The statistics and math equations of breast cancer are staggering. The average American woman diagnosed with breast cancer is 64. 10,000 American women under the age of 40 with be given the diagnosis of a malignant breast cancer. About 1300 of these women will die from this disease. Breast cancer is the leading cause of cancer for women between the ages of 20 and 59. But here is one that should give you hope. When detected early, breast cancer has a five-year survival rate of around 85 percent.

Mammograms can save lives. The importance of this test is well documented, as is the importance of early detection. Having a mammogram only makes sense. Good sense. With mammography, breast cancer can often be detected up to two years before it can be felt. The mammogram is considered to be the cornerstone of early detection of breast cancer. At this time it is the most accurate non-invasive way to detect breast cancer at an early stage. Approximately 90 percent of breast cancers are detected with mammography.

Today more and more women are getting mammograms. The numbers rise with each passing year, however, this test is still very much underused despite all the good promotion. Not all women are following the recommended mammogram schedule, including women who are 60 years of age and older -- those at highest risk. Half of the breast cancers diagnosed in the United States occur in women over 65 years of age, yet a study by Johns Hopkins researchers found that only about half of the women in this age group had mammography.

Conflicting reports from those in the medical community have clouded the mammogram issue, confusing many women. Though the American Cancer Society has stood firmly behind its recommendation that women begin mammogram screening at age 40, this issue became blurred recently when a panel from the National Institutes of Health (NIH) did not concur with the guidelines already in place for mammogram screening.

At this time, we still do not know the cause or causes of breast cancer. A breast cancer gene has been identified, and it is likely that there is a genetic basis for its development. But, this may be only one of the factors involved. Certain women are at a higher risk for developing breast cancer. Women with a strong family history of breast cancer, a personal history of breast cancer, early menstruation (before the age of 11), late menopause, a first pregnancy (to term) after the age of 30, and women who do not breastfeed are often considered to have an increased risk. Other factors, such as long-term estrogen therapy, a high fat diet, and alcohol use may play a part in the development of breast cancer, though at this time their role remains unclear. Still, more than 70 percent of the women diagnosed with breast cancer have no known risk factors. It is important to look toward the goal of early detection of breast cancer, since we are not yet able to prevent its occurrence.

You may have heard the alarming statistic, that one out of every eight women in the United States will develop breast cancer. Though there is no question that breast cancer is a major health care issue, this statement can be misleading. This statistic is taken from data indicating that the lifetime risk of a woman developing breast cancer was approximately 12 percent (or one out of eight) if she lives to be over 100 years old. Since breast cancer risk increases as a woman ages, the risk in any one year of developing breast cancer can be far from the quoted, "one out of eight." But these numbers may be enough to remind women of the importance of regular breast care.

Women need to perform regular breast self examination, schedule annual breast examinations by their health care provider, and have regular mammography screenings at the frequency recommended for their particular age and situation. Early discovery of breast cancer leads to better outcome and chance of survival. The key to cure is early detection and prompt treatment.

So what is a mammogram?
Mammography is a special X-ray technique used to examine and visualize the breast. It can detect tumors and cysts, and will help to differentiate between benign (non-cancerous) and malignant (cancerous) tumors. A radiologist will read the X-rays, looking for signs of cancer, changes in breast tissue, and other breast problems.

How is it done?
On the day of your mammogram you will be told not to apply any deodorant, talcum powder, creams, ointments, or perfume. They could cause the image to be obscured. You might want to wear a two-piece outfit. If you've had a prior mammogram at a different facility it is important to bring that mammogram along, or arrange for it to be delivered. This will allow the radiologist and your health care provider to compare your test results, making it more likely that they will notice subtle changes. When you arrive at the facility, you will fill out a brief medical history, noting the reason for the mammogram and any breast irregularities you or your health care provider have discovered. (Tell your technician prior to the procedure if you are pregnant or nursing, or if you have breast implants. Don't worry, implants won't rupture during the procedure.) You will then be asked to undress from the waist up, remove any jewelry, and to change into a gown that opens in the front.

The mammography technologist will position your breasts. One breast at a time is placed on a flat surface that contains the X-ray plate. A compression paddle will press firmly into your breast, flattening out your breast tissue, so that the tissue is more easily visualized, using only a minimal amount of radiation. The technologist may ask you to hold your breath while the picture is taken. While some women state it is only “uncomfortable,” others state it is quite painful. No matter the description, the test takes literally seconds. Typically two views of each breast are looked at - one from above and one from the side.. In some cases, the breasts might be marked with small plastic markers by the technician for areas that have moles, scars, or other areas they might want to look closely at, prior to the X-ray being done. The breast compression does not harm the breast tissue. Your mammogram will generally take about 20 to 30 minutes. Planning your mammogram shortly after your period, during the first two weeks of your menstrual cycle may help to make the procedure more comfortable for you, since your breasts are less tender at this time. Some facilities will perform a breast exam along with the mammogram.

The results
Some centers will give you on the spot results, while others will send final results back to your physician. If they do give you the results immediately, it will most likely be done by the radiologist who specializes in women’s breast health.

What's the difference between screening and diagnostic mammograms? Screening mammography is performed on women over the age of 40, who are free of symptoms. Most screening mammograms show no abnormality. Diagnostic mammography is performed to resolve a particular question related to the breast.

When do I get my first mammogram? This question has been at the center of controversy between physicians, the American Cancer, and the National Institutes of Health (NIH). Fortunately for women, the American Cancer Society has held firm, still recommending that women begin mammogram screenings at age 40, followed by mammograms every one to two years in the forties and every year after the age of 50. “The research evidence now tells us that by beginning a program of annual mammography at age 40, women can give themselves the best chance of detecting cancer early, when there is a higher opportunity for long-term survival, and more treatment options," said Myles P. Cunningham, MD, president of the American Cancer Society. Breast cancers typically grow faster in women in their forties than in older women. Numerous studies have shown that there is a decrease in death from breast cancer in women between the ages of 40 and 49 through regular mammography.

Each woman has the daunting task of ultimately deciding for herself when to begin having regular mammogram screenings. Women over the age of 40 may want to err on the side of caution, choosing to have a baseline mammogram, even if they are without symptoms. Your primary care provider may also recommend a mammogram at this age. But, ultimately, the burden of decision rests with the woman.
How often do you need to schedule a mammogram after you have your baseline? It depends on your age and medical history. Typically, after your baseline mammogram at the age of 40, as recommended by the American Cancer Society, a woman who is symptom-free should schedule a mammogram, at a facility accredited by the American College of Radiology, every two years until the age of fifty. After age fifty, an annual screening mammogram is recommended. Women with a family history of breast cancer or other risk factors may be advised to have more frequent mammography.

How safe is a mammogram?
Mammography does expose you to some radiation. The typical radiation exposure is very low and is considered to be safe. Federal law requires that any facility doing mammography follow certain safety guidelines. Research suggests that the benefit of early cancer detection will far outweigh any risk from the level of radiation exposure during a mammogram.

Screening mammograms are not generally recommended for the low-risk women under the age of 40. The younger you are, the more vulnerable your breast is to radiation.
How reliable is a mammogram? Take care in choosing your mammogram facility. The accuracy of your mammogram depends heavily on the experience and skill of the radiologist reading it.

Mammograms are not foolproof -- they do not always tell all. Some breast changes, including lumps that can be felt, do not show up on a mammogram. Some cancer could be hidden by breast tissue, and might not show up on a mammogram. Changes may be particularly difficult to spot in the dense, glandular breast tissue of younger women. Last year there were approximately 180,000 new cases of breast cancer that were diagnosed in the US. It is estimated that as many as 10 percent of these cancers, or 18,000 cases, did not show up on a mammogram.

By utilizing monthly breast self-exams, regular clinical examination by your health care provider, and annual mammograms, you can increase the likelihood of early detection if cancer is present . One study found that 15 percent of cancers were detected by breast exam. When the breast exam was performed along with a mammogram, doctors were able to detect 5 percent more cancers than with mammography alone.
New imaging techniques are on the horizon. Within the next decade, advances in the field should allow radiologists to better visualize breast abnormalities - both malignant and benign. It is not likely that any imaging technique in the near future will totally replace the mammogram.

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