Mass General Director of Breast Imaging Offers Advice On Mammograms

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Photo credit: Mass General Cancer Center

With debate among nonprofit organizations, physicians’ groups, and the U.S. government resulting in varying recommendations, women might think mammograms are not useful in catching cancer. Connie Lehman, MD, PhD, Director of Breast Imaging at Massachusetts General Hospital, wants to clear up the confusion.

“Simply put, mammograms are the best way to detect breast cancer early and avoid the risk of late diagnosis,” Dr. Lehman says. “Breast cancer is the most commonly diagnosed cancer among American women. When we find it early, women have more options for less aggressive treatments and a better chance of being cured.”

However, despite widespread advocacy, only about half of women in the United States engage in regular screening mammography.

Guidelines for Ages

Dr. Lehman emphasizes that all major medical groups agree that women ages 50 to 74 should have a mammogram at least every two years, and all agree that early screening for mammograms, beginning at age 40, can save the most lives.

“We know that the most years of life lost to breast cancer occur in women diagnosed before age 50,” says Dr. Lehman. “In the 40s, breast cancer is a rapidly growing disease, compared to when a woman is in her 70s. When cancer is caught early, physicians and patients have more treatment options. They might avoid chemotherapy or have the option of breast-conserving surgery, instead of a mastectomy.”

Access to Mammograms

Under the Affordable Care Act, a screening mammogram is free. No copay or deductible is required. To improve access, Mass General has added early morning, evening, and Saturday hours for mammograms at their centers in and outside of Boston. The hospital started a “Pink Card Program,” which allows women to take a card and walk in for a same-day mammogram. Mass General is also working on programs to deliver all information about mammograms to patients in their preferred language to avoid misunderstandings. They are also using text message reminders so patients don’t miss their scheduled exams.

“We use the most advanced tomosynthesis mammography for every patient, every time. Every exam is acquired by a highly trained technologist and then interpreted by a highly specialized breast imaging radiologist,” says Dr. Lehman. “With this combination, Mass General’s cancer detection rate is high and our false positive rate is low. It does matter where you go.”

Assessing Risk

Dr. Lehman encourages women to know their personal risk of breast cancer. Mass General’s multidisciplinary approach is to provide the best assessment and consultation to reduce the risk of breast cancer in their patients.

The Breast and Ovarian Cancer Genetics Clinic at the Mass General Cancer Center helps to identify families that may have a hereditary breast and/or ovarian cancer syndrome. Each patient’s history is reviewed with Leif W. Ellisen, MD, PhD and his team. When appropriate, they will make medical management recommendations. If you are identified as high-risk based on genetic testing and/or family history, you can choose to be followed by specialists in higher-risk screening and management.

“It is important that people receive appropriate screenings, as well as counseling regarding overall risk assessment including the possibility of genetic testing,” says Dr. Ellisen.

Tips from Mass General Imaging

Learn more about the Breast and Ovarian Cancer Genetics Risk Assessment Program and the Breast Imaging Program and Mammography Service at Mass General Cancer Center.

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