Darlene Gill, lead mammography technologist at Mercy Medical Center, administers a mammography to a patient.
SPRINGFIELD -- As a breast cancer detection tool, mammograms are best when combined with a physical exam by a healthcare provider, said Dr. Lisa Planeta, surgeon and director of the Mercy Medical Center Breast Care Center.
Decades ago, the mammography machine was designed to help increase healthcare providers' ability to identify early stage breast cancer, she said.
"Prior to the advent of mammography, all we had was a physical exam, which is good at picking up breast cancers, but they have to be of a certain size," Planeta said. "When mammography came along we were able to detect those cancers when they were smaller, and have a higher cure rate."
To stress her point, Planeta noted that there is no society that advocates the sole use of a mammogram, which is a low-dose X-ray, for breast cancer screening.
"There are tumors that we can feel on exam that we cannot see on a mammogram and there are tumors we can see on mammogram that we can't feel on exams," she said. "You need to do both. There are really no other techniques that supplant the use of mammograms at this point."
Other screening techniques could be used along with a mammogram, such as a breast ultrasound or an MRI. Because an MRI is more sensitive than a mammogram in picking up cancers, it is used for patients with a higher rate of getting breast cancer, she said.
In women who have a genetic anomaly that puts them at a high risk of breast cancer, a physical exam and MRI would be used for women at age 25, and mammography added at age 30, Planeta said.
There are different schools of thought on when women should begin annual mammogram screening, Planeta said, noting that the American Cancer Society recommends clinical breast exams start for women in their mid-20s and mammograms at age 40. A woman's first mammogram, no matter the age, is called a baseline mammogram and it is used to compare to results from later screenings.
"A good percentage of breast cancer occurs in women under age 50 so it's important that we are able to screen them by 40," she said.
While there could be false-positive readings from a mammogram that could lead to additional screening and biopsies, the potential for diagnosing breast cancer early is important, Planeta said.
Planeta recommends that women do monthly self-exams and look for signs of not only feeling a lump, but notice whether the nipple is pulling back or there is puckering of the skin.
"What we look for are changes in the contour of the breast," she said.