Despite the dust-up caused by the U.S. Preventive Services Task Force when it questioned the usefulness of annual mammograms in most women under age 50, the vast majority of physicians will tell you that getting the test once a year is a good idea.

But only half of the women who should be getting them -- those 40 and up and those with a family history of breast cancer -- are doing so, says Dr. Katherine Lee, co-director of the High-Risk Clinic and director of the lymphedema program at the Cleveland Clinic's Breast Center.
You can't blame a woman for dreading the squeezing, pulling, squishing and flattening that come with a mammogram. But after more than 40 years, it remains the gold standard of breast-cancer screenings. Other options for women who are healthy, have no family history and aren't carriers for one of two genes that can cause breast cancer are limited.
“We've got our work cut out for us,” Lee said. “We realize
[women] want a test that's not as uncomfortable and a little quicker with fewer false negatives.”
Dr. Lauren Kinsell, medical director of breast radiology at Summa Health System, said her staff hears a variety of reasons why women prefer other tests over a mammogram.
“There are some women who refuse mammograms because they have implants and they're afraid that it will rupture them,” she said. “Generally, that is not a concern.”
Others are afraid that if they have already had breast cancer, a mammogram could spread new cancer to the other breast, she said. Again, not true.
And still, “We hear many times, 'My mother's breast cancer wasn't picked up (on) a mammogram,' “Lee said.
The last statement is often the case. Unfortunately, mammograms don't detect all breast cancers -- especially inflammatory breast cancer, which usually doesn't start as a solid tumor.
Researchers continue to study methods that one day could supplant mammography. In fact, some offshoots of mammography-- scintimammography (molecular breast imaging), thermography (infrared mammography) and digital tomosynthesis, which produces 3-D images of the breast -- could one day become first-line treatments.
In the meantime, mammography and breast self-exams remain the best starting points. When in doubt, talk to your physician.
Mammography
Mammography technology has improved enough that many hospitals and screening centers have replaced traditional mammography equipment with digital mammography, which stores images in a computer instead of on X-ray film. The digital machine captures images faster, which means less time being squished and squeezed, and may detect cancer more effectively in women with dense breast tissue.
All mammography at Summa Health System locations in Summit County is digital, said Kinsell.
The Clinic is in the process of replacing all of its machines to move to digital. But for now, its only locations providing digital mammography are the Breast Center on the main campus and the Beachwood office.
University Hospitals Case Medical Center and its facilities also have converted to digital mammography. MetroHealth Medical Center does not offer digital mammography.
Who gets it?
Women typically begin having mammograms beginning at age 40, although many physicians suggest having a baseline mammogram at age 35. Any woman whose mother had pre-menopausal breast cancer should start screening 10 years prior to when she becomes the same age as when her mother was diagnosed, Kinsell said.
Pro: Mammograms are pretty affordable, noninvasive and -- apart from the squeezing and flattening -- quick and relatively painless.
Con: The test is less likely to find breast tumors in women younger than 50 because younger women have more dense breast tissue than fatty breast tissue.
Breast cancers tend to develop more often in the denser tissue.
Con: X-ray images provide limited number of views of the breast.
Con: Between 5 percent and 15 percent of mammograms register as “false positive,” meaning that they result in more screening tests and/or a biopsy that turns out to be normal.
(Source: cleveland.com)