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Breast Cancer Questions: Answered

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Breast Cancer Questions: Answered

Breast cancer screening recommendations can often be confusing. At what age should you start having a mammogram and how often should you continue? Is breast cancer preventable and if so, what can you do?

Cooper Clinic radiologist and breast imaging subspecialist R. Vance Dell, MD, receives questions like this on a daily basis. He answers the most commonly asked questions, some of which you may be surprised to know.


How often should I get mammogram?

Cooper Clinic recommends women receive their first mammogram at age 40 and continue annually. 

“The pattern I unfortunately see too often is women getting just three or four mammograms throughout their 40s,” says Dell. “That’s not screening. Screening, by definition, is on an on-going basis.”

Dell says receiving random mammograms (once every few years) doesn’t save lives. In fact, skipping an annual mammogram can give possible undetected cancers time to grow.

“We’ve found many advanced cancers in women who have skipped several years,” says Dell. 
Dell says women should continue with annual screenings regardless of if they’re pre or post-menopausal.

Is there a radiation risk with mammograms?

Some women are concerned with the potential radiation risk associated with getting a mammogram. While radiation in high doses can cause cancer, Dell says the amount received from a mammogram isn’t cause for concern.

"A woman can receive a high-quality, 3D mammogram every year and the total radiation is virtually the same as getting on an airplane in New York and flying to Paris,” says Dell. 

Does having dense breasts increase my risk?

Approximately 50 percent of women over age 40 have dense breasts. Women who fall into this category have a slightly increased risk for breast cancer.

On a mammogram, dense breast tissue appears as a solid white area which can make it difficult to see through. Because of this, Dell says women with dense breasts may need an additional screening, such as a high-quality ultrasound. 

“With the combination of a 3D mammogram and a high-quality breast ultrasound, I can give a woman with dense breasts her screening results with as much confidence as I do to a woman with non-dense breasts,” says Dell.

Can hormone replacements increase my risk?

Estrogen alone does not increase the risk for breast cancer unless you’ve been taking it for more than 10 years. That being said, a combination of estrogen and progesterone can create a risk.

“A combination of estrogen and progesterone can increase the risk for breast cancer soon after you begin taking it,” says Dell. “This risk can continue for several years even after you stop taking the replacement.”

Dell says there are low-dose hormone combinations that don’t come with the traditional risk, so it’s important to consult with your physician before starting a replacement.

As for birth control pills? Dell says the hormone levels aren’t high enough to create a risk. 

Is breast cancer preventable?

One in eight women will be diagnosed with breast cancer at some point in their lives. 

“The fact that a woman doesn’t have any first degree relatives with breast cancer or the fact that she has children and breast fed does not protect her from developing breast cancer,” says Dell.

What Dell says may help? Watching your weight and alcohol consumption.

“Women who are obese have an increased risk for breast cancer, especially those who are post-menopausal,” says Dell. “This is due to the way the breast metabolizes estrogen and progesterone.”

Dell says alcohol consumption, even just one drink a day, has also been shown to increase a woman’s risk for breast cancer.

“We are winning the war on breast cancer and most of this has to do with finding breast cancer in its smallest stage,” says Dell. “Breast cancer is a highly curable, but the key is to diagnose and treat it at its earliest stage.”

Cooper Clinic provides women the specialized and comprehensive preventive care needed for breast cancer screening and diagnosis, including 3D mammogram technology. Cooper Clinic patients can schedule breast imaging the day of their comprehensive physical exam.

Mammograms are also available separate from the comprehensive exam, with an order from your physician.

To schedule a 3D mammogram at Cooper Clinic, call 972.560.2651 or click here.