MAMMOGRAPHY MYTHS THAT CAN PUT YOU AT RISK

Knowing the truth about mammography could help save your life, or the life of someone you love. According to the Canadian Cancer Society, about 87% of women diagnosed with breast cancer are still alive after five years, and the earlier cancer is diagnosed and treated, the better the outcome.

A mammography uses low-dose X-rays at safe levels to take images – or mammograms – of the inside of your breasts. It is the gold standard of breast cancer screening and has contributed to fewer Canadian women dying of breast cancer.

A 2020 study concluded, “Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.” Yet, some persistent myths still exist and dissuade people from getting screened.

MYTH 1: MAMMOGRAMS DON’T HELP

The best way to detect breast cancer early is by having regular screening mammograms before you develop symptoms of breast cancer, such as pain, lumps, nipple discharge, or other changes to the breast. But, many women are reluctant to go for regular screening mammograms because they find the experience uncomfortable.

Having a mammogram every year, or every two years (based on your risk factors), makes it easier for a radiologist to compare your images and see changes or areas of concern. When breast cancer is detected through imaging and before it is clinically apparent (e.g., palpable lump), it’s more likely to be small and more easily treated. Small cancers detected early can be removed and breast conserving surgery can be performed. Additionally, small cancers often do not require chemotherapy or radiation therapy.

MYTH 2: MAMMOGRAMS CAUSE CANCER

Mammography uses a very small amount of radiation – it’s like getting an X-ray. The risk of harm is extremely low and radiation levels are highly regulated. Thanks to technology, radiation doses in mammography have decreased with time while increasing in accuracy. For example, the addition of tomosynthesis to your mammography provides a 3D scan of the breast that can then be viewed in slices. This provides a greater level of detail and a clearer view of the breast tissue with the same small dose of radiation as a standard mammography. The benefits of detecting and treating something that is life-threatening far outweigh the risk of harm from radiation.

MYTH 3: MAMMOGRAMS ARE INACCURATE

The Canadian Cancer Society estimates that in 2022, 25% of all new cancer cases in women will be breast cancer. On average, 15 Canadian women will die from breast cancer every day.

No screening test is 100% accurate, but the scientific evidence shows that having regular mammograms lowers the risk of dying from breast cancer. Some women may have dense breast tissue with less fat and more glandular and connective tissue. Dense breasts can make a mammogram harder to read, so smaller cancers may be hidden. In these cases, handheld or automated breast ultrasound may be ordered in conjunction with a screening mammogram.

MYTH 4: MAMMOGRAMS ARE TOO PAINFUL

During a mammography, two X-ray plate surfaces slowly move together, compressing the breast for a short time. This compression is necessary to get the clearest image of breast tissue using the least amount of radiation. Each breast will be imaged at least twice to create a top and side view for each one.

Everyone’s pain threshold is different, but the discomfort is temporary and minimal, and the benefits far outweigh the risks. We recommend that you schedule your appointment one week after your last menstruation to decrease breast tenderness.

Mayfair Diagnostics uses the leading-edge Senographe Pristina Dueta mammography system in 11 of our clinics. Pristina helps make mammograms more comfortable for patients through its ergonomic design and a special feature called patient-assisted compression. After the breast is properly positioned by a technologist and initial compression is set, you can choose to use a handheld wireless remote control to adjust the level of compression to what’s comfortable for you, under the guidance of a technologist.

Some patients find mammograms uncomfortable, due to the pressure, and are therefore less likely to go for regular breast cancer screening with mammography. Patient-assisted compression allows the patient to reduce the pressure of the exam, while still maintaining excellent diagnostic quality. Giving patients some measure of control during their exam can help decrease their anxiety and increase their willingness to return.

In the four years we have been using Pristina, we have received many positive comments from our patients about their mammography experience:

• “I experienced the least amount of pain as compared to previous exams.”
• “Was the most comfortable mammogram imaging that I have ever had.”
• “Like the new technology used for mammograms.”

MYTH 5: LOW RISK FACTORS MEAN I DON’T NEED SCREENING

All women should have a mammogram, even those with no added risk factors. Many people start having regular mammograms every year at about age 40, since Alberta Health Care covers one mammogram per year starting at that age. If you have pain or a concern about your breasts earlier than that, you can of course go see your doctor and arrange to have a mammogram. To get a mammogram, you will need to speak to your doctor about your family history, when to start screening, and how frequently you should be screened.

Mayfair Diagnostics recommends the following for women at standard risk:

• Under 39 – screening not needed.
• Age 40-49 – screening every year.
• Age 50-75 – every two years, if there are no risks factors that would necessitate a shorter interval.
• Age 75+ – screening will depend on your medical history.

REFERENCES

Alberta Breast Cancer Screening Clinical Practice Guideline Committee (2022) “Alberta Breast Cancer Screening: Clinical Practice Guideline 2022 Update.” www.screeningforlife.ca. Accessed August 12, 2022.

Canadian Cancer Society (2022) “Breast cancer statistics.” www.cancer.ca. Accessed August 12, 2022.

Duffy, S.W., et al (2020) “Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women.” Cancer, July; 126 (13): 2971-2979. Accessed August 12, 2022.