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October is Breast Cancer Awareness Month
Frequently asked questions about early detection

In the last few years, changing guidelines for mammograms have left many women confused and uncertain about the best plan for early detection of breast cancer. We hope that this information can help you be informed so that when you sit down with your doctor, you can make the best decision for your health.

I’ve heard different recommendations about what age to begin getting mammograms and how often?
Most major medical organizations including the American Medical Association (AMA) and the American Cancer Society (ACS) recommend annual mammograms beginning at age 40. In 2009, the U.S. Preventive Services Task Force (USPSTF) changed its screening recommendations and said that women of average risk for breast cancer could wait until age 50 to start getting mammograms and then follow up only every two years, rather than annually. The current USPSTF recommendations, which do not apply to a small group of women with unusual risk factors for breast cancer, created a heated debate within the medical community. Moab Regional Hospital and nearly all major medical groups still recommend women begin getting routine screening mammograms at age 40 and do so every year. However, the bottom line is, different organizations advocate for different ages and frequency. If you are over 40, talk with your doctor about your risk for breast cancer, and decide on a plan that is best for you.

What is a mammogram?
A mammogram is an x-ray picture of the breast. Mammograms can be used to check for breast cancer in women who have no signs or symptoms of the disease. This type of mammogram is called a screening mammogram. Screening mammograms usually involve two x-ray pictures, or images, of each breast. The x-ray images make it possible to detect tumors that cannot be felt. Screening mammograms can also find tiny deposits of calcium that sometimes indicate the presence of breast cancer.
Mammograms can also be used to check for breast cancer after a lump or other sign or symptom of the disease has been found. This type of mammogram is called a diagnostic mammogram. Besides a lump, signs of breast cancer can include breast pain, thickening of the skin of the breast, nipple discharge, or a change in breast size or shape; however, these signs may also be signs of benign conditions.
Digital mammography units, like the one at Moab Regional Hospital, have become the new standard of care for breast cancer screening because of improved images. Digital mammograms are better for women who have dense breast tissue, are under the age of 50, or are pre-menopausal.

What is thermography and can it be used instead of mammography to detect breast cancer?
Unlike mammography, in which an X-ray of the breast is taken, thermography produces an infrared image that shows the patterns of heat and blood flow on or near the surface of the body. Some health care providers claim thermography is superior to mammography as a screening method for breast cancer because it does not require radiation exposure or breast compression, however the Society for Breast Imaging does not currently support the use of thermography imaging of the breast as either a screening tool in the detection of breast cancer or as an adjunctive diagnostic tool. According to the FDA, there is no valid scientific evidence showing that thermography, when used alone, is effective in screening for breast cancer. To date, the FDA has not approved a thermography device for use as a stand-alone to screen or diagnose breast cancer.

Is radiation exposure during a mammography an issue?
Mammograms require very small doses of radiation and digital mammograms require even less, and although occasionally additional digital images are needed, they still average 17% less radiation exposure than traditional film units. We are exposed to radiation from natural sources all the time. The average person in the U.S. receives an annual dose of about 3 mSv from naturally occurring radioactive materials and radiation from outer space and people living in the plateaus of Colorado, Utah or New Mexico receive about 1.5 mSv more per year than those living near sea level. The exposure from a Mammogram is about 0.7 mSv which is comparable to natural background radiation for two to three months, depending where you live. The benefits of mammography, however, nearly always outweigh the potential harm from the radiation exposure, nevertheless, women should talk with their health care providers about the need for each x-ray. In addition, they should always let their health care provider and the x-ray technician know if there is any possibility that they are pregnant.

I don’t have insurance. How much does a mammogram cost. Do I need a referral from my doctor?
Mammograms can range in price. The Southeastern Utah Health Department offers vouchers for women under 250% of the Federal poverty guidelines. For example, a single woman making less than $28,725 or a woman in a four person household making less than $58,875, may qualify for a free mammogram. Call the Southeastern Utah Health Department at 259-5602 for more information. Moab Regional Hospital is offering vouchers for $175 screening mammograms during the month of October. The voucher can be used any time during the year, at your regular mammogram time. This is more than 50% off of the regular price of a mammogram. Contact the radiology department for more information at 719-3690. In Utah you do not need a referral from a physician to schedule a mammogram, however, it is good to work with a primary care provider that can help you navigate a care plan if your mammogram comes back with an abnormal finding.

Tips from Cindy Hirschfeld, MRH Mammography Technician
• On the day of the exam, don’t wear deodorant or antiperspirant. Some of these have substances that can show up on the x-ray as white spots. If you’re not returning home, you may want to take your deodorant with you to put on after your exam.

• If you are going to a facility for the first time or your most recent mammogram was at another facility, bring a list of the places, and dates of mammograms, biopsies, or other breast treatments you have had before. The facility can request these for comparison to your new mammogram.

• You may find it easier to wear a skirt or pants, so that you’ll only need to remove your top and bra for the mammogram.

• If you are still having a menstrual cycle, try to schedule your mammogram a week or two after your period, when your breasts are not tender or swollen to help reduce discomfort and get a good picture.

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