Shhhh … don’t tell anyone. I just had a BIG birthday! The BIG 4-0! That’s right!; I’m 40 now! Leading up to my actual birthday, there were a lot of conversations in which someone would ask how I was doing and then follow it up with, “Well, you know you have a BIG birthday coming up; how are you feeling about that?” Or sometimes it went like this like this: “WOW, 40! Are you OK with being 40? You know what happens when you turn 40?” I actually didn’t know what was going to happen, but I can tell you what did happen – I’m 40, and I’m OK! I’ve only been 40 for a little over a month, and so far it feels the exact same as being 39, ha!
One thing that does change when you’re a woman and you turn 40, is that you have to start going for a yearly mammogram. I have a family history of breast cancer, so when I was 35 I had my first baseline mammogram. Now at 40, I have to start going every year… or do I? I took some time before my first mammogram as a 40-year-old to talk with Jennifer Manders, MD, who is a breast surgeon at The Christ Hospital. I had a lot of questions and she had the answers!
What age should I get my first mammogram?
Dr. Manders: A woman with an average risk for breast cancer and no new masses or skin changes should get a “screening” mammogram. The recommendations for when to start mammograms vary amongst multiple different guidelines. I still recommend that women should start at age 40 and get mammograms on an annual basis. But, I would recommend that each woman have a conversation with her own health care provider to determine the right age to start screening.
Does a family history of breast cancer impact what age I should get my first mammogram?
Dr. Manders: For a woman with a family history of breast cancer or who has a higher risk for breast cancer for other reasons, she may get a recommendation to start screening earlier in her life. Depending on the situation, she might start at an age that is 10 years younger than the youngest age of diagnosis in her family. For example, if her mother had breast cancer at 42, she might start getting imaging at 32. Some women even start as young as 25 if a gene mutation has been identified. Those types of situations are best handled by a health care provider who can counsel women about the options available for imaging, the timing, the frequency, and the risks and benefits of different tests available.
Are mammograms covered by insurance?
Dr. Manders: Yes, mammograms are covered by insurance. Sometimes screening mammograms are free, depending on the insurance policy. If a diagnostic mammogram is ordered because of a new or existing problem in the breast, those are usually still covered but applied to an annual deductible, which may require a higher out-of-pocket expense for the patient. Checking with the insurance company before any tests are performed might help to give each woman an idea of cost and coverage.
What should I expect from a mammogram? Is it painful?
Dr. Manders: Mammograms are not the most comfortable test one can undergo, but it usually isn’t painful. The breast is placed between a compressor and a “plate” and the tissue is squeezed. This allows the tissue to be spread out and decrease the amount of overlapping breast tissue. This makes the mammogram more accurate and easier to interpret.
What is the difference between 2D vs. 3D imaging ? Is one better than the other?
Dr. Manders: The difference between 2D and 3D refers to the number of images that are taken of each breast in each compression position. If a single image is captured (2D), then all of the breast tissue is evaluated at once. If multiple images are taken in each position, focusing on different depths of the tissue being compressed, then there is less overlap of surrounding tissue (3D). The images are then reformatted to appear as though we are scanning through the breast rather than looking at everything at once. This helps immensely when interpreting very dense tissue. Given the additional images taken, the amount of radiation used in 3D imaging is higher. The American Cancer Society has a lot of helpful information about the safety of radiation and the specific dosage with each type of mammogram.
How long does it typically take to get results for a mammogram?
Dr. Manders: In general, screening mammograms can be read in as quickly as three days, although the time varies from institution to institution. The mammogram technician can usually give a good estimate of when results will be available.
How are the results for mammograms classified? What happens after receiving them?
Dr. Manders: Mammogram results are coded according to a BIRADS (Breast Imaging-Reporting and Data System) classifications. This is a standardized system that is trademarked and published by the American College of Radiology. The results dictate the next step in management, depending on the individual situation. Check out this chart to learn more.
Don't put off getting your annual mammogram! You can even schedule a mammogram appointment online, at one of our convenient locations.