Mammography is the process of using low energy X-rays to make pictures of human breast tissue, looking for nodules, masses or clustered calcifications. This year more than 250,000 women will be diagnosed with invasive breast cancer and at least 40,000 women will die from their breast cancer. Tens of thousands more would likely die if it were not for screening mammograms. Regular use of screening mammograms are believed to reduce breast cancer mortality by up to 40 percent. Mammograms find tumors when they are small — before you can feel them and when the cancer can be more successfully treated. Mammograms do not, however, find all cancers.

For every 100 women having a mammogram 90 will be normal and about 10 will be called back for more studies such as ultrasound images or more X-rays, of these about two will be suspicious for cancer and needle biopsy (tissue sampling) will be recommended. One of these two will likely have cancer. Approximately one woman in 100 screened will have cancer.

Who then should have routine screening mammography?The American College of Radiology presently recommends that women of average risk should begin yearly mammographic screenings at age 40. Higher risk should start screening at an earlier age and may benefit from more advanced screening methods such as contrast enhanced MRI (magnetic resonance imaging), complete bilateral breast ultrasound, specialized nuclear medicine studies and other modalities for more specific workup. These guidelines are not specific and may vary from other medical disciplines as more information and statistics continue to be gathered ,based on ongoing increasing knowledge and outcomes. Medicine and medical imaging is not a one-size-fits-all discipline.

Women with strong family history of breast cancer (first-degree relatives, increased genetic risk, previous personal history of breast cancer and increased tissue density within their breasts) are considered at higher risk. You should discuss your history with your primary care provider to determine if you are at high risk. Yearly professional breast exam and occasional self-breast exams can be useful, but mammograms are better at detecting smaller cancers. You should check for abnormal skin changes (thickening or redness), lumps, developing asymmetry, nipple retraction or focal tenderness. If you are concerned, schedule an appointment with your primary care provider and consider a mammogram.

All screening mammograms done today are done with digital techniques and are monitored to be in a reasonable and safe radiation dosage range. Mammography facilities are all state-certified and the equipment is continuously monitored to be effective and reasonably safe. Most mammograms performed today use 3D digital technique. This is called tomosynthesis and produces better detail than 2D digital imaging.

As stated previously, some medical disciplines differ as to specific mammographic guidelines and the effectiveness of screening but they all agree that early detection and the smaller size of detected cancer on initial diagnosis results in greater five-year survival rates and overall better treatment and outcomes.

UnityPoint Health — Trinity Regional Medical Center and Norma Schmoker Women’s Center are fortunate to have a local cancer treatment center in the hospital with access to specialized cancer treatment physicians including a surgeon, medical oncologists and radiation oncologists.These physicians use a multi-disciplinary approach in treating breast cancer. They form a great team and tailor their plan of treatment for your cancer based on the input from all of them. They bring a high level of up-to-date expertise, experience and compassion to help you through a very difficult and somewhat terrifying experience of dealing with breast cancer, while you remain in your community and close to your home and family.

Dr. John J. Alcini Jr. is a radiologist affiliated with UnityPoint Health — Trinity Regional Medical Center.