Mammograms still No. 1 in early detection of breast cancer
October 1, 2013
October is National Breast Cancer Awareness Month, and annual screening mammograms are still the best early detection method for women in their 40s and beyond, according to Dr. Michael Hallenbeck, radiologist at SNMH Diagnostic Imaging Center.
"Annual mammograms can detect cancer early – when it is most treatable," Dr. Hallenbeck said. "In fact, mammograms show changes in the breast up to two years before a patient or physician can feel them."
Linda Aeschliman, a nurse navigator at the Sierra Nevada Women's Imaging Center, said special funding is available through the Barbara Schmidt Millar Fund and the Susan G. Komen Fund for women who aren't insured or can't afford the screening. She also noted that health insurance coverage obtained under the Affordable Care Act must, as of Jan. 1, include well-women checkups, including screening mammograms.
"All new health insurance plans must cover preventive care and medical screenings, like mammograms and colonoscopies, as well as women's services such as breast-feeding support, contraception and domestic violence screening. Health insurance companies cannot charge copayments, coinsurance or deductibles for such services," explained Covered California, the nonprofit organization set up to help guide individuals and businesses through the selection and enrollment process.
The enrollment period for 2014 coverage begins today.
The SNMH Women's Imaging Center has also set up a series of Moonlight Mammogram events to encourage women to get their annual screenings.
"Some women are anxious about getting a mammogram," Aeschliman said. "We are happy to answer questions and provide information, which can go a long way to relieve that anxiety."
The Moonlight Mammogram program adds a little fun to the process, she said. "We stay open in the evening and have music, food, beverages, and offer chair massages to women getting their mammograms," she said. "Bring a friend or family member."
Some women cite a variety of fears as reasons not to get mammograms, including that the procedure can be painful.
"Our mammogram unit uses flexible compression to achieve the best and sharpest images, while applying the least amount of compression," Aeschliman said.
Dr. Hallenbeck suggested that women with sensitive breasts should schedule the procedure for when their breasts are least tender, so as not to experience too much discomfort.
Some express fear of radiation exposure, but Dr. Hallenbeck said, "X-rays usually have no side effects in the typical diagnostic range for this exam. In fact, the benefit of an accurate diagnosis far outweighs this risk."
Dr. Hallenbeck urges women to start annual screenings at age 40, or sooner if they detect a lump in their breast. This follows the recommendations of the American Cancer Society, the American College of Radiology, and the Society of Breast Imaging.
Screenings are also important for women whose family histories include breast cancer.
"Breast cancer may also be caused by inherited gene mutations, which account for five to ten percent of all breast cancers," Dr. Hallenbeck said.
While family history is an important factor, Dr. Hallenbeck said the Imaging Center employs the broader risk assessment tool developed by the National Cancer Institute: age, age at start of menstruation, age at first live birth, number of first degree relatives with breast cancer (mother, sisters, daughters), number of previous breast biopsies, and at least one breast biopsy with atypical hyperplasia (accumulation of abnormal cells).
"Other risk factors include age at menopause, dense breast tissue on a mammogram, use of birth control pills or hormone replacement therapy, a high-fat diet, drinking alcohol, low physical activity, obesity and environmental exposures," he said.
Mammography is now the best screening tool, but Dr. Hallenbeck said new technology is on the way.
"In the near future, SNMH will add Breast Tomosynthesis or 3D mammography, which will significantly increase the cancer detection rate in women with dense breast tissue."
Also, the hospital will be adding Automated Whole Breast Ultrasound.
"This is an extremely useful adjunct to screening mammography in patients with dense breasts and in women looking for a screening alternative to mammography," he said.
Upcoming Moonlight Mammogram evenings are planned for Oct. 10, 17, and Nov. 14. Women may call 530-274-6262 to get scheduled, or 530-274-6246 for general information about breast screenings. Dr. Hallenbeck recommended this web site for women who want to learn more about breast cancer and screening: /www.cancer.gov/cancertopics/factsheet/detection/mammograms. For more information, visit snmh.org.
All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.