“They saw something on my mammogram, and I have to go back for more tests.”
This was the text I woke up to from my best friend back in January. I stared at it in disbelief and told myself it was probably nothing, maybe just a cyst. After an ultrasound, a biopsy and several days of waiting, the diagnosis was confirmed. Breast Cancer. I sat at my kitchen table that day, sobbing and pleading with God to please, please fix her. She is my person – the godmother to my son, my “sister from another mister,” and the strongest woman I know. This could not be happening.
Over the next few weeks, there were consultations with surgeons and oncologists to determine a treatment plan which included surgery, chemotherapy and radiation. Her prognosis is excellent, but when I think about how her cancer could have gone undetected, it shakes me to my core. She’s 45 years old, healthy, and has no family history of breast cancer. She’s a devoted wife, mom, sister, and friend who volunteers for everything. She cares for her aging parents, attends almost every single event for her kids, and volunteers in their schools. She’s always “doing” and taking care of everyone else first (I’m pretty sure we can all relate …). So I’m grateful that she made time to get that routine mammogram, despite everything else on her plate, because it literally saved her life.
Who should get screened and when?
There is a lot of confusion surrounding when women should begin getting mammograms and how often they should be screened. A simple Google search will turn up multiple recommendations from various medical organizations, leaving many women wondering, “how do I know which guidelines to follow?”
Generally speaking, most of the recommendations state that women of average risk should be getting annual mammograms by age 45, or as early as age 40 if they choose, but the United States Preventative Services Task Force (USPSTF) recommends women of average risk should be getting mammograms every two years beginning at age 50. Are you confused yet???
It becomes even more confusing depending on which recommendations your doctor may follow, which could result in conflicting advice. How do you know what is right for you?
Should you get screened?
Given the various guidelines and recommendations, it may be overwhelming to determine the right answer to this question. Here are a few important things to do and keep in mind as you make your own individual decision:
- Know Your Risk Factors: Do you have a family history of breast cancer? Do you have the BRCA1 or BRCA2 gene mutation? What is your overall lifetime risk of developing breast cancer? If it is over 15%, you are considered “high risk” and the guidelines summarized above would not apply to you. The Breast Cancer Risk Assessment Tool can estimate your risk with a few general questions. It only takes a minute!
- Talk to Your Doctor: Depending on your risk factors, your doctor may recommend screening at age 40 (or before) or suggest that you wait until age 45 (or even 50). However, if you are at least 40 years of age and of average risk, the decision is completely up to you, despite what your doctor may recommend. My best friend had just turned 45 when her cancer was found in a routine mammogram. I’m grateful that she started getting screened at the age of 40 instead of waiting.
- Perform Monthly Self Breast Exams: Regardless of your age, all women should be performing monthly self breast exams. While mammograms are able to detect cancer before you can actually feel a lump, self exams enable you to know your body and allow you to detect any changes in your breasts. Self exams are even more important if you opt to wait until age 45 or 50 to begin routine screening mammograms, but remember that they do not provide the same level of detection. I had my first mammogram at age 40 because I detected something unusual in a self exam. Thankfully it turned out to be nothing, but it certainly made me more aware.
Insurance coverage
Tricare (military health insurance) covers annual mammograms for all women of average risk beginning at age 40, and beginning at age 30 for women who are high risk. This means that if your doctor recommends waiting until 45 or even 50, you can still choose to have annual screening mammograms starting at age 40 and Tricare will pay the cost.
Tricare does not currently cover the newer 3-D mammogram technology. 3-D mammograms provide a much more detailed and accurate picture making it easier to identify abnormalities, particularly for women who have dense breast tissue. While the 3-D technology is FDA approved, it is not yet available everywhere. However, if your clinic or medical facility does have the technology, you can still opt to do it, but you will pay the difference between what Tricare will allow for a regular 2-D mammogram and the cost of the 3-D mammogram. Depending on your circumstances and risk factors, it may be worth it – talk to your doctor!
What about false positives?
Much of the debate surrounding when women should begin getting annual screening mammograms has to do with the possibility of a “false positive” result. A “false positive” result means that something is detected in the mammogram, but after additional testing, it turns out not to be cancer. This could result in an additional diagnostic mammogram, an ultrasound, and/or a biopsy.
No one wants to go through a myriad of additional tests for nothing. However, if that person was you, or your mother, sister, friend … your person – well, wouldn’t it be worth all of that if it could save a life?
This amazing lady is 45 years old and her cancer was detected in a routine mammogram. Her doctor recommended a few years ago that she take advantage of the 3-D technology because she has dense breast tissue, so her cancer was found early, and it is treatable. Thank goodness, because her tumor was located deep inside her breast where she could not feel it. It had the potential to be very, very aggressive, and the mammogram was the only way it could have been detected at such an early and treatable stage.
If she had waited to begin annual screening mammograms, I would be writing a very different story today.
Have you had a mammogram? If so, when?
If you are due for a mammogram, I challenge you to schedule your appointment today!
If you have not yet reached the age for a routine mammogram, your challenge is to:
1) Ask your family members to see if you have a family history of breast cancer.
2) Encourage your mother, sister, or friend to schedule her mammogram today!
I had mine on October 5th – how about you?
