3 key questions women should ask before cancer scans

October is Breast Cancer Awareness Month — a time when the disease affecting hundreds of thousands of American women each year gets renewed attention.

American women have a one in eight chance (12.9%) of developing breast cancer during their lifetimes, while American men have a one in 800 chance (0.13%), according to the National Institutes of Health’s National Cancer Institute.  

Each year about 264,000 women are diagnosed with breast cancer, and approximately 42,000 women die of the disease, the Centers for Disease Control and Prevention (CDC) reports. (About 2,400 men are diagnosed with breast cancer each year and some 500 men die from it annually, CDC data shows.)

Since breast cancer is more commonly found in women aged 40 and up, medical professionals and organizations recommend routine breast cancer screenings for middle-aged and senior women. This includes mammograms — a breast cancer screening method that’s led to age-based debate among experts.

There are also important breast cancer risk factors to note, say experts. 

“Having one first-degree relative with breast cancer doubles a woman’s risk,” Dr. Kathleen Kiernan Harnden, director of breast oncology at the Inova Schar Cancer Institute in Annandale, Virginia, told Fox News Digital.

Other high-risk factors include a family history of breast cancer, a known genetic mutation or a previous breast biopsy, according to Harnden.

Given this, Harnden said there are three questions all women should ask themselves before they request a mammogram consultation or appointment: 

• Do I have an increased risk of breast cancer?
• How can I reduce my risk for breast cancer?
• Will my mammogram be three-dimensional (3D) or two-dimensional (2D)?

Harnden recommends 3D mammography over 2D because multiple images are taken from different angles, which may make breast tissue analysis clearer.

Here’s a deeper dive into these topics.

What is breast cancer?

Breast cancer is a disease that occurs in breast tissue when cells in the breast “change and grow out of control,” according to MedlinePlus, an online health information service produced by the U.S. National Library of Medicine.

The cells that cause breast cancer usually form a tumor — an abnormal mass of tissue.

Cancer cells and cancerous tumors (malignant) are dangerous because they can disrupt organ functions and kill healthy cells if left to spread, which can cause serious harm or death if left untreated, according to a report from MedicalNewsToday, a medical news website owned by Healthline Media.

Breast cancer is the second most common cancer in women after skin cancer, says the National Cancer Institute.

Breast cancer diagnoses are extremely rare in teens. Teen girls between ages 15 and 19 have an incidence rate of 0.2 per 100,000, the CDC indicates.

Girls younger than 15 don’t have a calculated breast cancer incidence rate because the CDC suppresses data when there are fewer than 16 cases, which the agency notes on its “United States Cancer Statistics: Data Visualizations” webpage.

Breast cancer incidence rates steadily increase with age, but it remains low for women under age 40, CDC data shows.

While not all experts agree on whether women under age 40 should receive mammograms, young women in their 20s and 30s have been diagnosed with breast cancer, according to incidence data published by the CDC, which dates back to 2019.

Women between the ages of 20 and 24 have a breast cancer incidence rate of 1.8 per 100,000. 

The incidence rate jumps to 10.5 per 1000,000 women, 30.1 per 100,000 women and 64.8 per 100,000 women, for women ages 25 to 29, 30 to 34 and 35 to 39, respectively.

Breast cancer incidence rates spike from ages 40 to 74, the CDC’s data shows.

The incidence rate for middle-aged women steadily increases every four years. For example, women ages 40 to 44 have a breast cancer incidence rate of 131.7 per 100,000 women while women ages 55 to 59 have a breast cancer incidence rate of 273.3 per 100,000 women.

Breast cancer diagnoses are even more common in senior women. The CDC’s data show women from age 60 to 64 have a breast cancer incidence rate of 339.8 per 100,000 women while women from age 65 to 69 have a breast cancer incidence rate of 425.2 per 100,000 women and women from age 70 to 74 have a breast cancer incidence rate of 475.8 per 100,000 women — the highest of any age group.

Declines in breast cancer incidence rates start to happen after age 75, according to the CDC.

What is a mammogram? 

Mammograms are an X-ray procedure that helps doctors detect early signs of breast cancer, according to the CDC.

The machines used to conduct mammograms have plastic plates that flatten breasts, so X-ray images can be taken and analyzed by radiologists for abnormalities.

Mammogram results are typically reported in a few weeks, according to the CDC.

Women with dense breasts have a higher chance of getting breast cancer, the health agency reports, but some women have higher-density breasts if they’re younger in age, pregnant or breastfeeding, taking hormone replacement therapy or have a lower body weight.

“Dense tissue can hide cancers,” the CDC wrote in a “What Does It Mean to Have Dense Breasts?” report.

“Fibrous and glandular tissue looks white on a mammogram. So does a possible tumor,” the CDC continued. “Because it’s hard to tell the difference between a tumor and dense breast tissue on a mammogram, a small tumor may be missed.”

Dr. Mona Jhaveri, cancer researcher and founder of Music Beats Cancer, a creative nonprofit organization in Washington, D.C., told Fox News Digital that dense breast tissue occurs in half of all women ages 40 and up.

“It’s well known that detecting cancer lesions in women with dense breast tissue can be difficult,” Jhaveri said. “Mammography is the standard of care for breast cancer screening, [but] it certainly has its risks and limitations.”

Potential risks associated with mammography screening include overdiagnosis, false positives, anxiety and radiation injury, according to a study published in the National Library of Medicine.

The U.S. Preventive Services Task Force — an independent, volunteer panel of national experts in disease prevention — says women who place a higher value on the potential benefit of mammography over potential harm can choose to begin breast cancer screening once every two years between ages 40 and 49 years. 

The CDC says similar breast screening guidelines have been issued to women ages 40 to 49 with “average risk” by the American Cancer Society, American College of Physicians, American College of Obstetricians and Gynecologists, American College of Radiology, American College of Physicians and American Academy of Family Physicians.

Three out of the six aforementioned cancer organizations recommend annual mammograms for concerned women who are between the ages of 40 and 49, if they so choose.

Women who are age 50 and older are generally advised to get mammograms done annually or bi-annually.

All cancer organizations advise women to speak with a health care provider to weigh the potential benefits and risks of getting a mammogram.

Age and family history of cancer are two factors that are taken into consideration during mammogram consultations, the CDC reports.

What should you know about mammogram radiation?

Dr. Jessica Shepherd, a Dallas-based OB-GYN who is chief medical officer at Verywell Health, a health information website, said most breast cancer cases are diagnosed after age 50, which is why mammograms are usually done for women who are closer to that age marker.

“The dose of radiation from a mammogram is pretty low and very rarely poses a risk, making them a safe diagnostic tool, and typically someone only needs a mammogram once a year. Therefore there is no risk of too much radiation exposure,” Shepherd told Fox News Digital.

She noted that there’s a “small link to an increased risk of breast cancer over time due to [mammogram] frequency and also size of the breasts,” but “overall this increase in risk is very small.” 

Delaying a breast cancer diagnosis has a higher risk than radiation exposure, Shepherd said.

“When caught early, breast cancer is highly treatable, and mammograms can be highly beneficial in these cases,” Shepherd continued. “If [breast cancer is] allowed to advance, a patient may have to receive more complex treatment such as surgery or chemo, which is way more invasive than radiation exposure from a mammogram.”

Breast cancer screening alternatives

Other breast cancer screening methods exist for women who aren’t eligible or don’t want to undergo a mammogram.

The CDC lists breast ultrasounds, breast magnetic resonance imaging (MRI) clinical breast examinations and self-checks as possible screenings for breast cancer.

Ultrasounds generate pictures (AKA sonograms) using sound waves while MRIs are computerized body scans that generate pictures using magnets.

Clinical breast exams are conducted by a doctor or nurse. During exams, medical professionals check for abnormal lumps or other physically detectable changes in breast tissue by hand.

Women can check their breasts for common breast cancer symptoms, including lumps, pain and changes in size.

“You should report any changes that you notice to your doctor or health care provider,” the CDC wrote in a “What Is Breast Cancer Screening?” guide. 

“Having a clinical breast exam or doing a breast self-exam has not been found to lower the risk of dying from breast cancer,” the CDC also said.