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What to Expect When Getting a Mammogram

According to the CDC, 1 out of 8 women will develop breast cancer during their lifetimes. Routine mammography saves lives, reducing a woman's risk of dying from breast cancer by 30 - 50 percent.

Listen as Ermelinda Bonaccio, MD discusses the importance of annual mammograms in this "What to Expect Series" from Roswell Park Comprehensive Cancer Center.
What to Expect When Getting a Mammogram
Featured Speaker:
Ermelinda Bonaccio, MD
Ermelinda Bonaccio, MD is a Clinical Chief, Breast Imaging Section, Department of Diagnostic Radiology at Roswell Park Comprehensive Cancer Center.

Learn more about Ermelinda Bonaccio, MD
Transcription:

Bill Klaproth (Host): Mammograms have helped reduce breast cancer mortality in the US by nearly 40% since 1990, yet there are women that skip this important checkup. Here to talk with us about the importance of getting a mammogram is Dr. Ermelinda Bonaccio of Roswell Park Comprehensive Cancer Center. Dr. Bonaccio, thanks for your time. Why is it so important for a woman to get a mammogram and not skip it?

Dr. Ermelinda Bonaccio (Guest): Well, as you’ve already said in the introduction, mammogram is really the only test that has been shown in multiple different types of trials to lower your risk of dying from cancer. That 40% decrease in mortality that you mentioned -- some of that is due to improvement in treatment, but a large part of it is also due to – or early detection – due to the more widespread use of mammograms.

Bill: And that early detection really is key, and that’s the main reason – because if there is something going on there, you want to find it early, that’s for sure.

Dr. Bonaccio: Yes, exactly. We want to find it early. Not only are we more likely to prevent death, but also a women’s more likely to be able to have less aggressive therapy, have a lumpectomy instead of mastectomy, maybe not need chemotherapy depending on how early we find it.

Bill: And those are all important factors. At what age should a woman start getting a mammogram?

Dr. Bonaccio: There’s been a lot of confusion around the ages as to when a woman should start a mammogram. Different recommending organizations have recommended different ages to start, but the bottom line is starting annual mammography at age 40 for average risk women saves the most lives. The differences in the recommendations have nothing to do with that fact. We know that if you start your mammograms at 40, that will save the most lives. It has to do with how the different organizations actually balance the benefits of having a mammogram with the risks of having a mammogram.

Bill: All right, so that’s good to know, annual mammography at age 40. And then how important a role does age and family history play in when to start getting a mammogram?

Dr. Bonaccio: That recommendation is for women who are an average risk. The truth of the matter is, there’s a lot of attention to family history, but most women who get breast cancer do not have a family history or any other significant risk factor for breast cancer. That recommendation is for average risk women and, as I said, most women who get breast cancer don’t actually have a risk factor other than being a woman. There are situations, though, for women who have strong family histories of breast cancer -- especially if those family members had breast cancer at a very young age – that we might start screening at a younger age, but that is done in the setting of a consultation with your primary care physician, or a high-risk breast clinic that takes a full history. We don’t do that routinely.

Bill: I think that’s really important what you said there, “Most women that get breast cancer don’t have a family history.” I think it’s really important to know.

Dr. Bonaccio: Yes, it is important to know because I’ve had so many women tell me that they’re not getting a mammogram because there isn’t a family history, they’re healthy, but that really shouldn’t be a reason to not get a mammogram.

Bill: So you said annual mammography starts at age 40 for somebody with normal risk factors. How often should a woman get a mammogram after that? Is it yearly?

Dr. Bonaccio: Again, the yearly mammogram will save the most lives. You will get the most benefit if you have a mammogram every year starting at age 40. When they talk about having a mammogram every other year or starting at a later age, those recommendations are based on balancing the benefit, which is lowering the risk of dying from breast cancer, with the risks. The risks in mammography are mostly related to what we call a false positive mammogram, having a mammogram and needing either additional views or maybe an ultrasound, or even less commonly a biopsy and then finding out that you don’t have cancer. If you have a mammogram every year and the earlier you start having a mammogram, you’re just more likely to have a false positive, but when you look overall in my mind and in the mind of Roswell Park and when large recommending bodies like the National Comprehensive Cancer Network, look at the data, we feel that the benefits outweigh that risk, and therefore, one should have a mammogram every year.

Bill: And that seems to go back to that early detection if you do it every year --.

Dr. Bonaccio: Exactly, exactly. Most women are always surprised, or many women will tell me that they’re surprised that it’s already been a year. Often times, even women who intend to go every year, go more like 15, 16 months that they end up having their mammogram.

Bill: Right, so the procedure itself, how quick is it? Is it painful? What about the risk of radiation? What should a woman expect?

Dr. Bonaccio: The mammograms have evolved so that they’re very low dose. The risk of radiation is not significant, especially at women aged 40. Really our breasts are most sensitive to radiation at a very young age in their teens and twenties. As far as – it’s not typically painful. It’s uncomfortable, but it’s not typically painful. It’s usually a very short test, so each image is a very short amount of time we’re in compression, literally seconds. I think it’s important to feel comfortable talking to the technologist because they can compress at a slower rate so that it’s a little bit more tolerable. The compression is released as soon as the image is obtained. And, like I said, most women find it to be uncomfortable and not painful and very quick. A mammogram itself just takes a few minutes to obtain those images, and then the radiologist will read the mammogram. At most places, you have a choice – some places you get your four views, and you leave, in which case it only takes about 15 to 30 minutes to have a mammogram, and then they’ll call you with your results. About 8-10% of women will have to come back for an additional image or like I said, an ultrasound – there’s a finding, and we’ll have to do imaging to further delineate it. Some places will give you your mammogram results right then after we get the initial four images – tell you right away if you need additional imaging or if the mammogram is normal. When you have a mammogram in that setting, it usually takes a little bit longer, maybe about 30 minutes to an hour to get your mammogram and get your results. We, at Roswell, actually offer you the choice. You can either wait for your results, or you can just get the four views and leave, and we’ll call you with results the next morning.

Bill: That’s good to know. I was going to ask you that. So in general, at Roswell, within 30 minutes that same day, basically, you can get your results?

Dr. Bonaccio: Well, the 15 to 30 minutes is if you actually don’t wait for your results and we’ll call you the next morning with the results. If you wait, it usually takes a little bit longer, about 30 minutes to an hour and you should have your results.

Bill: So, if you decide to wait then, within 30 minutes to an hour you’ll have your results?

Dr. Bonaccio: Yes, yes.

Bill: Well, that’s really great, and that’s important to know, as well because I know a lot of women are anxious about this, and they want to get those results. That’s wonderful at Roswell that you can deliver them so quickly.
Thank you, so much, for your time today, Dr. Bonaccio, I really appreciate it. For more information, visit RoswellPark.org, that’s RoswellPark.org. You’re listening to Roswell Cancer Talk. I’m Bill Klaproth, thanks for listening.