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Demystifying mammograms

Begin annual breast screenings at 40


In 2015, the American Cancer Society issued new guidelines for breast cancer screenings suggesting women should have mammograms beginning at age 45.

However, the American College of Radiology, and others still firmly believe what Novant Health has been recommending all along – breast screening for women should begin at age 40, possibly earlier for those at high risk.

“We continue to follow the guidelines set by the American College of Radiology and Society of Breast Imaging,” said Dr. Nicole Abinanti of Mecklenburg Radiology Associates and director of women’s imaging for the Novant Health Breast Center in Charlotte, North Carolina. “Breast cancer is more easily treated with better outcomes when it’s found at an earlier stage. Annual screening mammography has been shown to reduce deaths from breast cancer, and the most lives are saved when screenings begin at age 40.”

Detecting cancer early has other known benefits, Abinanti added, including the possibility of less-expensive and less-invasive treatments.

Understand the types of screenings

Mammograms have helped reduce deaths from breast cancer in the United States by nearly one-third since 1990, according to the American College of Radiology. The screening can reveal small tumors up to two years before a woman or her physician can feel them.

Women at normal risk of breast cancer should have their first mammogram by age 40 and then on a yearly basis.

“All women should be familiar with the known benefits, limitations and potential harms associated with breast cancer screening,” Abinanti said. “They should be familiar with how their breasts normally look and feel and report any changes to their health care provider right away.”

MRI is a technology used for screening high-risk women. Women who are at high risk for breast cancer based on certain factors should get a breast MRI and a mammogram every year. This includes women who:

  • Have a lifetime risk of breast cancer of 20 to 25 percent or greater, according to the risk assessment tools mainly based on family history.
  • Have a known BRCA1 or BRCA2 gene mutation.
  • Have a first-degree relative (parent, brother, sister or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves.
  • Had radiation therapy to the chest when they were between the ages of 10 and 30
  • Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have first-degree relatives with one of these syndromes.

Talk with your doctor about your options

Tomosynthesis, also known as 3-D mammography, allows a woman’s breasts to be imaged from multiple angles. During a 3-D mammogram, an X-ray tube moves in an arc over the patient and takes multiple low-dose images that are regenerated by a computer.  The angled images provide 1-millimeter-thin snapshots of the breast tissues that, collectively, provide radiologists a more detailed, three-dimensional view than standard two-dimensional mammograms.

“The examination itself is almost identical for patients,” Abinanti said. “It just takes about four seconds longer per view. We are able to better detect potential problems that may be hidden from sight by overlapping normal tissues.”

Women who would most greatly benefit from tomosynthesis or 3-D mammography are those with dense breasts and those who have an increased risk of breast cancer. However, Abinanti said that all women may benefit from a 3-D mammogram, as it has been shown to increase the cancer detection rate while decreasing callback rates and minimizing overdiagnosis.

Novant Health now also offers abbreviated breast MRI - a shorter version of a full breast MRI. The new, abbreviated version is for women who don’t have a high risk for cancer, but who have dense breasts and want screening beyond the mammogram.

“This is for women who want something in addition to the mammogram,” Abinanti said. “Recently, radiologists began reporting to women the density level of their breast tissue and being able to offer the abbreviated breast MRI gives an added level of comfort to women with dense breasts.”

During examinations and traditional mammograms, 40 percent of women are found to have dense breast tissue, which makes it harder to spot small cancers. The State of North Carolina has made it a law that women with dense breast tissue must be notified following a mammogram stating that their tissue is dense and they should talk to their doctors about further testing.

Let the mammogram come to you

Another option where women can have a screening mammogram is with the Novant Health mobile mammography unit. The mobile mammography unit is a motorized coach that brings a mammography machine to where women work and live. Insurance is accepted and most mammograms are covered under preventive screening. Novant Health also has grant dollars that will support screenings for those without insurance.

Watch to learn more about the Novant Health mobile mammography unit.

The mobile unit also attends civic activities and faith-based services. It’s a convenient option ensuring all women have access to high-quality breast health services, regardless of ability to pay or travel to a full-service imaging center.

Plan and prepare

Abinanti provided several tips to help you prepare for your mammogram:

  • Schedule your mammogram the week after your menstrual cycle.
  • Limit caffeine and smoking before your screening.
  • Do not wear deodorant or other creams as they can lead to false positives.
  • Take pain relievers if you tend to feel discomfort from the compression.

Learn more about breast care services and screenings offered near you:
Novant Health (North Carolina)
Novant Health UVA Health System (Virginia)





Published: 7/13/2016
Updated on: 10/27/2017