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Dr. Karen Goodhope, St. Luke's Hospital

Five things women should know about mammograms

From mixed messages about when to start getting a mammogram and how often, to fears it might be painful, there are various reasons women may not get this important breast cancer screening when they should. As we recognize Breast Cancer Awareness Month, it is important women understand that screening mammography saves lives and mammograms have been the gold standard in breast cancer screening for decades.

Five other key things women should know about mammograms:

1. What is the difference between a screening and diagnostic mammogram?
A screening mammogram is performed for women with no signs or symptoms of breast cancer. A diagnostic mammogram is recommended for women experiencing symptoms such as a lump, breast pain, nipple discharge, or skin or nipple changes.

2. At what age should a woman start getting mammograms?
The American Cancer Society and the American College of Radiology recommend beginning annual screening at age 40. If there is a family history of breast cancer, earlier screening may be recommended by a woman's doctor.

3. Why do women sometimes have to go back for additional testing after a mammogram?
When reviewing the screening mammogram, the radiologist may see something questionable. In order to clarify the results and rule out any issues or determine if more testing is warranted, a woman may be asked to have additional mammograms or a breast ultrasound.

4. Is a mammogram painful?
A mammogram should not be painful. Compression is used during a mammogram to ensure the patient remains perfectly still and to improve the quality of the image. If the compression is uncomfortable, a woman should inform the technologist at the time of her exam.

5. What does dense breast tissue on a screening mammogram mean?
Dense breast tissue can make a mammogram more difficult to interpret. If a woman's tissue is dense, her doctor may recommend additional studies such as breast MRI or ultrasound, depending on her personal risk factors. Many states have passed legislation requiring that women be notified about their breast density. Although Missouri has considered this type of legislation, no law has been passed to date. For more information about this, a woman should consult with her doctor or ask at the time of her mammogram.

Dr. Karen Goodhope is a breast radiologist at Midwest Breast Care - an affiliate of St. Luke's Center for Diagnostic Imaging. For more information, visit the Mammography Services page.

This article was published in the St. Louis Post-Dispatch on October 3, 2013.