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Posted: October 5, 2013 5:08 p.m.

Mammograms vital for women over 40

Since October became Breast Cancer Awareness Month almost 30 years ago, pink has most certainly found its way into the spectrum of colors — the oranges, golds and browns — associated with autumn.

Stores are filled with pink scarves, pink cellphones and pink housewares, all designed to raise money, yes, but also to remind women, busy as they are juggling the demands of families and careers, of the importance of taking the time and effort to take care of themselves.

And, though women might sometimes feel overwhelmed by the plethora of pink and the swirl of statistics that are as certain as sweater weather in October, there are some statistics that Dr. Amanda Bauer, diagnostic radiologist at the Newton Medical Center’s Women’s Diagnostic Center, never tires of repeating: In cases that don’t involve the lymph nodes, women who have breast cancers detected by mammograms have a 99 percent 5-year survival rate.

Early detection is the key to saving lives. Nationally, doctors detect one cancer case in every 200 mammograms read, Bauer said.

That’s why the American Medical Association, the American College of Obstetricians and Gynecologists, the American College of Radiology, the American Cancer Society, the National Cancer Institute, and the National Comprehensive Cancer Network are in agreement that, beginning at age 40, women with an "average risk’’ of breast cancer should have annual screening mammograms. It’s also why the vast majority of states have laws mandating that insurers provide at least some coverage for mammograms for women ages 40 and up.

And many insurers, in fact, require that women in that age group get screening mammograms as a condition of continued coverage.

In screening mammograms, Dr. Bauer said, there typically are four images taken, two of each breast. And it’s important to get those "baseline" images as soon as a woman reaches age 40, so that future mammogram images can be compared to the baseline.

Bauer said women should have mammograms annually from ages 40 through 80, and in some cases, if a woman is in good health and active, even beyond age 80.

Why should women typically wait until age 40 for mammograms? Bauer said that’s typically when risks begin to rise and breast tissue begins to thin, allowing mammograms to detect cancers.

When other risk factors are present, however, such as a strong family history of breast cancer, a close relative who has had ovarian cancer, or when a woman feels a lump, earlier screenings are needed.

In fact, Bauer said that if a woman has had a close relative — a mother or sister — who was diagnosed with a pre-menopausal breast cancer, doctors often recommend that screening begin 10 years before the age that the relative’s cancer was detected. In other words, if a woman’s mother or sister was diagnosed at age 39, the woman might be urged to begin having mammograms at age 29.

On the other end of the age range, Bauer stresses that it’s never too late to begin having mammograms. She recalls one of her patients who was in her 60s: "healthy, active, and never saw the need.’’ The patient’s first mammogram detected a very large, but "not very aggressive’’ cancer that had been growing for years. Because she had not had mammograms, it had grown to the point of "interfering with her quality of life and possibly length of living,’’ Bauer said.

Other important things to know:

• When a screening mammogram detects an abnormality, what typically follows is a "diagnostic’’ mammogram, at which more images will be taken from more angles. That’s why a diagnostic mammogram takes more time. A doctor will be in attendance, Bauer said, to determine immediately if further steps such as a biopsy are warranted. Diagnostic mammograms will also be taken when a woman at any age detects a lump or shows others signs that might indicate breast cancer.

• The radiation exposure is minimal. Bauer said the radiation in a four-view screening mammogram is "much less than the amount you receive by just walking around this planet."

• An unusual result requiring further testing does not mean that a woman has breast cancer. According to the American Cancer Society, about 10 percent of women who have a mammogram will require more tests. Only 8-10 percent of that 10 percent will need a biopsy, and about 80 percent of the biopsies will turn out not to be cancer.

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