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Mammograms: Your Questions Answered

October is Breast Cancer Awareness Month. Below, Dr. Lori Lilley discusses frequently asked questions related to mammograms and breast cancer screenings.

Have a question you’d like to ask Dr. Lilley? Email us and reference this blog post. We’ll compile your questions and answer them in a future blog post.

#1 – When should I start getting mammograms?

Although there is some controversy regarding this subject, in general, age 40.

1/6 of breast cancers occur in women between ages 40 and 49.

The majority of these women had no family history of breast cancer.

If a close relative had breast cancer at a young age, you should start breast screening 10 years younger than the relative’s age at diagnosis. If you have a mutation in BrCa 1 or 2, you should start  breast cancer screening in your mid 20s.

#2 – Should I get a regular mammogram or a 3d mammogram?

A 3d mammogram is superior to a 2d mammogram.  The 2d mammogram shows only a few images, and the tissue is compressed basically from top to bottom and from left to right.

In a 3d mammogram, “also known as breast tomosynthesis”, many slices are taken through the breast at 1 mm intervals, and they are put together in a 3 dimensional way. It becomes easier to see masses, especially in dense tissue. There are also less call backs for false positives.

#3 – Is there a lot more radiation for 3d mammogram?

No , only a small amount more.

#4 – Is an ultrasound better?

An ultrasound is helpful for some lumps, but the best screening tool is still an annual mammogram.  If a mass is palpable (able to be touched/felt) and not seen on mammogram, an ultrasound is used to assess the breast tissue.  An ultrasound can also tell us if a mass is solid or cystic.

#5 – Why can’t I get an MRI?

In some instances we do order an MRI.  Insurance requires you to fulfill some criteria before we can order this.  If you have a strong family history and your Gail risk assessment score (breast cancer risk assessment tool) is over 20%, an MRI for screening purposes (as an adjunct) to mammogram , can be ordered.

If you have certain genetic mutations, we use an MRI for screening.  In these situations we still get an annual mammogram alternating with an annual MRI, and your breasts are therefore being screened every 6  months.

If you have a  history of mantle radiation, for example for Hodgkin’s lymphoma, we may get an MRI. We also frequently use MRI for staging and for ruling out other concerns preoperatively in dense breasts.


#6 – Do I need genetic testing?

Sometimes your family history raises suspicions and we order genetic testing.  If there is breast and ovarian cancer, early prostate cancer, or pancreatic cancer in your family , you may need testing.

If you get breast cancer at a young age, you may need testing. If you develop a second or contralateral cancer, you may need testing. There may be other hints as well that you need genetic testing. Some insurance carriers require that you see a genetics counselor prior to having these tests.

#7 – Do mammograms cause cancer?


#8 – At what age do I STOP getting mammograms?

As long as someone is in good health and anticipating living a while longer, some studies say eight years longer.

We see a lot of healthy people in their late 80s and even sometimes 90s now.  Even at an older age, cancer can be treated with excision (surgical removal) and sometimes if health is poor, cancer can be treated with hormonal therapy alone.

Remember: 60-70% of women diagnosed with breast cancer have no positive family history.

Someone is diagnosed every two minutes in this country, and even though treatments are better than ever, one person dies every 13 minutes.  The best thing you can do is screen, catch and treat breast cancer early.

There are 3.3 million breast cancer survivors in the United States, so GET YOUR MAMMOGRAM! It can save your life or the life of someone you love.

About Lori Lilley, MD

Dr. Lori Lilley is board certified in general surgery and advanced trauma life support with clinical interests in breast surgery and geriatrics. Read more about Dr. Lilley, and schedule an appointment today.

Imaging Services at WakeMed North

Need a mammogram? WakeMed North Hospital offers a range of imaging services for women, from mammograms to ultrasounds, bone density testing and more. Learn more about imaging services at WakeMed North Hospital, and schedule a same day appointment by calling: 919-350-8566.