Your Mammogram: Frequently Asked Questions

Breast cancer is the second leading cause of death in women, after lung cancer. And yet, it doesn’t have to be this way. El Camino Health Medical Oncologist Shane Dormady, MD, emphasizes that “The key to treating breast cancer is to make sure you catch it early. Cancer can be cured if caught at an early stage and by delaying these screening studies, we give cancer more time to potentially go undetected and cause problems for our patients.”

El Camino Health offers a full range of breast health services. From screenings to reconstructive surgery and more, you can depend on expert care in a comfortable environment.

Like many women, you may have questions about your mammogram, especially if you have never had one before. We have gathered some of the most common questions and answered them for you.

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At what age should I start getting mammograms?

Getting your first mammogram at age 40 is recommended by the American Congress of Obstetricians and Gynecologists, the American College of Surgeons, the American College of Radiology, The National Comprehensive Cancer Network, and the Society of Breast Imaging. El Camino Health agrees with that recommendation. The benefits of catching breast cancer early far outweigh the risks of false positives and having to schedule additional imaging.

How often should I have a mammogram?

We recommend yearly mammograms because they can help detect breast cancer early, which can lead to a higher rate of survival and less aggressive treatment. In addition, mammograms can detect breast cancer before it can be felt, and often years before physical symptoms appear.

I’ve never had a mammogram. Does it hurt?

As a first timer, you will probably find the discomfort from a mammogram is less than you anticipated. Each image takes about 10 seconds, so you’ll be done in no time. Try not to schedule your mammogram just before or during your period, when your breasts may be more swollen and tender.

Should I have a screening mammogram if I am pregnant?

If there’s a chance you might be pregnant, let your healthcare provider and technologist know. Screening mammograms aren’t routinely done on pregnant women.

What are the risk factors for breast cancer?

• Age. 1 out of 8 invasive breast cancers are found in women younger than 45, and 2 out of 3 invasive breast cancers occur in women aged 55 and older.
• Genetics. According to the American Cancer Society 5-10% of breast cancer cases result from hereditary genetic mutations. The most common hereditary cause of breast cancer are mutations in the BRCA1 and BRCA2 genes. These mutations are more common in Jewish women of Ashkenazi descent, but they can and do occur in any ethnicity.
• Family history of breast cancer. You don’t have to have a breast cancer gene to have a family history of breast cancer. Having a first degree relative (mother, sister or daughter) with breast cancer doubles a woman’s risk, while two first-degree blood relatives with breast cancer triples it.
• Personal history of breast cancer. A woman with cancer in one breast has a three to four times increased risk of developing the disease again.
• Dense breast tissue. This means your breasts have more glandular tissue as opposed to fat. In addition to being a risk factor for breast cancer, having dense breast tissue may make it harder to detect tiny tumors and require additional screening.
• Previous atypical biopsies. Certain non-cancerous breast biopsy findings can increase your risk. Previous chest radiation. Chest radiation increases breast cancer risk, especially if a woman had radiation in her teens, when her breasts were still developing.
• Longer exposure to estrogen and progesterone. This includes women who had their first period before age 12, continued to menstruate after age 55, had a first child after age 30, used oral contraceptives, or had HRT after menopause.
• Lifestyle. Being overweight or obese after menopause and/or consuming more than one alcoholic drink a day raises breast cancer risk. Tobacco use may also raise breast cancer risk.

I just got a call back after my mammogram. What does this mean?

Getting called back does NOT mean you have cancer. The majority of women who get called back don’t turn out to have breast cancer. Reasons for a call back could be:

• You have dense breast tissue and need further imaging
• The pictures were not clear or didn't include all the breast tissue
• The radiologist sees calcifications, a mass, or some sort of irregularity, none of which is necessarily cancer

What happens if I get called back?

A callback may lead to further testing via one or more of the following procedures:

• Diagnostic Mammography, the same procedure as screening mammography except that more films are taken with an emphasis on a suspicious area.
• Breast Ultrasound, which uses sound waves to create an image called a sonogram.
• Breast MRI creates detailed images of the inside of the breast using magnetic energy and radio waves.
• Breast Biopsy involves removing small amounts of tissue or fluid for examination under a microscope.
• Referral to a High-Risk Breast program.

Learn more about common breast cancer diagnostic procedures.

I was referred to a “High Risk Breast” program. What does this mean?

An increasing number of breast centers are offering high-risk breast programs. Such programs, including the one at El Camino Health, have been established to identify, support, and monitor women who have an elevated risk of developing breast cancer. Women are deemed high risk for a variety of reasons, such as having the BRCA 1 or BRCA 2 genetic mutation or dense breast tissue. If you are referred to our High-Risk Breast program, we will assess your risk factors, counsel you, and work with you to initiate your ongoing personalized surveillance and a prevention plan.
Learn more about our High-Risk Breast Program.

Is there anything I can do to reduce my risk of breast cancer?

Yes, there are some lifestyle changes you make. However, this does not mean you can skip your mammogram! The tips below can help reduce your risk, but they don’t eliminate it.

• Exercise. You don’t have to spend two hours at the gym. According to a study by the National Institutes of Health Women’s Health Initiative, as little as 1.25 to 2.5 hours a week of brisk walking can reduce breast cancer risk by up to 18 percent.
• Limit alcohol consumption. Multiple studies have found that risk goes up with increasing alcohol intake.
• Maintain a healthy weight after menopause -- increased fat tissue raises estrogen levels.
• Avoid combined hormone therapy – taking estrogen and progesterone for menopausal symptoms. Don’t smoke, and if you smoke, quit. Avoid secondhand smoke.

This article appeared in the October 2024 edition of the HealthPerks newsletter.