Breast cancer screening and diagnosis
When you see a pink ribbon, do you automatically think of breast cancer? Many organizations have done a great job raising awareness for the most common type of cancer among women.1 In fact, maybe you know at least one person who has been diagnosed. It can be scary stuff. So, it’s important to know the ways we can check our bodies and stay on top of our health. The phrase “better safe than sorry” may ring true when it comes to taking a preventive approach to finding cancer.
The key to early detection and diagnosis is knowing which breast cancer tests and screenings are available, and which one may be best for you. You can think of breast cancer tests in two ways: preventive (before or without any symptoms) and diagnostic (after a sign or symptom occurs).
Not a common conversation topic, is it? But talking about it can be a way to make a difference. Reminding the important ladies in your life to get their regular mammograms (or breast cancer screenings) shows you care about their well-being. After all, the appointment itself may not be all that bad. A mammogram is an X-ray of the breasts that checks for any unusual looking tissue or lumps. It can help find early signs of cancer that you or your doctor may not be able to see or feel.2 Think of it like a dentist appointment. You see your dentist regularly to check for cavities, right? (We hope.) Well, a mammogram is like a regular check-up for your breasts.
What’s the difference between a screening and diagnostic mammogram?
There are two types of mammograms: screening and diagnostic. After talking through your health history and risk factors with your doctor, they may tell you which kind of mammogram to get.
This is your standard go-to if you may be at average risk for breast cancer with no obvious signs or symptoms of a breast condition. If you schedule routine mammograms as a preventive screening, this may be the type of mammogram you’ll have.
If you’ve had an abnormal screening mammogram or may have signs of a possible breast condition (like a lump, pain, discharge, thickening breast skin, or changes in breast shape or size) you’ll likely get a diagnostic mammogram. Your doctor might also order this for any special circumstance, like if you have breast implants. Many implants may make it more challenging to see every part of breast tissue, so more images may be needed to get the full picture. This kind of mammogram provides a more detailed X-ray than a screening mammogram and may take a little longer, so be sure to plan accordingly.
You can typically expect to get your mammogram results within a few weeks. If you don’t hear from your doctor within a month, give your mammogram clinic a call.3
This is an option that may provide a clearer image of breast tissue compared to a standard 2-D screening mammogram. (You can put your red and blue 3-D glasses away, it’s not that kind of 3-D.) This type of mammogram may combine multiple X-rays to help create a three-dimensional picture of your breasts.
This may be the best option if you have dense breasts because both dense tissue and cancer tissue show up white on a standard mammogram. So, it might be hard to tell the difference between normal breast tissue and abnormal (possibly cancerous) tissue. This is why a false-negative could happen. A 3-D image may let doctors see more than just density, which may lead to a more accurate diagnosis. Like a diagnostic mammogram, this type of mammogram might also be a good option if you have breast implants.
Are mammograms covered by insurance?
Screening mammograms used for preventive care are generally covered by insurance. (In fact, most preventive cancer screenings are.) But because a diagnostic mammogram is used to, well, diagnose something, you may have to pay a copay or coinsurance, depending on your insurance plan.4 Sign in to your health plan account to check your benefits, especially your preventive benefits, and learn about your plan coverage for this type of screening.
Clinical breast exam and breast self-exam
You may notice that at your yearly physical, your doctor does a quick breast check. During this hands-on exam, your doctor may check for any warning signs (like lumps or skin abnormalities) on your breasts, nipples, underarm and collarbone. The lymph nodes near your breasts may also likely be checked to make sure they’re not enlarged. If something doesn’t feel right, your doctor may make a note and likely get you scheduled for a diagnostic test, like a mammogram, ultrasound or MRI.5
Perhaps the most important thing you can do is know your body and check it regularly. Check yourself once a month, know what you’re looking for, and stay calm if you notice something new. Keep in mind, fibroadenomas are common noncancerous breast lumps. So, if you feel a little lumpy, don’t panic. Keep a journal of your self-exams and share it with your doctor as part of your overall preventive strategy.6, 7
Breast ultrasound and MRI
If anything suspicious pops up during a breast exam or screening mammogram, your doctor may want you to get a breast ultrasound. This scan generates a more detailed picture of what’s going on inside the breast tissue. The sonogram shows whether the lump that was found during your exam is a cyst (usually noncancerous), solid mass (possible tumor), or a little bit of both.8
For certain high-risk women, a breast MRI along with mammography may be the right combination of tests. You may be considered high risk if you have the gene associated with breast cancer, a first-degree relative who has had breast cancer, or if you’ve had radiation treatment on your chest. A breast MRI is just like any other MRI. Except you’d be lying face down inside that big, noisy MRI machine. (Which honestly may feel better than face up.) 9
What happens after a diagnosis?
If results from any of the diagnostic screenings confirm a suspicious looking lump, the next step may be to have a biopsy to test the breast tissue for cancer. (It’s the only sure way to confirm an accurate cancer diagnosis.) If that biopsy comes back positive for cancer, then you may start to talk about treatment options and monitoring tests with your doctor.10
Who should I talk to if I’m concerned about breast cancer?
Once you turn 40, you can ask your primary care provider (the doctor or provider you might see for your yearly exam) about getting regular screening mammograms. Or, if you’re younger than 40 and found something suspicious during a self-check, schedule an appointment with your doctor to discuss. Be sure to visit the provider who has performed your clinical breast exams in the past, whether that’s your primary doctor or gynecologist. Depending on your age, health and risk factors for breast cancer, you and your doctor may decide on the next steps to take. Keep in mind, you don’t need a doctor’s note to schedule your preventive screening mammogram. Feel empowered to make the health care choices that may be right for you and your body.11
- Breast Cancer Facts & Figures cancer.org, 2020.
- Diagnostic Mammogram nationalbreastcancer.org, 2020.
- What is a Mammogram? cdc.gov, 2020.
- Free Breast Cancer Screening & Prevention webmd.com, 2020.
- Clinical Breast Exam nationalbreastcancer.org, 2021.
- Breast Self-Exam breastcancer.org, 2019.
- Fibroadenoma - Symptoms and causes mayoclinic.org, 2020.
- Ultrasound nationalbreastcancer.org, 2021.
- Breast Magnetic Resonance Imaging (MRI) hopkinsmedicine.org, 2021.
- Breast cancer - Diagnosis and treatment mayoclinic.org, 2020.
- Cancer Screening Guidelines cancer.org, 2020.