Today is the 20th anniversary of National Mammography Day. Back in 1993, it was Bill Clinton who proclaimed that the third Friday in National Breast Cancer Awareness Month should be a day for encouraging women to get a mammogram.
Twenty years ago, the benefits of mammograms—a low-dose x-ray that provides an image of breast tissue—weren’t nearly as hotly debated as they are today. Yes, it was uncomfortable to have your breasts squashed and flattened to get a good picture, but most people believed that for women 40 and up (and younger if they had a higher risk of breast cancer), an annual mammogram was smart preventive care.
Today—as with most things in the 21st century—there are differing, strong opinions on the subject. The debate first got heated when in 2009 the U.S. Preventive Services Task Force (USPSTF) changed its mammogram recommendations from age 40 and every year thereafter to age 50 and every other year for those not at an elevated risk. The American Cancer Society and The National Cancer Institute did not agree.
The USPSTF argument was that screening at a younger age didn’t make a significant difference in cancer detection and did hike the odds of stressful false positives. A study published last month in the journal Cancer, however, supports the opposing point of view that earlier screening and detection does save lives, and is particularly important for younger women whose tumors may be more aggressive.
So what’s a woman to do?
My family tree is riddled with breast cancer. So it was a no-brainer for me and my doctor to decide that I should get a baseline mammogram when I turned 40 and annual mammos thereafter. Your best bet, according to the American Cancer Society, is to talk with your doctor about your personal risk factors. Those at higher risk for breast cancer—testing positive for BRCA 1 or 2, having dense breasts, having one or more first-degree relatives (mother, sister, or daughter) with breast cancer—may want to get a baseline mammogram before age 50 and follow up with annual tests. (You can even calculate your own 5-year risk using the Breast Cancer Surveillance Consortium’s Breast Cancer Calculator. Discuss those results with your doc.)
How much will a mammogram cost?
Thanks to the Affordable Care Act (ACA), women’s preventive health care services, such as mammograms, are covered with no cost sharing under health plans sold on the exchanges. If you are part of a grandfathered health insurance plan (meaning it was in existence before Obamacare went into effect and has stayed the same since), you may have to pay a co-pay for your mammo. The ACA covers a mammogram every 1 to 2 years for women over 40.
Where can you get a mammo?
If you don’t know where to get a mammogram or can’t afford one, try these options:
• National Cancer Institute (1-800-4-CANCER)
• American College of Radiology (1-800-227-5463)
• American Cancer Society (1-800-ACS-2345)
• National Breast and Cervical Cancer Early Detection Program (1-888-842-6355)
What should you ask?
Do you offer digital mammograms?If you have dense breasts, you might want to opt for a digital mammogram if your breast center offers it, according to a 2005 study. Digital mammos expose you to less radiation and the images, viewed on a computer, may provide a better picture of dense breasts. And new 3-D technology, like digital breast tomosynthesis, may soon make finding tumors in dense breasts even easier.
How many mammograms do you do each day? Places that specialize in breast health or that do a dozen or more mammograms a day will have more experience.
Will I get the results right away and who will talk to me? Best to have a radiologist study the mammogram and discuss it with you after your screening. You should also find out if the radiologist will compare your most recent mammogram with older mammos.