I turned 40 in February and was reminded a few weeks later at my annual exam that it was time to start thinking about getting a mammogram. Great – as if turning into a woman of a certain age wasn’t hard enough, I now had to gather the motivation to make an appointment that would not only make me feel 40, but rather squished and awkward. It was easy to put off making the call.
My angst and procrastination continued when articles published in the British Medical Journal, JAMA and New England Journal of Medicine regarding mammography screening prompted more news media discussion about the value of mammograms in reducing deaths from breast cancer among women. The American Congress of Obstetricians and Gynecologists, American Cancer Society, American College of Radiology, National Accreditation Program for Breast Centers and Society of Breast Imaging recommend that women start getting annual mammograms at age 40, while the U.S. Preventive Services Task Force recommends beginning at age 50. All the experts agree mammograms between age 50 and 74 will decrease the risk of dying of breast cancer.
“Virginia Mason continues to recommend screening mammography every year, beginning at age 40, for as long you are in good health,” says Carly Searles, ARNP, at the Virginia Mason Breast Clinic. “Given the recent discussions, you might want to discuss what screening schedule is best for you.”
The two main risk factors for breast cancer are being female and getting older. However, family history can also play a role. Having two first-degree relatives (a mother, sister or daughter) with breast cancer increases risk five-fold. To my knowledge, no one in my family has ever had breast cancer – cardiovascular disease and accidents are the usual ways we’re taken out. However, my aunt died of ovarian cancer, so I have since been keenly aware that our bodies can angrily turn on us without so much as a whisper that something is wrong.
“This is why screening is so important,” explains Carly. “It can detect early stage tumors before you can feel them, while they are small and there are more options for treatment.”
Despite the different opinions of experts and organizations regarding when to begin mammography screening and at what frequency, the main message is this: Talk to your health care provider about what screening recommendations are most appropriate for you. Virginia Mason has specialized Breast Clinics in Seattle and Federal Way, where you can also receive guidance to help you decide what works for you.
All women should do the following to detect breast cancer:
- Consult your health care provider about your individual risk factors and how to modify or manage them to reduce your risk. This includes what age is right for beginning screening mammography.
- Know your family history and share it with your provider. Early onset breast cancer (premenopausal) in a close relative or three close relatives on the same side of the family with breast cancer, ovarian cancer or both may indicate elevated risk. In some cases genetic testing may be suggested.
- Practice breast awareness by checking your breasts periodically. Don’t get too stressed out about your technique. It’s most important to be familiar with what is normal for you.
- Always report to your provider any changes to your breasts, including lumps, thickening or discharge. It may be nothing, but early detection is best.
- Talk to your mother, daughters, sisters and girlfriends about breast cancer screening. Keeping the conversation alive will help ensure survivability rates stay strong.
Once you decide to start mammography screening, Carly suggests scheduling your mammogram around your birthday or another special occasion each year. “Getting appropriate screening will ensure you’ll have many more birthdays to celebrate with family and friends,” she says.
Admittedly, I have yet to schedule my happy birthday mammogram. But, I do have it on my list of things to speak with my primary care provider about the next time I visit her.