Breast Cancer Screening

Breast cancer screening is a vital part maintaining breast health for every woman. This involves periodically checking the breasts for signs of cancer with one or more tests. The goal of screening is to detect breast cancer and other abnormalities early, before a woman has any symptoms such as a breast lump that can be felt.

Highlights

• One in 8 women will be diagnosed with breast cancer in her lifetime.
• Most women diagnosed with breast cancer have no family history.
• All women starting at age 25 should talk with their doctor about a risk assessment.
• Begin yearly screening mammograms by age 40.

Breast cancer is the second most common type of cancer in women in the U.S (skin cancer is the first). However, when diagnosed in its early stages, breast cancer is one of the most treatable forms of cancer. For many women, this means less aggressive treatment and an excellent outcome.

According to many experts, the use of mammograms and other screening tests has reduced the number of breast cancer deaths by 40% since 1990. It is important for every woman to be screened regularly. The recommendations for breast cancer screening can vary based on an individual’s risk level and personal factors. The goal of screening is to detect breast cancer signs and other abnormalities early, before a woman has any symptoms such as a breast lump that can be felt.

Breast Self-Awareness

• Learn to identify changes in your breasts by performing a breast self-exam.
• Continue yearly check-ups and clinical breast exams by healthcare providers.

Average Risk Women

• All women should discuss their breast cancer risk with a primary care provider by age 25.
• Yearly screening mammograms should start by age 40.

Women with Dense Breasts

• Women with dense breasts have dense breast tissue that not only makes cancer harder to find on a mammogram—it also increases the risk of developing breast cancer.
• Yearly screening mammograms with 3-D technology/tomosynthesis.
• Consider an additional screening test such as breast MRI, fast MRI, or ultrasound.

High-Risk Women

• Women with a strong family history of breast cancer or genetic mutation may benefit from starting screening younger than age 40.
• Consult your doctor or our Risk Assessment and Management Program (RAMP) about when to start mammograms & if a high-risk breast MRI is needed.

Women Aged 75 and Older

• No upper age limit for breast cancer screening if you are in reasonably good health.

At UC Health, we take great pride in our specialized breast radiologists, who deliver compassionate and world-class care using the most innovative breast cancer screening technologies. The UC Comprehensive Breast Cancer Center maintains accreditations through the American College of Radiology as a Designated Comprehensive Breast Imaging Center and the American College of Surgeons’ National Accreditation Program for Breast Centers. 

A UC Health mammogram is the gold standard in Cincinnati and is available to all – no referral needed. Schedule your mammogram at uchealth.com/584-pink/.

• What is a screening mammogram?
  • The current gold standard in breast cancer screening is a mammogram, which are images of the breast taken with low-dose X-rays. This typically involves two X-ray pictures of each breast taken from two different angles – top to bottom and side to side.
  • 3-D mammography or tomosynthesis is a specialized mammogram consisting of multiple images of the breast taken from multiple different angles, which can improve breast cancer detection.
  • Mammograms are proven to be highly effective cancer-screening tools. These X-ray images make it possible to detect breast cancers and other abnormalities that can’t be felt.
• How is a mammogram performed?
  • During your mammogram, a radiologic technologist will position your breast in the mammography unit. Your breast will be placed on a platform and compressed with a plastic paddle.
  • Breast compression is necessary in order to:
    • Even out the breast thickness so all tissues can be seen.
    • Spread out the tissue so that small abnormalities are less likely to be obscured by overlying breast tissue.
    • Allow the use of lower X-ray dose, since a thinner amount of breast tissue is being imaged.
    • Hold the breast still in order to minimize blurring of the image caused by motion.
    • Reduce X-ray scatter to increase sharpness of the picture.
  • You will be asked to change positions between images, and the process will be repeated for the other breast. You must hold very still while the X-ray picture is taken to reduce the possibility of a blurred image.
  • The examination process takes about 30 minutes.
• How can I prepare on the day of my mammogram?
  • Wear a two-piece outfit so you can stay in your regular clothes from the waist down.
  • Do not wear deodorant, talcum powder or lotion under your arms or on your breasts, because these can appear on the mammogram as spots.
  • Temporarily avoid caffeine and take a pain reliever, like ibuprofen, prior to your appointment to decrease discomfort.
  • Describe any breast symptoms or problems to the technologist performing the exam.

• How and when will results be delivered?
  • Our board-certified radiologists who specialize in breast imaging will interpret your mammography results. You can expect your results to come in the mail up to three weeks after your exam. You will receive a phone call if additional imaging is required to evaluate a possible abnormality. A report will also be sent to your referring doctor.
  • Don’t be alarmed if you are asked to come back for additional imaging. Being called back for more testing does not mean that you have cancer. In fact, fewer than 1% of women who are called back for additional tests are found to have breast cancer. Getting called back occurs fairly often and usually just means an additional image or ultrasound needs to be performed to look at an area more clearly.
  • Initial mammography images alone are not usually enough to tell whether there is a benign or malignant disease. If a spot seems suspicious, your radiologist may recommend further diagnostic exams.
  • Breast implants can hinder accurate mammogram readings because both silicone and saline implants are not transparent on X-rays and can block a clear view of the tissues behind them. This is especially true if the implant has been placed in front of, rather than beneath, the chest muscles. Experienced technologists and radiologists know how to carefully compress the breasts to improve the view without rupturing the implant.
  • While mammography is the best screening tool for breast cancer available today, mammograms do not detect all breast cancers.
• What are the screening methods for breast cancer?
  • As with most cancer types, early detection is known to improve the chances of positive treatment outcomes. Proactive breast screening methods are comprehensive exams that may offer additional procedures, such as MRIs, or more frequent examinations compared to regular annual screening evaluations. The appropriate surveillance procedures and frequency will be determined by your breast team of physicians.
  • Clinical breast exam
    • A clinical breast exam is much like the self-breast exams you perform regularly at home, but a doctor or nurse practitioner conducts this physical exam. The examination will include visual inspection and palpation of the breast and underarm areas to detect changes or abnormalities.
  • Mammogram
    • Mammography can detect abnormalities in breasts before more obvious symptoms are present. Mammography remains the most reliable screening method for early signs of breast cancer. Annual mammograms are recommended for average-risk women beginning at age 40.
    • Some women who have an increased risk for breast cancer may begin at an earlier age. In some cases, there are limitations to the effectiveness of mammograms. For example, in women younger than 40 and those with denser than normal breast tissue, mammography may not be as effective in detecting abnormalities.
    • 3-D mammography or tomosynthesis is a specialized mammogram consisting of multiple images of the breast taken from multiple different angles, which can improve breast cancer detection.
  • Breast MRI
    • A breast MRI is the most sensitive test for breast cancer. It is recommended as a screening tool in addition to mammography for women who have dense breasts or an increased risk for breast cancer, especially those who are at high-risk.
    • Fast MRI, also called abbreviated breast MRI or AB-MRI, is a shorter version of a standard breast MRI that is lower cost and still highly sensitive for breast cancer.
  • Breast ultrasound
    • Breast ultrasound may be used in addition to mammography for women with dense breast tissue seen on their mammogram. Mammograms and breast MRI are the first choice tests for breast cancer screening. However, for those who cannot undergo MRI, adding an annual breast ultrasound may assist in better identifying lumps in dense breast tissue. Ultrasound tends to find noncancerous lesions more often than mammography or MRI, which may lead to additional testing and biopsy to exclude cancer.
• What are they looking for during a breast cancer screening?
  • Our breast radiologists will look for any abnormality on your images that could be breast cancer. Because cancerous and noncancerous growths can look the same, any abnormalities are usually followed up with additional testing. The screening images make it possible to detect cancers early before there are symptoms such as a lump that can be felt.
• What breast cancer risk factors do we assess?
  • Many risk factors include the following. More information can be found within the Risk Assessment and Management Program (RAMP).
    • Family history
    • Age
    • Inherited gene mutation
    • Breast density
    • Prior radiation therapy
    • Hormone risk factors
    • Postmenopausal hormone therapy
    • Lifestyle risk factors

• How much does a breast cancer screening cost?    
  • Annual mammography scans are usually covered 100% by medical insurance. Please follow up with your insurance provider to make certain we are within network. Financial assistance is available to those who do not have medical insurance.
• How do I schedule an appointment?
  • To schedule an appointment, call 513-584-PINK (7465).