Q & A with Christine Pellegrino, MD: Mammograms

Q: What is a mammogram? Do mammograms hurt?
A mammogram is an x-ray image of the breast. Radiologists review mammograms to look for suspicious areas that need further evaluation. If you have an abnormal mammogram, you may need additional testing or a breast biopsy so pathologists can examine your breast tissue to confirm or rule out cancer. The good news is that most biopsies are negative, which means that most women who have this test do not have breast cancer. During a mammography screening, a technician will compress your breast between two “paddles” to get the best x-ray images possible. It can be uncomfortable, but most women don’t experience intolerable pain. The key to being more comfortable is to relax. And remember, one slightly unpleasant moment can help catch abnormalities before it is too late.

Q: I don’t have a family history of breast cancer. Do I still need a mammogram?
Yes, if you’re over the age of 40 it is crucial to have an annual mammogram. Mammography screenings can save your life because they help your doctors detect breast cancer in the early stages when treatment is more effective. Also, the mammogram you have at age 40 will serve as your baseline screening. It shows doctors how your “normal” or healthy breast tissue looks, so if changes occur later, they will be more detectable by comparison.

Q: When and how often should I have mammograms?
Again, you should have a baseline mammogram by age 40, but you should talk with your doctor about your breast cancer risk long before then. If you have a strong family history of breast cancer or you’ve already had breast cancer, your doctor may recommend earlier and more frequent breast cancer screenings. I also recommend that women perform monthly breast self-examinations, so they become more familiar with their breast tissue and can let us know if they notice any changes.

Q: I’ve put off having a mammogram. Is it the only option for breast cancer screening?
Mammography screening is the most commonly used breast cancer screening for women who are at average risk for breast cancer. We may use ultrasound studies or magnetic resonance imaging (MRI) scans when we don’t get enough information through regular mammography screenings or we’re evaluating women at very high risk for breast cancer.

Q: What is the difference between digital and film mammography?
Digital mammograms do offer some advantages over traditional film mammograms. Radiologists can change the resolution or enlarge specific areas of digital images to get a better view of suspicious areas. We also use computer-aided detection software with digital mammograms. This technology flags suspicious areas for radiologists. While digital mammograms may be more effective in younger women who have dense breast tissue, we often recommend film mammograms for older women whose breasts tend to be less dense.