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Ask a Doc: Breast Health

Michael Schmidt, M.D. of Envision Radiology answers your questions about breast health.

Why is an annual mammogram important?

Statistics show that 1 in 8 women will develop breast cancer in their lifetime.  That’s a sobering fact.  The good news is that breast cancer is very treatable when it’s detected early.  That’s why mammography is so important.  An experienced examiner can typically feel a lump in the breast that is the size of a small pea.  Mammography can find a lump the size of a grain of rice.  Thus, a mammogram allows for earlier detection, which can impact treatment outcomes. If we catch a tumor at 10 millimeters or smaller, there’s an excellent chance of total cure.  An annual mammogram, combined with regular self-exams, is the best available screening option for breast cancer.

Who should get a mammogram?

The age at which you start mammograms depends on your personal health history and risk factors.  You should consult with your primary care physician or OB-GYN about what is best for you.  Depending on those risk factors, women should start having annual screenings in their 40s.  The risk of breast cancer increases with age, so you should not discontinue mammograms without consulting your doctor.

Are mammograms covered by insurance?

Virtually all health insurances cover an annual mammogram and screening visit. You don’t need a doctor’s order…you can simply call and schedule the procedure.

I’ve heard about tomosynthesis as a new technology for mammograms.  What’s different about it?

The most important difference is that tomosynthesis (or “tomo,”) provides excellent, detailed images that are taken in very thin slices.  The tomo system at NOCHS combines both 2D and 3D images, so as a radiologist, I have many ways to look at images that are taken with no more radiation exposure than a standard mammogram.  If any tissue looks questionable, I can review it literally slice by slice to distinguish healthy tissue from potentially cancerous tissue.  That reduces the number of callbacks that women receive for additional testing.  This technology is especially helpful for women with dense breast tissue that can be hard to evaluate in a standard mammogram image. The curved paddle also makes some of the compressions less uncomfortable, but comfort is not the most important thing.  Clarity, and the ability to dive deep into a view of questionable tissue, are the reasons why tomo is so valuable to the radiologist.

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