Women's magazines in every checkout lane feature countless articles on personal health and well-being. Understanding that one out of eight women will eventually develop breast cancer, Gundersen's breast care experts emphasize the importance of early detection, timely diagnosis, and modern treatment when it comes to breast cancer. Early detection is critical because breast cancers found during screenings are more likely to be smaller in size and still confined to the breast making them much more treatable.
Breast cancer screening guidelines
There are many breast cancer screening tools available in our community, leaving many people wondering what option is best.
For early detection of breast cancer, Gundersen recommends digital screening mammography for all women starting at age 40 (a recommendation of the American College of Radiology). The frequency of screening varies according to national guidelines. Ask your healthcare provider what is appropriate for you.
Dense breast tissue:
Having dense breast tissue may slightly—but not significantly—increase your risk for breast cancer. Dense breasts can also make it more difficult for doctors to spot cancer on mammograms.
For patients with dense breast tissue, we recommend:
- Annual digital breast tomosynthesis (DBT or "3D mammography"), available at the Norma J. Vinger Center for Breast Care in La Crosse.
Although studies have shown all patients may benefit from DBT compared to standard digital mammography, patients with denser breasts, described as "heterogeneously dense" or "extremely dense" in their mammogram report, benefit more due to more tissue overlap.
Women at increased risk of breast cancer may benefit from additional screening strategies, such as magnetic resonance imaging (MRI ). Your healthcare provider can help you decide what those strategies are.
You may be at higher risk if:
- You are age 50 or older
- Your mother or sister has had breast cancer
- You have already had cancer in one breast
- You have had a prior breast biopsy
Why isn't molecular breast imaging recommended?
Molecular breast imaging (MBI) involves an IV injection of radioactive tracer and a special camera that can detect radioactivity that can signal the presence of breast cancer.
At this time, the American College of Radiology does not support use of the MBI as a screening tool, even for women with an elevated risk of breast cancer because:
- There have been no large trials to validate MBI as a screening tool.
- MBI results in whole-body radiation, compared to the lower-dose, breast-only radiation with mammography.
- There is no way to biopsy suspicious areas found with MBI.
To schedule a DBT, call the Center for Breast Care at (608) 775-2886. If you have questions, talk to your primary care provider.
Screening mammograms vs. Diagnostic mammograms
Screening mammograms provide a general overview using low-dose X-rays, in search of cancer in women with no known breast problems. While not intended to diagnose cancer, screening mammography indicates when additional evaluation is necessary.
Diagnostic mammograms use special X-ray views that allow close, careful examination of any suspicious area of the breast. You should be evaluated by one of our breast radiologists and receive a diagnostic mammogram if:
- You have any breast-related concerns, such as a lump, discharge or dimpling
- Your screening mammogram detects an abnormality or questionable finding
Fortunately, only a small number of the approximately 10 percent of women recalled after a screening mammogram for additional evaluation prove to have cancer.
Digital breast tomosynthesis
The Norma J. Vinger Center for Breast Care now offers digital breast tomosynthesis (DBT), which provides a more accurate view to standard digital mammography. Think of breast tomosynthesis as a three-dimensional mammogram with multiple images taken of the entire breast rather than just one. It allows our specialized breast radiologists to see layers of tissue that may normally be hidden and look at areas of concern from multiple angles.
Studies have shown that DBT:
- Detects some cancers more readily, resulting in earlier diagnosis which, in turn, may result in less aggressive treatment and better outcomes
- Decreases the number of patients called back for additional testing (false positives), resulting in less anxiety and decreased costs
Anyone who is due for a standard mammogram can elect to have a DBT. Currently, DBT is offered in La Crosse only at the Norma J. Vinger Center for Breast Care.
Medicare covers payment for DBT. If you have private insurance by a different company, be sure to ask if DBT is a covered benefit before scheduling an appointment. If DBT is not covered but you would like to have it, the out-of-pocket fee is $75. If you do not have insurance, please speak to a Gundersen financial counselor to find out what your out-of-pocket cost will be.
Call the Center for Breast Care to schedule a DBT. If you have questions, talk to your primary care provider.
Knowing the importance of early detection in women, Gundersen is dedicated to making screening mammograms more accessible in our Tri-State Area. A 40-foot, self-contained digital mobile mammography coach travels to medical clinics, businesses, churches, communities, malls and other locations to bring this life-saving screening to women. Screening mammograms are performed right in the unit and take approximately 20 minutes.
Women are able to receive the highest quality mammography testing in a convenient setting. Other features of the mobile mammography coach include:
- Full field digital mammography
- Screenings performed by a registered mammography technologist
- All mammograms will be viewed by a breast radiologist at Gundersen's Norma J. Vinger Center for Breast Care
- The coach is able to run off its own generator, so no additional power supply is needed
One yearly screening mammogram for women over 40 years of age is covered by insurance, Medicare and Medicaid. Women will not be turned away due to inability to pay. Screening is by appointment only.
Gundersen's mobile mammography unit travels to some regional Gundersen locations where mammography services would not otherwise be available. We currently provide services to Scenic Bluffs in Cashton, La Crescent, Harmony, Postville, Spring Grove, Lansing, Galesville, Houston, Holmen and Prevea Health in Arcadia.
How to supplement a mammogram
Mammography is useful because it can show breast tumors too small to be felt. However, about 10 percent of tumors are not visible on mammograms and can only be found by physical examination. That's why an exam by a primary care provider is important before the mammogram.
Regular breast self-examinations are encouraged between screening mammograms. Please discuss your risk factors with your doctor, especially if you have a previous history of breast cancer or a family history of the disease. If you see any change such as a lump, discharge, dimpling or anything unusual, contact your provider.
Sometimes after your initial mammogram, you will get a call or letter asking you to return for additional special views or an ultrasound study. This should not be cause for concern because women are called back fairly often. It simply indicates an area on the film needs to be looked at more closely.
Mammography is a department of Gundersen Lutheran Medical Center.