When should I start getting screened for a Mammogram and are they painful?

By: Dr. Gholam Kiani
DHR Health Women’s Hospital

According to the National Breast Cancer Foundation, a woman is newly diagnosed with breast cancer every 2 minutes. To put this in context, in the year 2020, roughly 325, 000 women will become part of a club they never wanted to join. Yes, this is shocking information, but my purpose in disclosing these statistics isn’t to scare, but rather to inform and empower women. You’re asking how, right? You might be surprised to learn that almost 64% of breast cancer cases are diagnosed at a localized stage, which means the cancer has not yet spread outside of the breast. Cases such as these, that are caught early, have a 5-year survival rate of 99%. The best tool available to medical practitioners to identify these early cases is the mammogram. This x-ray technology, available for some fifty five years, is unfortunately underutilized in the state of Texas, where we rank 8th lowest in mammography rates nationally.

Low utilization is sometimes attributable to confusion with screening guidelines. When exactly should a woman get a mammogram? Well, for healthy women with an average risk, screening can be offered to women beginning at age 40, with mammograms conducted every 1-2 years. It is crucial that mammograms be initiated no later than age 50. Between ages 55 and 75 it is acceptable for mammograms to be undertaken biennially. Beyond age 75, your practitioner can discuss the discontinuation of mammograms relative to health status and longevity.

If you are considered above average risk, which means you have a family history of breast cancer in a first degree relative (e.g. child, sibling, parent) or have a genetic predisposition as a carrier of a BRCA mutation, it is crucial that annual mammograms begin between ages 25 and 40 with additional clinical breast exams initiated no later than 10 years before the age of the earliest diagnosis in the family.

Interestingly, an extremely common reason that some women avoid mammograms is because they are afraid that they are painful. In fact, in the clinic this is one of the most common questions. Mammograms are typically described as “uncomfortable,” rather than painful. Your breasts will be inserted between two x-ray plates and you might feel some uncomfortable tugging, pulling and squishing, but this is usually far less painful than most women envision. In fact, a recent survey conducted by women undergoing mammograms in Colorado revealed that they felt eyebrow waxing and wearing high heels were more painful.

In closing, please remember to keep your annual well woman exam appointments and also note that breast implantation does not mean you are exempt from mammograms. While it is true the implant itself is impervious, the surrounding tissue is still vulnerable. As always, if you feel a lump or bump in your breast that is concerning to you, make an appointment with your gynecologist for assessment. Remember your breast health is in your hands.