Mammogram news

There continue to be different recommendations and guidelines for the right age for women to begin annual screening mammograms. There is no disagreement, however, for those of us with a personal history of breast cancer; we need one every year. No one looks forward to this yearly appointment, but women have varying degrees of anxiety about it. If your breast cancer was first found by a mammogram, you may be both more anxious and more trusting or even grateful. If a mammogram did not show your cancer, you may be more skeptical but also less worried about the day's event.

As an aside, here are a few tips about how reduce or manage mammogram anxiety. First, make sure you go somewhere with a radiologist on site who will immediately read the film and give you the results. Some women find it helps to take a friend and to have a plan for immediately after the test. For example, consider going to a late lunch or an early glass of wine after hearing the likely good news. If your cancer was found at a mammogram, you may find it helpful to now have those annual tests at a different location. Just walking into the same space where you first heard the diagnosis can be traumatic.

You probably are aware that there have been some technological improvements to mammogram machines. There are now 3D mammograms that reduce the issues of breast density limiting the view and may reduce the number of biopsies that turn out to have been unnecessary (although we would all much rather have a biopsy to be sure!).

What is 3D mammography (also called digital breast tomosynthesis, digital tomosynthesis, or just tomosynthesis)? As is obvious from the name, the machine creates a different kind of picture of the breast than conventional 2D mammograms. Taking pictures that can be viewed as almost slices of the breast enable the radiologist to take a more careful and thorough view. Although approved by the FDA and widely available, these machines are expensive and not in use at every mammography center. Some places may require that you sign a form indicating that you know insurance may not fully cover the cost and that you are willing to pay the balance between the standard fee and one for a 3D view.

Some studies have found that 3D mammograms do find more cancers than the earlier models and that they also reduce the number of false positives. This may be particularly advantageous to younger women who are apt to have more dense breasts. Trying to read conventional mammograms of dense breasts has been compared to trying to see the polar bear in a snow storm. Since this limits the accuracy of mammograms, some states (including Massachusetts) have laws that require mammogram centers to inform women of the limits of the film for dense breasts. Although intended to help consumers be fully informed, many women find these letters confusing and upsetting.

Get information about mammography at BIDMC here.

One personal observation about these new machines: I don't know if this is everyone's experience, but I have found them to be less uncomfortable than the older models. If that is true for most women, these advances are clearly a win/win situation: more accurate films and less discomfort.