A little peace of mind
By Denise Baran-Unland Correspondent January 15, 2013 11:36AM
Yearly mammograms are recommended starting at 40. | File Photo
Updated: February 17, 2013 6:14AM
A day or two after your screening mammogram, you receive the dreaded phone call: You need additional testing. Does this mean you have breast cancer?
Possibly, although the odds are against it, said Neda Zelehovitis, certified breast health nurse at the Silver Cross Center for Women’s Health in New Lenox.
When a woman has a screening mammogram, the technician takes two pictures of each breast and compares them to her previous mammogram. If the technician sees any change, she will be asked to return for additional pictures, Zelehovitis said.
The Silver Cross Center for Women’s Health calls back about 14 women each week, she said. Despite what some people think, the more sensitive digital mammography has not increased the number of patient callbacks vs. the older analog test.
“Many people get nervous when they’re asked to come in again, especially if they have a family history of breast cancer or know someone that went through it,” Zelehovitis said. “They worry that the technician didn’t take the right pictures, but that has nothing to do with it. The radiologist might see something and want a better picture. Most of the time, the women come in, get their pictures and go home.”
The two most common reasons for callbacks are density spots (which could be cysts or fibrous tissue and not necessarily cancer) and calcifications. Many times, those dense areas disappear if the breast is compressed harder and extra pictures are taken in different positions. If the dense areas remain, the woman will immediately have an ultrasound.
Determining the significance of calcifications may require a diagnostic mammogram, ultrasound or biopsy. Calcifications, which resemble salt sprinkled on black paper, Zelehovitis said, are almost always benign and are often nothing more than dead cells.
“All women have calcifications,” Zelehovitis said. “Some women have more of them than others.”
The reason calcifications can be concerning is that certain sizes and shapes may indicate breast cancer and signal the need for additional pictures. In addition to diagnostic mammograms, ultrasound is a very useful tool to help clarify suspicious mammograms.
“It can show if a cyst is solid, has fluid inside it or has blood supply to it,” Zelehovitis said. “It can also show if it has rounded edges or an irregular shape. If it’s just a cyst, we can let it go or we can decide whether to watch it or biopsy it. If a pre-existing cyst has grown or changed shape, we biopsy it.”
Even when a biopsy becomes necessary, the odds are still good the result will pronounce the cyst as benign. For every four biopsies performed, generally only one tests positive for cancer, Zelehovitis said.
If a woman does need to return for additional testing, most facilities are committed to scheduling her as quickly as possible. For example, central scheduling at the Silver Cross Center for Women’s Health contacts the woman within 24 hours from receiving the callback order so patients are not waiting and worrying.
“We know people tend to think the worse until they’re told everything is all right,” Zelehovitis said.
Is there anything a woman can do to increase the odds she won’t be called back? Not really, Zelehovitis said, except she should not wear any deodorant, powder or lotion on her breasts and underarms the day of the test. Metallic elements in those items may show up as spots.
“Many places will have deodorant wipes the woman can put on before she leaves,” Zelehovitis said.
It’s extremely important, Zelehovitis said, that all women, starting at age 40, make time for that yearly mammogram.
Research shows the survival rate improves when breast cancer is caught early.
Also, anytime a woman feels a lump, she should get it checked out, no matter how young she is or how foolish she feels.
“It’s your health,” Zelehovitis said. “Be aggressive with it.”
Although current debate questions the value of monthly breast self exams, since most lumps are found “on accident” by one’s spouse or while showering, Zelehovitis feels they’re still worthwhile because they help women become acquainted with their breasts.
If something looks or feels different during one of those exams, it probably is.
Finally, women should know that breast cancer, when caught and treated early, is no longer the automatic death sentence of decades past.
“New medicines come out every year,” Zelehovitis said.