Wardrobe by Paul Simon 0 IS THE NEW PINK. The Facts about Screening Mammography

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1 Wardrobe by Paul Simon 0 IS THE NEW PINK The Facts about Screening Mammography

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3 American Cancer Society Guidelines for Early Detection Screening Mammography Annually starting at age 40 CBE (Clinical Breast Examination) BSE (Breast Self Examination) Monthly starting at age 20 Breast MRI Every three years for women 20-39; annually for women 40 and older Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15% Mammography is the only screening method that is consistently proven to reduce breast cancer deaths. In addition, early detection through mammography gives women more treatment options with reduced surgery, better cosmetic outcomes, and often eliminates the need for harsh therapies. This low-cost and safe tool is the major reason breast cancer deaths have declined by 30% since 1990, when screening guidelines were enforced in the U.S. And since breast cancer found in women under age 50 is often more aggressive, it s imperative to schedule your mammogram every 12 months.

4 Why You Should Start A Mammogram Routine at Age 40 While any health decision is a personal one that involves weighing risks and benefits, most health organizations and breast health experts, including Charlotte Radiology, fully support the American Cancer Society s recommendation advising annual screening mammograms starting at 40. As one of the largest breast cancer screening programs in the country, Charlotte Radiology s patient data supports this recommendation. We analyzed 12 years of data and found that of the breast cancers detected using screening mammography, more than 20% were found in women ages 40-49; which is 1 in 5 women. The November 2009 U.S. Preventive Services Task Force report left many women confused about when they should get their mammogram. This report announced that women age no longer need to be screened for breast cancer and that women over 50 only need screenings every second year. The Task Force report has been criticized by many experts, and its conclusions are contradicted by many clinical studies done in the United States and abroad that prove the benefits of mammography.

5 Some specific flaws are outlined below: The Task Force did not involve breast cancer experts in their studies (such as breast surgeons, oncologists, and radiologists). They used data from older and poor quality studies that included poor mammography techniques and outdated technology, significantly biasing the results. They did no direct research, but used computer models to estimate screening mammography benefits at various ages. This approach is less reliable than the gold standard used for most medical research a randomized, double-blind study measuring actual outcomes. Their results directly contrast those found in carefully designed trials showing significant mortality reduction due to screening women ages 40+ and improved treatments. The Task Force overstates the harms of screening mammography, suggesting that additional testing may cause anxiety and inconvenience. They ignore the anxiety a woman may face by being deprived of needed cancer screening or the burdens and costs to a woman who develops a later stage, more lethal cancer requiring more extensive treatments due to the lack of early detection. The Task Force suggests only screening women under 50 with a family history. However, approximately 75 % of women diagnosed with breast cancer have no family history of the disease. Limiting screening to those with risk factors will not detect the majority of breast cancers.

6 What is a Mammogram? A mammogram is a low-dose x-ray exam of the breasts. A screening mammogram is appropriate for women ages 40 and older, who have no breast problems or concerns. If performed annually as recommended, it is the key to detecting breast cancer early and saving lives. If you are called back after your screening for a diagnostic mammogram, do not be alarmed. Often times more views are needed in order to make an accurate diagnosis. If you notice a lump, changes in the breast skin, nipple discharge, or have a personal history of breast cancer you should contact your physician to be scheduled for a diagnostic mammogram. Charlotte Radiology is recognized as a Breast Imaging Center of Excellence, and our facilities are accredited by the ACR. Experience matters To get an accurate mammogram reading, you need a high-quality image and a good interpretation of that image. One factor that may affect accuracy is the experience of the radiologist who reads the mammogram. At Charlotte Radiology, we believe annual, quality mammograms are the cornerstone of breast health. This foundation begins with an impressive staff of board-certified physicians and technologists who specialize in mammography and

7 have all of the latest technologies at their fingertips. By continuously offering compassionate care combined with the most advanced equipment available such as digital mammography, breast MRI and computer-aided detection, we are the first choice for more than 85,000 women a year. What to Expect Your mammogram will be performed by a mammography-certified, female technologist. The exam takes less than 30 minutes. You are asked not to wear body powder or deodorant; two-piece clothing is more convenient. After you check in, you will be escorted to a private dressing room, where you will be asked to undress from the waist up. You will be given a gown that opens in the front. The technologist will ask you several questions, so she can better understand your breast health history or concerns. Multiple pictures are taken and during each x-ray the technologist will gently position your breast between two plastic compression paddles on the mammogram unit each lasting only a few seconds. It should not be painful, but may be uncomfortable if your breasts are very sensitive, or you are having a problem with tenderness or swelling. To reduce tenderness, have a caffeine-free diet for several days before the exam. The compression will not harm your breast in any way and is important in obtaining a good image for evaluation. You must hold very still while the x-ray picture is taken to reduce the possibility of a blurred image. When the exam is complete, the technologist will assure the images are high quality and will escort you back to your dressing room.

8 When will I Receive Results? After your screening mammogram, a radiologist specialized in mammography will review your images. A written results report will be sent to you and your physician within two weeks. If you have had a previous mammogram at a facility other than Charlotte Radiology, please let us know so we may obtain these films. It is extremely important for the radiologist to have prior films for comparison, as it enhances the doctor's ability to detect subtle changes on your current mammogram. A member of our staff will contact you personally if you need a diagnostic mammogram to further evaluate an area of concern. During your diagnostic appointment, a radiologist will meet with you to discuss results and further recommendations if needed. Our radiologists also utilize Computer-Aided Detection (CAD) to assist in their review of your mammogram, as CAD has been shown to increase the ability to detect breast cancer. The Effectiveness of Mammography While mammography is the best screening tool for breast cancer available today, mammograms do not detect all breast cancers. Overall, mammography is about 85-90% effective at detecting breast cancer (considering all age groups). The overall effectiveness of mammography increases with age, but advances in technology like digital mammography have improved sensitivity in younger women. Regular clinical examination by a health care professional is also an important aspect of early detection.

9 Approximately 10% of women are called back from screening mammograms for additional views (also called a diagnostic mammogram). This is necessary in order to complete the evaluation and make an accurate diagnosis. In some cases a biopsy may also be needed to determine whether an area of concern is benign. 80% of breast lumps are non-cancerous. Lastly, the radiation dose used for mammography is very low, and there is no evidence that this level of exposure causes harm. The amount of radiation is similar to the amount from an airplane flight of a few hours due to the thinner atmosphere not something we typically worry about. To receive the best possible benefits for mammography, follow the annual guidelines and find a quality facility that is accredited by the American College of Radiology, has specialized physicians and technologists, and the latest technology such as digital mammography.

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11 Schedule Your Mammogram Today Schedule your mammogram at a Charlotte Radiology Breast Center location near you. Visit us at to schedule your mammogram or call / Toll-free AdBel Medical Plaza 1401 Matthews Township Parkway, Suite 310 Matthews, NC Ballantyne John J. Delaney Drive, Suite 130 Charlotte, NC Medical Center Plaza 1001 Blythe Boulevard, Suite 103 Charlotte, NC CMC-Northcross Statesville Road, Suite 110 Huntersville, NC Pineville Medical Plaza Park Road, Suite 280 Charlotte, NC Gastonia South New Hope Road Gastonia, NC Morehead Medical Plaza 1025 Morehead Medical Drive, Suite 150 Charlotte, NC Piedmont Park 197 Piedmont Boulevard, Suite 110 Rock Hill, SC Randolph Road 1960 Randolph Road, Suite 200 Charlotte, NC CMC-Morrocroft 4525 Cameron Valley Parkway, Suite 1000 Charlotte, NC CMC-Union Medical Plaza 1550 Faulk Street, Suite 1200 Monroe, NC University Medical Park 101 W.T. Harris Blvd, Suite 2122-A Charlotte, NC 28262

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