Mammogram Myths: Dispelling Common Misbeliefs About Breast Cancer Prevention

In a year that’s made all of us think a great deal about our health, one point that’s become clearer than ever is the importance of routine checks and preventive care.

As we kick off Breast Cancer Awareness Month in an unprecedented year, we realize that many women have experienced uncertainty about mammograms. If you’ve put off a routine mammogram for any reason at any time, our professionals are taking no excuse (and doing so with care) as they fact-check the misconceptions they most commonly hear from patients about mammograms.

MYTH: Breast cancer doesn’t run in my family, so do I really need a mammogram every year? “As the nurse navigator at Breast Care Services, I often hear patients think that there must be a family history of breast cancer in order for it to be a concern for them—so not true,” says Michelene Schwabenbauer, RN, of Penn Highlands DuBois.

FACT: Dr. Suzanne Iorfido, breast radiologist at Penn Highlands DuBois, says a remarkable 75 percent of women diagnosed with breast cancer actually have no family history of the illness. Iorfido explains that the only real way to know your risk is to through a mammogram. “We recommend mammograms annually so we can find breast cancer early, before it can be felt by the patient or their doctor on a breast exam,” Iorfido says. “When found early, breast cancer is more easily treated, and the patient tends to do better overall.”

Iorfido describes the newest type of mammogram, a 3D mammogram, which is also called “breast tomosynthesis.” This is a technology that allows radiologists to diagnose breast cancers “when they are even smaller and more subtle than ever before,” Iorfido says. “Ultrasound and breast MRIs are additional exams that can be used to further evaluate the breasts for potential areas of concern.”

MYTH: Mammograms use harmful levels of radiation.

FACT: “Mammograms are a type of X-ray, so they do use radiation,” Iorfido says, “however, it is a very small amount.” Adds Karl Nichols, Diagnostic Imaging Director at Penn Highlands Brookville: “Everyone is exposed to natural radiation every day.” Also known as “background radiation,” Nichols says this can come from exposure to our electronics, as well as radon, solar, and cosmic radiation.

Meanwhile, Iorfido assures us that modern mammogram technology is able to produce very high-quality images with very little radiation—“so the benefits of finding a potential cancer far outweigh any potential risk,” she says. “To put this in perspective, having a mammogram is equivalent to what we experience from just living normally in our natural environment for a seven-week period; or, as another example, the radiation we would get from taking one cross-country flight. In other words, have no fear!” Iorfido also offers assurance that facilities offering mammograms are regulated very tightly to ensure they’re being performed optimally by multiple national governing bodies, including the FDA.

MYTH: I get breast ultrasounds. Why do I have to have mammograms too?

FACT: Nichols explains that ultrasounds of the breast are often used together with mammograms to ensure the doctor sees everything he or she needs to—but they show different things and are not a substitute for mammograms.

MYTH: Breast cancer hurts—so if I don’t feel pain, then I must not have cancer.

FACT: “Most breast cancers are not felt, let alone hurt,” says Schwabenbauer. And for the mammogram itself, if a beloved elder has warned you about the discomfort factor—however well-meaning they may have been—these days, many women simply don’t have that experience. One 40-year-old patient reflects on her first mammogram, which was done this year at Penn Highlands DuBois. “I was amazed at how painless it was—not like the way I’d heard a woman in my family describe the process.” The best news of all is that while the latest machines are careful to mind a woman’s comfort, they’re also more effective not only at identifying potential problems, but at helping a woman understand more about her body. What do we mean? Keep reading.

MYTH: The only point of a mammogram is to spot a potential tumor. It’s scary to show up every year when there’s a possibility I’ll get bad news.

FACT: Dr. Kelly Snyder, obstetrician/gynecologist at Penn Highlands Life’s Journey, says mammograms, like routine self-exams, are useful in helping women simply to get to know our bodies better. These routine practices aren’t just for identifying problems—they also help us see and feel our body’s own baseline for what’s healthy so we can monitor for anything to change later in a way that’s concerning. Many patients come away from their mammogram better understanding which of the four categories of breast density they have, which can be beneficial wisdom. That’s because women with 50 percent or more breast density on a mammogram may be significantly more likely to receive a breast cancer diagnosis within 15 years than women in the lower categories of breast density.

MYTH: I had breast implants so I cannot get a mammogram, or it will somehow damage the implant.

FACT: Schwabenbauer says that whenever a patient presents with implants, the mammogram machine takes two sets of pictures. “The first set is to basically check the implant to confirm that it is intact,” Schwabenbauer says. “These pictures are completed with minimal compression—just enough to hold the implant in place for the picture. The second set of pictures are taken of the breast tissue itself. The implant is positioned so that as much of the breast tissue can be captured in the picture.”

MYTH: I’ve already had one “normal” mammogram, so I don’t see the need to keep having them.

FACT: Says Penny Shope, Breast Health Coordinator and Lead Mammography Technologist at Penn Highlands Huntingdon: “It is very important to have a baseline mammogram at age 40. This will establish a reference point for all future breast imaging.” Shope adds that from that point, annual screening mammograms are necessary because “breast tumors and breast cancers develop at different rates, and some breast cancers are very aggressive.” She says some women wait years or even decades between mammograms, and then they present with a lump that turns out to be a large spiculated mass that affected large lymph nodes. “These lesions most definitely would have been picked up years ago, long before the cancer became metastatic,” Shope says.

At Penn Highlands Healthcare, we are here to catch it early so we can cure it effectively. This month we’re bringing you breast cancer news you can use—and not just for women, as we’ll explore next week. To schedule your scan, visit www.phhealthcare.org/pink.