Mammography

Breast Cancer Prevention

Learn more about VNA Mammography services with a look behind the scenes.

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Breast cancer is the second most common cancer among women in the U.S. Close to 300,000 women are diagnosed with this potentially deadly disease each year. American women have a 1 in 8 chance of getting breast cancer during their lifetime.

The risk increases with age – if you are above the age of 45, having regular mammograms are important for the early detection of breast cancer. With early detection, your odds of surviving cancer increase exponentially.

Mammograms can boost survival rates up to 98% with early detection. Cancers that remain undetected eventually spread out of the breast tissue and into nearby organs and lymph nodes. At later stages, the survival rates may drop to as low as 25%.

Mammogram Scheduling Guidelines

The guidelines for the frequency of getting a mammogram are not exactly uniformly specified. Here are the various suggestions from major authority organizations in the field of cancer care and prevention on the subject:

For Women at Average Risk – Ages 20 to 39

For young women below the age of 40, annual mammograms are not recommended unless they are in a high-risk category. Instead, a clinical breast exam by a licensed healthcare provider at least once every three years is recommended.

For Women at Average Risk – Ages 40 to 49

• American Cancer Society: Annual mammograms are optional between 40 and 44, recommended between 45 and 49.
• American College of Obstetricians and Gynecologists: Annual mammograms are recommended.
• American College of Physicians: Annual mammograms are optional between ages 40 to 49, the recommended frequency is once every two years.
• American Academy of Family Physicians: Annual mammograms are optional between 40 and 49, recommended frequency is once every two years.

For Women at Average Risk – Ages 50 to 74

• American College of Obstetricians and Gynecologists: Annual screening mammograms recommended.
• American Cancer Society: Annual screenings between ages 50 to 54, followed by mammograms once every two years until 74.

Many organizations do not recommend mammograms for women above the age of 75 when they are in the average risk category. However, it is up to the provider when to stop mammography since it has to do with the overall health of the woman.

Women at High Risk – All Ages

The following are general guidelines for women who fall in the high-risk category for breast cancers:

• Annual screenings at least from the age of 40.
• Get an MRI along with a mammogram.
• Discuss medical history/family history with a healthcare provider.

The following women are considered “high-risk”:

• Women who are 20 percent or higher per lifetime risk score, are considered high risk.
• Women who have first degree relatives are considered high risk.
• Women who have had previous radiation to the chest are considered at higher risk.
• Women who have BRCA1 or BRCA2 genes are high risk.

Women are also encouraged to be aware of how their breasts normally look and feel so that any physical changes can be reported to their healthcare providers.

Insurance Coverage for Mammograms

The Affordable Care Act requires all health insurance plans, private or government-funded, to provide full coverage for screening mammograms for women over the age of 40. The health plans have to cover the cost of one annual screening mammogram.

Both Medicare and Medicaid cover annual mammogram costs for women above the age of 40. They both provide one free screening mammogram for women between 35–39. Private insurance plans follow the same general criteria, offering free annual mammograms for women after 40.

IBCCP – Free Mammograms for Uninsured Women

Qualifying uninsured women may also be able to receive a mammogram at no charge. The Centre for Disease Control (CDC) offers free screening mammograms for women who are uninsured or have low income through their breast and cervical cancer early detection program.

Numerous state programs are affiliated with the CDC Early Detection Program. In Illinois, the program is called the Illinois Breast and Cervical Cancer Program (IBCCP). Uninsured women who have income below 250% of the Federal Poverty Level are eligible.

IBCCP offers eligible women:

• Free breast and pelvic exams
• Free pap tests
• Free mammograms

VNA Health Care is the leading agency for IBCCP in DuPage, Kane, Kendall, Kankakee, and Will counties. VNA offers cervical cancer screening and general wellness exams from trained and dedicated healthcare providers.

Mammograms at VNA Health Care – What to Expect

All women should know that mammograms save lives. A screening mammogram is a relatively short process. It takes only about 15–20 minutes from start to finish. We have trained bilingual staff at our facilities to make your annual mammograms as pleasant as possible.

Our staff will answer any questions you may have about your mammogram. When you visit our nearest VNA health center in Illinois, we will first ask you about your medical and family history. This is important in deciding if you are at a greater risk of developing breast cancer.

After this, you will be taken to a private room for breast cancer screening. Here you will have to undress from the waist up. Take care not to wear any perfume or deodorant on the day of your mammogram as they can interfere with the machine.

A licensed technician will guide you through the entire process. The tech will take x-ray images of both your breasts from different angles.

For this, each breast will be positioned between two imaging plates, one at a time. The plastic plates will apply some pressure on your breast to spread the tissue. While this may cause some discomfort, it helps reduce the radiation required for a clear image.

After the process, you are free to go as the results may take a few weeks.

Follow-Up After a Mammogram

A mammogram can show one of three possible results:

1. No sign of cancer in either breast.
2. A non-cancerous (benign) condition or other abnormalities not related to cancer.
3. An abnormal finding that can often be associated with cancer.

Follow-ups are required when the third outcome occurs. This will only happen in a very small number of cases. But when it does happen, further tests are necessary to rule out or confirm the presence of breast cancer.

The doctor will prescribe a series of further tests, usually in this order:

1. A follow-up mammogram called a diagnostic mammogram.
2. A breast ultrasound, often taken along with the diagnostic mammogram.
3. A breast MRI, if the previous tests failed to rule out cancer.
4. A biopsy to remove a tissue sample for lab tests.

The biopsy is usually the final step where you can either definitively confirm or rule out the presence of cancer. If it shows no cancer, your surgeon and radiologist will recommend if you need another mammogram in 6 months, or you can go back to your regular screening schedule. At VNA, we will always follow the recommendations of your surgeon and/or radiologist.

With that said, if the biopsy does indicate cancer, you will be referred to an oncologist by your provider, and the Women’s Health Team at VNA will assist you every step of the way. In general, cancers detected early during annual mammograms have a high chance of being cured. Early detection saves lives!

Insurance Coverage for Follow-Up Tests

While most insurance plans offer full coverage for screening mammograms, the same cannot be said about diagnostic mammograms, MRIs, and biopsies. The Affordable Care Act does not provide full coverage for these procedures.

Accuracy of Mammograms

Mammograms have been used reliably to find breast cancer for decades. They are the most dependable tool currently available for breast cancer screening and early detection in modern medicine. However, these breast cancer screening tests are not 100% accurate on their own.

Mammography has an overall accuracy rate of around 87%. The accuracy of the technique is much higher in women above the age of 50. The test has better sensitivity in breasts with a higher percentage of fatty tissue. Since this percentage increases with age, the accuracy of mammograms also improves when looking at older women.

Meanwhile, younger women tend to have more dense tissue in their breasts. It is harder to find cancer in dense breasts. You should also inform your healthcare provider if you have breast implants as that can change the effectiveness of the mammogram.

The test has lower sensitivity in such situations and may not give any indication of breast cancer. This may occur in 13 tests out of 100, not showing cancers when they exist inside the breast. Also, keep in mind that no test has a 100% accuracy rate.

Mammogram – Risk vs. Benefits

Almost all major health organizations regard mammograms as useful for lowering the risk of breast cancer death among women. But there is still considerable debate regarding the health risks versus benefits of mammograms, especially among younger women.

In general, younger women have better breast health and are less likely to get breast cancer. Low-cost mammograms may lead to unnecessary diagnostic tests and additional treatments, due to over-diagnosis. Some masses in the breast are actually harmless – they don’t grow larger and often shrink with time.

However, mammograms are highly sensitive and may flag these cancerous growths. While this can lead to over-diagnosis, it does occur in relatively few cases.

The clear benefit of saving lives from breast cancer outweighs most of these risks.

Mammograms help save lives. Schedule your annual free mammogram today at VNA Health Care by making an online appointment.

Funding provided in whole or in part by the Illinois Breast and Cervical Cancer Program