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[00:00:50] From Susan G. Komen, this is Real Pink, a podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room.
[00:01:03] Whether you’ve had a mammogram or are preparing to have your first mammogram, chances are that you’ve heard a myth or two that might make you nervous about this important annual screening test. Here with us today to debunk some of the most common mammogram myths is Erica Kuhn, Komen’s Sr. Manager of Health Information & Publications. Welcome to the show, Erica!
[00:01:26] Erica Kuhn: Thanks so much for having me. I’m really happy to be here with you today.
[00:01:30] Adam Walker: I’m glad to have this conversation. I know there’s a lot of myths out there. I’ve actually talked with my wife pretty extensively about this as well. So while I don’t have much firsthand knowledge, I’ve got some conversations under my belt. Let’s create another conversation about this. Let’s start with the basics. What is a screening mammogram and why is it such an important test?
[00:01:53] Erica Kuhn: Yeah, so that’s an excellent question. So mammography is a test that uses X-ray images to create images of the breast, and those images are called mammograms. So a radiologist is a special doctor who reads those images and looks for signs of breast cancer. In the past, mammogram images restored on film, but nowadays they’re stored on a computer, which is nice because the images can be lightened or darkened or looked at more closely. And this is called digital mammography. Today, actually, most women get what’s called a digital breast tomosynthesis, or better known as a 3D mammogram. So screening mammograms are used to find breast cancer in people who don’t have any warning signs or symptoms. So this is such an important test because overall mammography is the most effective screening tool used today for most women. So when breast cancer is caught early, the chances for long-term survival are highest. And so screening mammograms, you know, can really lower a person’s chance of dying from breast cancer.
[00:02:55] Adam Walker: That’s great. Thank you for kind of giving that overview. That is actually more information than I knew about mammograms. Which is of course, while we’re having this conversation. So, there are a lot of myths about mammograms. Let’s debunk a few of those today. I’m just going to run through them and you can just kinda talk about each one if you don’t mind. So the first myth is breast self exams are as effective as mammograms. I feel like this is pretty obviously not true, but I’m going to let you talk about it first.
[00:03:24] Erica Kuhn: Yeah, this is definitely not true. So breast self exams are not a recommended screening task for breast cancer. So while it seemed promising when it was first introduced, breast self exams or BSE, they don’t reduce mortality or death from breast cancer. So studies show that when women who do routine breast self exams, so that’s a prescribed set of steps that they do. You know, on a certain day they don’t reduce breast cancer death. And also, women who did them compared to who didn’t, had more false positive results. So that means that they found something, but it wasn’t actually breast cancer. So, as I said before, mammograms are the most effective screening tool we use today to find breast cancer.
[00:04:10] Adam Walker: So, all right. So with what you just said, I just want to make sure I understand. Does that mean that there is not a need for self-exam? Or there should be self-exam and mammograms as well?
[00:04:20] Erica Kuhn: So we recommend that women are aware of their breasts. They know they’re normal, but there’s no, we don’t recommend monthly BSE or that prescribed step of steps.
[00:04:33] Adam Walker: Okay. Got it. And I’ve talked to a lot of women that talk about like knowing their normal and recognizing when things are not normal and therefore going and getting screened at that point. And so I like that, that concept of like, know you’re normal. And maybe part of that is a kind of a self-exam or maybe not. Okay. So, so the next one is, I don’t have any symptoms of breast cancer or a family history, so I don’t need to worry about having an annual mammogram, righ?. That makes good sense. Not really at all. No.
[00:05:06] Erica Kuhn: So most major health organizations, you know, agree that screening mammography lowers a women’s risk of dying from breast cancer. So, like I said, screening mammograms are used for women who don’t have any signs or symptoms. So this is exactly the time that you need to be getting a mammogram. So they can find cancer at an early stage, so before it can be felt. And remember, when breast cancer is found early, there are more treatment options. And then again, the chances for survival are highest.
[00:05:34] And so I think you mentioned family history. So again most women diagnosed with breast cancer actually don’t have a family history of breast cancer. About more than 85% of women with breast cancer don’t have that direct family history. You know, most people diagnosed with breast cancer are at average risk, and we don’t know what caused that cancer to develop. So, that’s why it’s really important for all women to be aware of other risk factors and again, to work in partnership with their healthcare provider to follow a breast cancer screening plan that’s right for them based on their age and level of risk.
[00:06:09] Adam Walker: You know, I love how you’ve framed that. That a mammogram is really for people that ideally don’t have any symptoms at all. Like that’s the purpose of it to start with. So, that’s a really sort of interesting take on that. I don’t think I’ve thought of it that way. So the next one, if you find a lump in your breast, it means you have cancer. What do you have to say about that one?
[00:06:31] Erica Kuhn: Yeah, no, absolutely not. So of course, you know, it’s very concerning if you do find a lump or change in your breasts. But actually most lumps are not breast cancer, but often, sometimes something less common or less serious, such as a benign breast condition.
[00:06:46] So many women actually have lumpy breasts. You know, breast tissue has a naturally bumpy texture, and if the lumpiness can be felt throughout the breasts, you know, that’s probably fairly normal for a woman. In some cases, lumps are related to a woman’s menstrual cycle, so they may go away at the end of our period.
[00:07:05] But however, any lump or change that is different or harder than the rest of her breast or different than her other breast, it should be checked out by a healthcare provider. So, let me repeat here. So a woman should see a healthcare provider if she finds a new lump or any change that feels different from the rest of her breast, if she finds a new lump or change that feels different from her other breast, or if she feels something different that she’s never felt before. And ultimately if she’s unsure about whether or not she should get it checked, it’s always best to see a healthcare provider. So you have that peace of mind.
[00:07:41] Adam Walker: Okay. So the next sort of myth or maybe objection is mammograms are too expensive to have regularly. What do you have to say about that one?
[00:07:52] Erica Kuhn: Well, fortunately that’s not true as well. So there are lots of resources out there to help you if you can’t afford a mammogram. And Medicare, Medicaid, and most insurance companies now cover the cost of screening mammograms. So, and all plans actually must now cover screening mammograms for women who are 50 and older with no copayment every two years. And then also as recommended by a healthcare provider for women who are 40 to 49. Now, if a woman doesn’t have insurance or doesn’t cover screening mammograms there are resources to help such as Komen’s screening and diagnostic program. And you can visit komen.org or call our breast care helpline at 1-877-GO-KOMEN for more information about this.
[00:08:36] Adam Walker: You know, when I asked that question, I didn’t know for sure, but I had a hunch there was a Komen program that would help with that. So I’m, I was, I’m excited. That’s really good. Okay, so, just a couple more. A mammogram will expose me to unsafe levels of radiation. True or false?
[00:08:53] Erica Kuhn: So a woman is actually exposed to a small amount of radiation when she has a mammogram. But saying that, studies show that the benefits of mammography outweigh the risks from radiation exposure over time. So, and then this is especially true for women over 50. So it’s partially true, but the benefits outweigh the risks.
[00:09:12] Adam Walker: But worth it. It’s partially true, but it’s worth it. Okay next one. Mammograms are painful. What do you say about that one?
[00:09:19] Erica Kuhn: Yeah, we tend to hear this one a lot. But mammograms should not be painful. So yes, the pressure can be a bit uncomfortable, but it only lasts a few seconds. And it shouldn’t hurt. So, a woman should really talk to her doctor or the technologist beforehand to help, you know, any ease concerns that she may have. And sometimes taking Tylenol or Aleve may help beforehand. But pain should never be a reason not to get a mammogram.
[00:09:46] Adam Walker: Okay. And so last objection. Someone might say, I had a normal mammogram last year, so I don’t need another one this year. I feel like that’s a bad idea. Is that, is it? Is it, would you agree?
[00:09:58] Erica Kuhn: Yeah, I would agree with that assessment. Okay. So it’s really important to get those regular mammograms because they provide an opportunity to detect, you know, early changes in the breasts that could be, you know, early breast cancer.
[00:10:11] So again, we know that the earlier breast cancer is found there are more treatment options and potentially less treatment which may result in better outcomes or less side effects. And then sometimes changes happen in between those mammograms. So it’s best to continue getting them regularly. You know, and speaking from experience, you know, I know we’re busy, we’re working, you know, we’re moms of young kids or teenagers running around, so time can get away from us.
[00:10:38] But, you know, it’s really important to take that time for ourselves and get our needed healthcare because it’s, you know, just a really simple test that could save your life. And while it’s great that you had a normal mammogram last year, the risk of breast cancer increases with age. So it’s really important to continue getting those regular breast cancer screenings.
[00:10:57] Adam Walker: I really like what you said. You said a real, it’s a really simple test that can save your life. And that, I mean, that might be the best summary of a mammogram that I’ve ever heard right there. That that’s very well said, because it is, it’s a simple test. It’s relatively short and it absolutely can save your life. That’s so important. So, all right. We’ve established how critical screening is for early detection. Let’s dive in a little bit. When does Komen recommend women start getting breast cancer screening tests?
[00:11:27] Erica Kuhn: Sure. So we recommend that a woman talk with her healthcare provider to understand her risk of breast cancer and then ask, you know, when she should be getting mammograms based on her level of risk.
[00:11:38] So, for example, women who are at higher risk should talk to their healthcare provider about what screening tests are right for them and when they should start. And then again, women at average risk should have a mammogram every year starting at age 40. And then let’s also not forget that women at average risk should also get a clinical breast exam, which is another screening tool.
[00:11:59] And they should get that at least every three years, starting at age 20, and then every year starting at age 40. That test is often performed at a woman’s annual physical or her well woman exam. And if you don’t get one, you know, certainly ask for one. And then one last thing I wanted to mention, you know, I know we’ve been talking a lot about screening mammograms and so if a woman notices a change from normal, it’s important to tell her healthcare provider because.
[00:12:25] Not only is mammography used for screening, but it can be also used as a follow-up test when something abnormal is found on a screening mammogram or you know, during a clinical breast exam or if she notices a change from normal. And that’s called a diagnostic mammogram. And although it’s called diagnostic mammogram, it doesn’t actually diagnose breast cancer. So, but it can show abnormal findings that may need some further testing.
[00:12:51] Adam Walker: Okay. So, so walk me through, sort of this, the process. What can people expect when they go for their mammogram and what are some of the things they can do to be prepared?
[00:13:03] Erica Kuhn: Sure. So, it’s a on the day of your exam, it’s a good idea to wear the shirt that you can remove easily because you’ll need to undress from the waist up. And then it’s really important not to wear any sort of deodorant or perfume or lotion on or around your breasts that day because ingredients in those products can show up on the mammogram and then make it harder for the radiologist to read that mammogram.
[00:13:28] So oftentimes when you go into the dressing room to unchange, there’ll be like alcoholic pads or cleaning wipes that you can use, just in case. And then once you undress, you’ll put on a gown, and then you’ll go out to a waiting room and then you’ll go back into the exam room. And I know one thing that I was really surprised about with the whole experience is how quick it is. You know, if the location is running on schedule, you’re usually in and out within like 30 minutes. And the test itself is, you know, 15 minutes or less, and most of the time is spent really just getting you in the right position. And again, if you’re nervous especially if this is your first mammogram, you know, please talk to the technologist. She can really help ease your fears.
[00:14:11] Adam Walker: Absolutely. So what are the potential findings from a mammogram? And if something abnormal is found, what sort of follow up test can someone expect?
[00:14:21] Erica Kuhn: Yeah, so there are different categories of findings on a screening mammogram. So they could be negative, which is what we all hope for. And that means that there’s no evidence of cancer. There is nothing suspicious or worrisome seen. And then there’s a benign finding category. And this also means that there is no cancer found, but there appears to be a benign finding, like a benign breast condition, such as a cyst or a fibroadenoma.
[00:14:46] And then, there’s a probably benign finding. And that means it’s likely not to be breast cancer, but more follow up is needed. And then there are a couple of categories that show something as suspicious, you know, so something looks like it could be cancer, or it’s highly suspicious of breast cancer. And then finally, there’s an incomplete category, and that just means that there’s more information needed to determine whether or not that finding is abnormal.
[00:15:11] So after all that if the mammogram does show something abnormal or suspicious, then follow up tests include things like diagnostic mammogram, which I mentioned earlier. Again, and it’s just like a screening mammogram, but there are just more views taken. or you may have a breast ultrasound, or in some cases you may have a breast MRI, but typically you start out with a least invasive test first to rule out breast cancer. And only a biopsy can confirm whether or not breast cancer is present.
[00:15:42] Adam Walker: Okay. That’s really helpful. So, what types of resources does Komen offer to provide support for screening and diagnostics? I know you mentioned something earlier, but wonder if you could elaborate a bit more and what should women do if they don’t know where to start?
[00:15:59] Erica Kuhn: Yeah, absolutely. So yeah, we have a wealth of information on our website at www.komen.org. If you look under the about breast cancer section, you can find a whole section dedicated to early detection and screening. And much of what I’ve talked about today can be found there plus so much more. We also have educational resources such as fact sheets and then a questions to ask your doctor resource on screening mammograms. But really if you have questions or you need support or don’t know where to start, I recommend that you again call our Breast Care Helpline and you can reach them at 1-877-GOKOMEN or that’s 1 8 7 7 4 6 5 6 6 3 6. Or you can email them at helpline@komen.org. And all calls are answered by a trained specialist or oncology social worker. And you can reach them Monday through Friday from 9:00 AM to 10:00 PM Eastern time. And they can really provide information and possibly access to no-cost screening mammograms or diagnostic services to income eligible applicants in certain areas. And they can also help you connect to a patient navigator if needed. The helpline team is the best, so I really encourage you to please call them if you have any questions or concerns or need help.
[00:17:17] Adam Walker: The helpline team is the best. I’ve talked to them and the services they provide is just, it’s profound. It really is. So it’s just such a great service. I love that. Love that. So, Erica, this has been great. Do you have any final advice for our listeners?
[00:17:35] Erica Kuhn: Sure. It’s really simple. Just go get your mammogram. I promise you, it’s quick and easy and you know, really you’re your own best advocate. So you know your body best. If something’s not right, talk to your healthcare provider and get checked.
[00:17:49] Adam Walker: And remember, a mammogram is a simple test. That can save your life.
[00:17:54] Erica Kuhn: That’s exactly right.
[00:17:57] Adam Walker: Thanks to Wacoal for supporting this podcast. Join the more than 1,000,000 people who have been fit at a Fit for the Cure event. Visit fitforthecure.com to learn more and book an appointment today.
[00:18:22] Thanks for listening to Real Pink, a weekly podcast by Susan G Komen. For more episodes, visit RealPink.com. For more on breast cancer, visit Komen.org. Make sure to check out at Susan G Komen on social media. I’m your host, Adam, you can find me on Twitter @AJWalker or on my blog, AdamJWalker.com.