ultrasound, but most of the time it’s both. Depending on the result, it could be a follow-up in six months or needing to see a breast specialist.”
Brianna Schall, ultrasound technician at Joyce Murtha Breast Care Center, said an ultrasound is done to expand upon what a mammogram detected.
“The mammogram tells us there’s something there and where it’s located,” she said.
“The ultrasound finds that area and further describes it to determine if it has benign or malignant characteristics, if it’s solid or cystic and what the borders of the mass look like.
“Are they are nice and smooth, which would tell us it’s something benign? Or does it have angular margins? And that would refer us to a biopsy.”
‘Get that mammogram’
She said while it’s common to be called back for additional testing, that does not mean something bad was detected.
“We have to confirm that the change isn’t something we need to worry about, or something we want to do six-month follow-up ultrasounds on to make sure there are no changes with this area,” Schall said.
“If we notice that change from six months ago, we can take action to biopsy it.”
A state law requires that all mammogram reports sent to patients must include breast density, which ranges from entirely fatty to extremely dense.
“Breast density limits the mammogram’s ability to see through the breast tissue, so it makes it harder for the radiologist to tell if there’s anything in the breast tissue,” Dibert said.
The American Cancer Society says women at high risk, those with greater than 20% lifetime risk, should get breast MRIs and mammograms every year.
“Women with dense breasts get MRIs even if breast cancer doesn’t run in their family, and that’s because their tissue is dense,” Dibert said.
Courtney Johnson, clinical nurse navigator at Joyce Murtha Breast Care Center, said women need to be aware of their bodies and perform self-breast exams.
“You are the person who is most familiar with your body, so we want you to be doing self-breast exams and preferably at the same time every month,” she said.
“Depending on whether you still get your cycle, the density in breasts change. You want to try to do them at the same time every month, so you’re feeling the same kind of breast tissue every month.”
She said doing self-breast exams and getting mammograms are essential in catching a problem early.
“Every year we want you to get that mammogram,” Johnson said.
“If you are able, we want you to keep coming for a mammogram. We have some 90-year-old women who still get their yearly mammograms, so it’s very important.”
Kelly Urban is a reporter for The Tribune-Democrat. She can be reached at 814-532-5073. Follow her on Twitter @KellyUrban25.