After many years of interpreting mammograms and talking with women about breast cancer screening, I continue to hear the same reasons for putting off or avoiding mammography. Most are based on understandable concerns, but many are misconceptions.
Here are five of the most common.
Myth #1: “Breast cancer doesn’t run in my family, so I’m not at risk.”
Most women who develop breast cancer do not have a strong family history of the disease. Family history and certain genetic mutations can substantially increase risk, but simply being a woman and getting older are major risk factors. Having no family history should not give women a false sense of security.
Myth #2: “I feel fine and don’t have a lump, so I don’t need a mammogram.”
That is precisely when screening mammography is intended to be used. The purpose of screening is to find breast cancer before it produces symptoms. Many cancers detected on mammography are too small to be felt by either the woman or her physician. A mammogram is not something we should wait to obtain until something feels wrong.
Myth #3: “If I get breast cancer, I’ll just find the lump myself.”
Unfortunately, by the time breast cancer can be felt, it may have been present for quite some time. One of the greatest advantages of mammography is its ability to detect some cancers when they are still very small or appear only as tiny calcifications. Detecting cancer earlier can mean simpler treatment and a better chance of cure. The best breast cancer is the one we find before you can feel it.
Myth #4: “I have dense breasts, so mammography won’t work for me.”
Dense breast tissue can make some cancers more difficult to see on a mammogram, but that does not mean mammography has no value. Mammography can detect abnormalities, particularly suspicious calcifications and certain masses or distortions, that may not be detected by ultrasound. Depending on a woman’s breast density and overall risk, supplemental screening with ultrasound or MRI may sometimes be appropriate. The important word is supplemental. These examinations generally complement mammography rather than simply replacing it.
Myth #5: “The radiation from mammograms can cause cancer, so I’d rather have an ultrasound or MRI.”
Mammography does use ionizing radiation, and no unnecessary radiation exposure is desirable. But the radiation dose from a modern mammogram is very small. Radiation can theoretically increase the risk of developing cancer, particularly with larger exposures and at younger ages. However, the potential radiation-associated risk from routine mammographic screening is extremely small compared with the risk of developing breast cancer and the benefit of detecting it early. Ultrasound and MRI do not use ionizing radiation, but neither is simply a replacement for mammography. Each imaging method provides different information. Fear of radiation should not prevent a woman from receiving an appropriately recommended mammogram.
The Takeaway
Breast cancer screening is not perfect. Mammograms do not find every cancer, and some women benefit from additional imaging based on their breast density, family history, genetics and other risk factors. But after decades of advances in breast imaging, one principle remains remarkably simple: finding breast cancer earlier gives us more options for treating it. Women should know their breast density, understand their individual risk and discuss the appropriate screening strategy with their physician. And perhaps most importantly, they should not let myths keep them from being screened.