This is a more informative remake of the take "Mammograms: Basic Information and 10 Things You Should Know" that I made last year.
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Well, as we all know it's October and that means (apart from Halloween) it's Breast Cancer Awareness month. And for me, this is a much bigger deal than it is for most people and this is because breast cancer runs in my family; my mom was diagnosed at the age of 36, my aunt (who didn't get screened) died at the age of 37 and my sister was diagnosed two years ago at the age of 32. I saw, first through the eyes of a child and then an adult the impacts breast cancer (like any cancer) can have on a family.
When my mom was diagnosed I was only eight but I was old enough to see that something was very wrong. However, when my sister was diagnosed I saw first hand how it ravaged her body when I cleaned her mastectomy wounds and radiation burns. I also remember how during her chemo treatment, she would curl up in the fetal position on my brother's lap and she even threw up on him a couple times, but he never let that get to him. Thankfully, both my mom and my sister are cancer free and I am thankful for every day that they are alive And in this myTake, I want to talk about our first line of defense. I speak of course of mammograms.
1. They are our very best defense against Breast Cancer
What is a Mammogram?
For those of you who don't know, a mammogram is an X-ray of the breast to visualize the internal structures. It looks for characteristics such as microcalcifications and masses of tissue that could indicate the presence of breast cancer. This allows breast cancer to be detected early, when it is most treatable.
B) Mammograms Save Lives
A recent Harvard study showed that 75% of women were getting screened regularly yet 75% of all cancer deaths were among the 25% of women who don't get screened. This means that if you get screened for regularly and develop breast cancer, you would have a 1 in 12 chance of dying from it and if you didn't you would have a 3 in 4 chance of dying from it. 9x higher!!! This also means that if every woman got screened the annual death toll from breast cancer in the US would go from 42,000 to 14,000.
C) They DON'T Cause Cancer
A mammogram will expose a woman to .0004Sv (an Sv is a unit of radiation) and the risk of cancer increases 5.5% for every Sv of radiation so each mammogram would increase the risk by .0022%, so it would take 450+ mammograms to increase the risk of breast cancer by just 1% and an average woman may have only 1/9th of that. Also, the compression won't cause cancer to spread (if that was true then a tight hug would be dangerous)
D) There is no alternative
There are some alternatives proposed for mammography such as breast thermography, untrasounds and MRIs. But thermography has been shown to miss 3/4s of the cancers detected by mammograms, ultrasounds cannot view the fine detail of breast tissue the way that mammography can and MRIs are too expensive to be used for population screening.
2. Know your risk factors for your first one
A) If you're not at High Risk, You Should Start Screening At Age 40-45
All women should be getting yearly mammograms starting at age 40-45 (depending on what guidelines you look at) with a baseline mammogram between the ages of 35 and 39.
B) If you Have a Family History You May Need to Start Sooner
if you have a family history (specificically a 1st degree relative such as a mother or sister) then you should start screening sooner. The general rule of thumb is that you should start screening when you're 10 years younger than your 1st degree relative was diagnosed. However, you should not start screening before turning 25.
C) If you Have Dense Breasts, you're Also at High Risk
Breast density refers to the ratio of glandular to fatty tissue in the breast. The greater the proportion of glandular tissue in the breast, the more dense it is. For the record glandular tissue comes up as a very light grey and fatty tissue comes up as a very dark grey while cancer comes up as white. It is common for young women to have dense breasts but as women get older the breasts get less and less dense.
However, in some women the breasts will remain dense post menopause and those women who's breasts remain very dense have triple the risk of BC than the average woman in their cohort. Also, women with less dense breasts have half the risk that the average woman does. On top of the increased risk, dense breasts are harder to read than others on a mammogram so the cancer wouldn't be detected until later. Causes of dense breasts include hormone replacement therapy and causes of less dense breasts include lactating at a young age.
D) Take action in Other Ways
On top of getting a mammogram when your time comes, you can also protect yourself from breast cancer in other ways. For one you can conduct monthly breast self exams and get annual manual breast exams from your gynecologist.
3. Ensure that you get the best mammogram possible
A) Remember not all Mammograms are Created Equal
If you can try to schedule and an appointment where they offer either breast tomosynthesis (3D mammograms) or spectral mammograms. For those of you who don't know, tomosynthesis is where the top part of the mammography machine moves over the cassette and takes multiple pictures and make a 3D image. Spectral mammography is where they inject a radioabsorbant dye into your bloodstream so it allows the radiologist to better view the "vascular structure" of the breast. Both of these rival MRIs in sensitivity. If you can't get those, at the very least try to get a digital mammogram.
B) Check Your Breasts Before the Procedure
If you check your breasts before the procedure you can tell your technologist. She will mark any area of concern on your mammogram so the radiologist will pay special attention to it.
C) Schedule the Mammogram the Week After Your Period
As you're probably aware, a mammogram does involve squishing the breast to image it. So it would be best to schedule your mammogram the week after your period when your breasts are less tender.
D) Treat Yourself Afterward
For a variety of reasons, getting a mammogram can be very stressful (and daunting to first timers) so it's good to have a way to blow off some steam. Especially if you're worried about the results.
4. Know what to expect during the procedure
A) Wear a Two-Piece outfit
For the procedure, you will have to undress from the waste up, so if you wear a two piece outfit you only have to take off your top as opposed to the whole outfit for the mammogram.
B) You will be Asked to Fill Out a Form
Before your exam, you will be asked to fill out a form about your breast history including any previous mammograms, family history of breast cancer, if you lactated and when as well as any symptoms you've noticed in your breasts.
C) Usually, Two Views of Each Breast Are Taken
A mammogram machine consists of an X ray generator and a cassette that is liked by an arm. Attached to the arm is a paddle that is used to compress the breast for the image. The machine can be moved up and down and swivel from side to side. Usually just before the procedure, your technologist will explain what she's doing. She will have you stand in front of the machine to take the first view where it will be up straight (CC view).
She will lift and arrange your breast in position onto up and raise the cassette to the appropriate height and push you into the machine to get as much of the breast as possible into the film. She will then lower the compression paddle to squeeze your breast against the cassette and and go behind a glass shield to take the picture. She will repeat the procedure on the other breast. For the next two images she will angle the machine 45 degrees and have you drape the arm over the side of the cassette as she gets your breast in position and compresses it (this is the LMO view).
D) You're usually done pretty quick
Even if it's not the most fun experience you're usually in the clinic for about half an hour and the procedure usually lasts around 5 minutes.
5. Just a heads up, it WILL be awkward
A) Both Mentally
There's no denying, mammograms will be awkward. For many women the thought of having a stranger handling their breast (not withstanding putting it in a machine) may seem a bit embarrassing. And while it may feel that way at first, it really just feels weird later on in the procedure. Also remember that there ain't no such thing as personal space in the mammography room and when positioning you the technologist will be very close the whole time.
B) And Physically
And in order to get your breast in position, your tech will have you stand in some awkward poses and it may be hard to keep your balance. Also your boobs aren't the only thing she's going to be touching. To get the rest of my body into the right position my tech would usually have one hand on my bottom. So when she would first get me in position for the images, I had a girl I just met holding my boob with one hand and the other on my rear :P Also it feels pretty awkward when the X-ray tube is right in your face.
C) Leave Your Modesty at The Door
You may feel a bit embarrassed about having someone handling your breasts but there's really no reason to. She is a professional who handles 10+ breasts per day. Also some women wear a gown for the sake of "modesty" but honestly, when someone's squishing your girls in a machine, modesty is out the window (it's also way easier for the techs if you go topless). 
D) And don''t be Surprised if you Feel Like A Stripper
Quite often, you will be given nipple stickers. While this may seem a bit "demeaning" it is also very important because the metal ball in the middle of the stickers will show up on the mammogram showing where the nipple is as a reference.
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