What every woman should know about Screening Mammograms
What is breast screening? Regular examination of a woman s breasts to find breast cancer early. It includes mammography (breast X-ray) and a physical examination of the breasts by a doctor or a nurse. What is a screening mammogram? A mammogram is a low dose X-ray of the breast. The X-ray can find changes in the breast, even when the changes are too small for you or your doctor to feel or to see. For most women, the X-ray results will be normal. Why have a screening mammogram? In Ontario, breast cancer is the most common type of cancer in women. As women get older the chance of getting breast cancer rises. Mammograms can help to find small breast cancers before there are signs and symptoms. If breast cancer is found at an early stage there is a high rate of successful treatment. As well, for many women, finding cancer early may allow for more treatment options, such as breast conserving surgery or less aggressive treatment.
When should women have screening mammograms? In Ontario, it is recommended that women aged 50 and older have a screening mammogram, generally every two years. Evidence shows that women aged 50-69 benefit most from regular mammograms. The evidence for mammography for women aged 40-49 is not as strong as for women aged 50-69. Therefore, in Ontario it is recommended that women in their forties talk to their doctor to make a personal decision. The time to go for screening is when you do not have any breast problems. If you are ever worried about any breast problem, see your doctor. What will happen during the mammogram? You will stand in front of an X-ray machine specially designed for mammograms. The technologist will place your breast on a plate that holds the X-ray film. A second plate will slowly come down on top of your breast to spread out your breast tissue. This allows the technologist to get a clear picture of your breast with the lowest dose of radiation. You will feel some pressure on your breast, but only for a few seconds while the mammogram is being taken. This pressure does not harm your breast tissue. Four X-ray pictures will be taken, two of each breast. The technologist will review the pictures to make sure they are of good quality. If needed, she will take extra pictures. How does it feel? You will feel some pressure on your breast. It feels similar to a tight blood pressure cuff. A few women experience some pain but it lasts for only a few seconds. If you feel pain during the X-ray, tell the technologist. She may be able to adjust the pressure. The two of you can work together so you are as comfortable as possible.
Some tips Most women s breasts are tender the week before and after their period. Book your mammogram for a time when your breasts are not so tender. Some women take a mild pain relief pill, such as the kind you would take for a headache, about one hour before the appointment. Only do this if it will not affect any other medicines or any health concerns you may have. Some experts suggest having less caffeine for two weeks before the appointment to help reduce tenderness. Where should you go to have a mammogram? To ensure you receive a good quality mammogram, go to a site that has been accredited by the Canadian Association of Radiologists (CAR) Mammography Accreditation Program. All Ontario Breast Screening Program (OBSP) sites have CAR accreditation. To find a CAR-accredited site, visit www.car.ca or call the Canadian Cancer Society Cancer Information Service at 1-888-939-3333. What is the Ontario Breast Screening Program? The Ontario Breast Screening Program (OBSP) is a program of Cancer Care Ontario. It provides top quality breast screening services for women 50 years of age and older. It is free-of-charge for women. The OBSP provides: High-quality mammograms in CAR-accredited sites; Physical exams of women s breasts by specially trained nurse examiners (at some locations); Female nurse examiners and technologists; Results of the screening appointment within two weeks to both you and your doctor; Help to set up extra tests or referrals if your results suggest that they are needed; and A reminder letter when it is time to return for your next screening mammogram. Usually, this is every two years. Women over the age of 74 do not receive a reminder letter. However, they are welcome to call for an appointment after they have discussed it with their doctor.
How to make an appointment at the OBSP Women aged 50 and older can: call to make their own appointment at 1-800-668-9304, or be referred by their doctor. What should you do to prepare for your mammogram? Wear a two-piece outfit so you will only have to remove your top. Do not use deodorant, body lotions, or talcum powder under your arms or near your breasts. These products can show up on the mammogram. If you think you might need help in understanding information, you can ask a family member or friend to come to the appointment with you. What does it mean if more tests are needed? About one out of ten women will need more tests because their mammogram is not clearly normal. The OBSP or your doctor will help set up these tests. Nine out of ten women needing more tests will not have breast cancer. In most cases, the follow-up tests are either special mammography views and/or breast ultrasounds. Sometimes, other procedures such as biopsies are needed. What about digital mammography? Like regular mammography, digital mammography uses X-rays to find small cancers. The breast is compressed for the same length of time. Digital mammography displays images on a computer rather than on film. Digital mammograms can be helpful for screening women with dense breasts. How effective are screening mammograms? Mammograms are the best way to find breast cancer early. But, they are not perfect. They may miss some cancers. However, many studies show that regular mammograms reduce the risk of dying from breast cancer. 1 Some cancers that appear on a mammogram may never progress to the point where a woman has symptoms during her lifetime. Therefore, some women may have surgery or treatment for a breast cancer that would never have been life threatening. Not all cancers found at screening can be cured. However, most women (more than 95 percent) are alive and well five years after early detection and treatment of breast cancer. 1 World Health Organization (2002). IARC Handbook for Cancer Prevention, vol. 7. Breast Cancer Screening. IARC Press. Lyons.
Are mammograms safe? Yes. Mammograms are done using small amounts of radiation. What some OBSP clients have to say: The staff is efficient and considerate. They made me feel comfortable having the mammogram. The staff is wonderful. I was nervous and they made me laugh and feel very comfortable. This resource is jointly produced, funded and distributed by the Canadian Breast Cancer Foundation Ontario Region and the Ontario Breast Screening Program. Canadian Breast Cancer Foundation As the leading national volunteer-based organization dedicated to creating a future without breast cancer, the Canadian Breast Cancer Foundation works collaboratively to fund, support and advocate for relevant and innovative breast cancer research; meaningful education and awareness programs; early diagnosis and effective treatment; and a positive quality of life for those living with breast cancer. For more information about the work of the Foundation s Ontario Region, please visit www.cbcf.org/ontario Early detection saves lives To request more copies of this booklet, please contact: The Canadian Breast Cancer Foundation Ontario Region Toll-free 1-866-373-6313 or resourceson@cbcf.org The Ontario Breast Screening Program Toll-free 1-800-668-9304 or www.cancercare.on.ca The Canadian Cancer Society Cancer Information Service at 1-888-939-3333 Distributed with the help of the Canadian Cancer Society 271128
Did you know? Because of early detection and better treatments the death rate for breast cancer in Canada is at its lowest since 1950. Only 11 per cent of women with breast cancer (one out of nine) have a family history of the disease. Eight out of 10 breast cancers are found in women aged 50 or over. What can you do? Know how your breasts normally look and feel. Know what breast changes to look for, such as: a lump or dimpling, changes in your nipple or fluid leaking from the nipple, skin changes or redness that do not go away, any other changes in your breasts. Look and feel for changes. If you notice any changes, see your doctor. Most changes are not cancerous but you should have them checked right away. Have a physical breast exam by a doctor or nurse as part of your regular health check-up. If you are 40-49, talk to your doctor or nurse about having a mammogram. If you are 50 or older, go for a free mammogram at the Ontario Breast Screening Program. To learn more or to make an appointment at the site nearest you, call the Ontario Breast Screening Program toll-free 1-800-668-9304 or visit www.cancercare.on.ca 11/08