Q: I am not 40 yet, but should I get a mammogram now since both my mom and her mother had breast cancer (although it was post-menopausal in both cases)?
A: This is a question that I get asked frequently. As you probably know, the general recommendation is for women to have a mammogram every one to two years beginning at the age of 40 and annually after the age of 50. More aggressive screening (beginning at younger ages) is recommended for women who are at higher risk–those who have already had breast cancer or who have a mother or sister who developed breast cancer BEFORE menopause.
There’s not enough scientific evidence to say that for women in your situation earlier mammograms will have a benefit in terms of earlier diagnosis and survival. It is certainly tempting to say that you should go ahead and have the mammogram if it will give you peace of mind, but this would not be good advice either.
Mammograms are a particularly poor imaging tool for finding tumors in young women because both the tumors and breast tissue are dense. If you get a mammogram now, there’s a significant chance that the X-ray will miss any tumor you might have or that it will find something that leads to a biopsy but turns out not to be cancer.
The best advice I can give you is this: See your doctor yearly for a breast exam and be attuned to any changes in your breasts. Most lumps, dimplings, or strange thickenings are found accidentally. Any redness, tingling, pain, or nipple discharge should be discussed with your doctor.
If you cannot shake the fear of the potential of breast cancer and want some type of evaluation, then discuss with your doctor whether you should have a breast MRI which is better at examining the dense breast tissue of younger women. Bear in mind that it is possible that your insurance will not cover the cost.
I am glad to hear that you are concerned about doing the right thing because even in this day and age with so much media attention given to breast cancer, the number of women who don’t follow the recommended guidelines for screening is startling.
Dr. Brent Ridge is the health expert for Martha Stewart Living Omnimedia. You can call and ask him a question live every Tuesday at 2 p.m. Eastern on Sirius Satellite Radio, Channel 112 (1.866.675.6675). You can also follow along as he learns to grow his own food and raise goats on his farm in upstate New York by visiting www.beekman1802.com.
Got a health question for Dr. Brent? E-mail him at firstname.lastname@example.org.