Why does the breast have to be compressed for a mammogram?

Breast tissue has multiple layers, a good analogy being a bag of marbles. Let's say you have a bag of blue marbles with one red marble in the center. When the blue marbles are all stacked on top of one another you cannot see the red marble in the middle; but, when youspread all those marbles out, you are now able to identify the red marble. This is what compression does for the breast tissue. Compression separates the tissue, reduces radiation and motion, and allows optimal evaluation of lesions that might be obscured by other tissue.


I only want an ultrasound. Why do I have to have a mammogram?

Ultrasound is a great adjunct modality that can be used in the assessment of breast problems. However, some findings in the breast are too small to be detected by ultrasound. Microcalcifications can be the size of a grain of salt. They cannot be felt by the patient or physician and can only be assessed with a mammogram. While some microcalcifications are benign findings, some with additional testing are determined to be the early stages of a breast cancer.


Is there ever a time when only breast ultrasound is performed?

Because breast ultrasound is non-invasive and has insignificant radiation exposure, it is useful in pregnant or lactating women, as well as younger women (<30 years), whose breast tissue is too dense to assess with a mammogram.


How much radiation do I receive during a mammogram?

The radiation dose used for a mammogram is very low. It is comparable to the amount of radiation you would receive from your natural surroundings in seven weeks. Most naturally-occurring "background" radiation comes from radon gas in our homes and cosmic radiation from the atmosphere. (RadiologyInfo.org)


How can uninsured or low-income women obtain a free or low-cost screening mammogram?

Contact the Oklahoma Project Woman navigator at 918-834-7200 or toll free at 877-550-7465 to see if you qualify for a no-cost mammogram. Oklahoma Project Woman is a statewide comprehensive program that provides breast healthcare to Oklahomans with no health insurance and limited financial resources.


How many women are diagnosed with breast cancer each year and how many survive the disease?

According to Cancer Facts & Figures-2011 from the American Cancer Society, breast cancer is the most common cancer among women other than skin cancer. About 230,480 women in the United States, including 2,680 from Oklahoma, will be found to have invasive breast cancer in 2011. About 39,520 women across the country (530 Oklahomans) will die from the disease in 2011.

The chance of a woman having invasive breast cancer some time during her life is about one in eight. The chance of dying from breast cancer is about one in 33. Breast cancer death rates are going down. This decline is probably the result of earlier detection and improved treatment.

When is ultrasound used?
Ultrasound examination is used to further evaluate a lump or mammogram finding by using high frequency sound waves. The most important information from ultrasound is whether the lump or area of concern is a fluid-filled cyst or is solid tissue that may be cancer. Ultrasound is also used to guide needle biopsies.

When is breast magnetic resonance imaging (MRI) used?
Some women may have a breast MRI procedure in addition to a diagnostic mammogram and ultrasound. In some cases breast MRI may help define the size and extent of cancer within the breast tissue. It may especially be useful in women whose dense breast tissue makes it more difficult to find tumors with a mammogram. Breast MRI is not a replacement for a screening mammogram.

What are the risk factors for developing breast cancer and what medical procedures are recommended for the early detection of this disease?

  • Simply getting older and being a woman puts you at risk
  • If you have a history of breast cancer in your family
  • Have never had children or had your first child after the age of 30
  • Began menstruating before age 12 or completed menopause after age 55

It is important to keep in mind these factors do not cause cancer, but are merely associations that may increase cancer risk. Having one or more of the risk factors does not mean a woman is certain to develop breast cancer.

Currently, there is no way to prevent breast cancer, so finding the disease as early as possible is the goal. Used together, and on a regular basis, a breast exam by a doctor or nurse and mammography offer the best chance of finding breast cancer early. Studies have shown for women aged 40-69, having regular mammograms, along with breast exams by a doctor or nurse, could reduce deaths from breast cancer by one-third or more.

When breast cancer is detected and treated early, chances for survival are greatest. And when breast cancer is detected while it is still small, you may have the option of choosing a treatment that preserves your breast.

If a woman does not have a family history of breast cancer, does she risk developing it?
Yes. In fact, 80 percent of women who develop breast cancer have no family history of the disease. While chances of getting breast cancer increase if a family member has also had it, this does not mean you are free from risk if no one in your family has had breast cancer.

Are there any warning signs of breast cancer?
The most common sign is a lump or thickening in the breast. Other warning signs include a change in the size or shape of the breast, discharge from the nipple or a change in the color or texture of the skin of the breast or skin around the nipple. However, often there aren't any tangible signs of breast cancer until the disease has progressed into its advanced stages. That is why a mammogram, which can detect breast cancer before it can be seen or felt, is so important.

How is breast cancer detected?
The most effective detection method is mammography. If a lump or abnormal density is detected, further evaluation will be necessary.

Research continues to evaluate other breast cancer detection techniques including ultrasonography, which uses high-frequency sound waves to create an image and determine if a lump is a cyst or a solid mass. These techniques are currently being studied and have not yet been proven to be as effective as mammography for the early detection of breast cancer.

What is mammography?
Mammography is the process of taking an X-ray picture of the breast. Usually, two views of each breast are taken, one from the side and one from above. This way, the physician can identify abnormalities, such as very small lumps, areas of calcification or other changes before they can be felt by a woman or her physician. In fact, mammography can detect breast cancer when it is in its earliest and most treatable stages -- up to two years before a lump can be felt.

What type of primary therapy is used for breast cancer?
It depends upon how early the cancer is detected. Primary therapy for breast cancer is usually surgery. The most common type of surgery is modified radical mastectomy - the removal of the entire breast, some of the underarm lymph nodes and the lining over the chest muscles. However, more limited surgery (breast-conserving surgery to remove only the tumor or a segment of the breast) can often be used. In such cases, removal of underarm lymph nodes and radiation therapy to destroy cancer cells that may remain in the breast tissue become part of the primary therapy.

Is breast surgery dangerous?
Doctors have been performing mastectomies for many years and are continuing to improve their techniques. However, there are risks associated with any kind of surgery. Risk depends on a lot of things, including your age, your medical history, your response to anesthesia and your general health. After considering these factors, your doctor will recommend the type of surgery that will offer you the most benefit with the least amount of risk.

How frequently should I plan to see a doctor after a mastectomy?
Your surgeon will tell you when to schedule your first postoperative exam. The two of you will then decide whether you should continue to make regular visits to the surgeon, or to a medical oncologist, an internist, a gynecologist or a family practitioner. Most doctors believe that women treated for breast cancer should have professional exams every three to six months for the first three years after surgery. More information on follow-up care, possible signs of recurrence, and taking care of yourself can be found in a guide available from the American Cancer Society.

What types of adjuvant therapy are used for breast cancer?
Because the purpose of adjuvant therapy is to kill any cancer cells that have spread, treatment usually is systemic (affecting cancer cells throughout the body). Two types of systemic adjuvant therapy are used for breast cancer, either alone or in combination: chemotherapy (using a combination of drugs), and hormone therapy (depriving the cancer cells of the female hormone estrogen, which some breast cancer cells need to grow).

Who is given adjuvant therapy?
In deciding whether adjuvant treatment is necessary, the doctor takes into account the extent of a woman's disease, her general health and other prognostic factors. Women whose breast cancer has spread to underarm lymph nodes usually receive adjuvant therapy. Doctors have observed that these women have a high rate of recurrence and concluded that breast cancer that had spread to the lymph nodes may also have begun to spread to other parts of the body. Research showed that adjuvant therapy helped delay or prevent recurrence in these women.

Decisions about adjuvant therapy for women whose cancer has not spread to the lymph nodes are more complex. Between 60 and 70 percent of these patients can be cured with primary therapy alone. However, breast cancer recurs in about one-third of these patients, indicating that even in early stage disease, some cancer cells may remain after primary therapy. Doctors and patients must weigh the possible benefits of adjuvant therapy against the risks.

When is adjuvant therapy started?
Adjuvant therapy usually begins between four and 12 weeks after surgery. Doctors do not know whether adjuvant therapy is as effective in reducing recurrence when treatment is started at a later time.

How is adjuvant therapy given, and how long does it last?
Anticancer drugs are given by mouth or by injection into a blood vessel. Either way, the drugs enter the bloodstream and travel throughout the body. Chemotherapy is given in cycles, a treatment period followed by a recovery period, then another treatment period, and so on. Most patients receive treatment in an outpatient part of the hospital or at the doctor's office. Adjuvant chemotherapy usually lasts for three to six months.

What is chemotherapy and when is it used?
Chemotherapy is the use of drugs to treat cancer. Remember, a mastectomy treats only the cancer in the breast. Anticancer drugs are used to reach areas of the body where cancer cells may be hiding, and destroy them before they multiply and hurt the normal cells and organs. More information on the supplementary treatment can be found in Chemotherapy and You available from the National Cancer Institute.

What is Radiation Therapy and when is it used?
Radiation therapy is a form of cancer treatment that is directed at the tumor. It uses high-energy particles or waves, such asx-rays, gamma rays, electrons or protons to destroy or damage cancer cells. Radiation therapy is one of the most common treatments for cancer and is often the main treatment for many cancers. More information on Radiation Therapy can be found in Radiation Therapy and You available from the National Cancer Institute.

How can I learn more about breast cancer?
The National Cancer Institute and The American Cancer Society both provide extensive information on all forms of cancer and treatments. For other resources, visit our Breast Cancer Resources page.