One of the best ways to detect breast cancer at the earliest possible point – when options for treatment and cure are best – is to get a screening exam. Screening exams can often detect breast cancer before any symptoms even arise.

The OSUCCC – James experts recommend the following breast cancer screening exams:

  • A monthly breast self-exam
  • A yearly physical exam by a medical expert (clinical breast exam)
  • Annual mammograms starting at age 40 (women who are younger than 40 but have a family history of breast cancer should start getting mammograms even earlier — 10 years before the age the family member was when diagnosed. For example, if your mother was diagnosed at 40, you should start getting your mammograms at 30.)

Clinical Breast Exam

Using the pads of the fingers to feel for lumps, your doctor will check your entire breast, underarm and collarbone area, first on one side and then on the other. Your doctor will also feel your lymph nodes near the breast to see if they are enlarged and check for differences in size or shape between your breasts, as well as examine the skin of your breasts for a rash, dimpling or other abnormal features.

Breast Cancer Anatomy 

Screening Mammogram

During a screening mammogram, a picture of the breast is taken using X-rays. Most women should begin getting annual mammograms at age 40, although women under 40 who have a family history of breast cancer should start getting mammograms earlier — 10 years before the age the youngest family member was when they were diagnosed. (For example, if your mother was diagnosed at 40, you should start getting mammograms at 30.)

Because there is no routine mammogram, it’s important where you get your screening. Experts who read and interpret mammograms — and only mammograms — all day, every day are the best choice for a first line of defense. Their in-depth expertise is specifically to detect breast cancer or to make sure there’s nothing to be found on your mammogram.

To make mammography services more convenient and accessible, the OSUCCC – James offers digital mammography and tomosynthesis or 3D mammography at all seven central Ohio locations as well as from a mobile mammography unit. (Our mobile unit travels to area businesses and houses of worship to offer mammography screenings for employees or members.) Breast tomosynthesis uses 3D imaging of the breast providing radiologists with multiple views and layers of the breast tissue to examine.

Mammogram Locations:

Each location and our new mobile unit offer the latest digital mammography technology including tomosynthesis or 3D mammography, are accredited by the American College of Radiology and are certified by the U.S. Food and Drug Administration. Further, each location is accredited by the American College of Radiology as a Breast Imaging Center of Excellence. Our new mobile unit is the first in central Ohio to offer 3D mammography.

Please call 800-240-4477 or 614-293-4455 to make an appointment at any of our seven locations or to schedule a mobile visit to your business or house of worship.

Diagnostic Breast Cancer Screening

If an abnormal area is detected during a screening mammogram, additional diagnostic tests may be needed. These may include:

Imaging Test

An MRI (magnetic resonance imaging) uses radio waves and strong magnets instead of X-rays. A computer then translates these waves into a detailed picture of the breast.

Ultrasound

An ultrasound provides an image of a specific area of the breast using sound waves.

Breast Tomosynthesis

Uses 3-D imaging of the breast from multiple angles during a short scan. The images are then reconstructed into a series of thin, high-resolution slices.

Biopsy

During a biopsy, your breast cancer specialist will removed a small piece of breast tissue to examine under a microscope. Biopsies for breast cancer are done in one of the following ways:

Fine Needle Aspiration

Breast tissue is removed using a thin needle.

Core Biopsy

Breast tissue is removed using a wide needle.

Surgical Biopsy

A small cut is made in the breast. Surgeons locate the tumor by touch or with a CT or CAT (Computed axial tomography) scan, ultrasound or mammogram.

Breast Density

A woman's breasts consist of fatty tissue, milk ducts, glands and supportive tissue. Her breasts are considered to be dense if they contain exceedingly more glandular and supportive (fibrous) tissue than fatty tissue. There are four levels of breast density:

  • Nearly all fatty tissue (about 10 percent of women are in this category)
  • Scattered fibroglandular (40 percent of women)
  • Heterogeneously dense (40 percent of women)
  • Extremely dense (10 percent of women)

Women in the heterogeneously dense and extremely dense categories constitute the approximately 50 percent of the female population whose breast tissue is considered dense.

Breast Imaging Dense Tissue
Fatty breast tissue (left) versus dense breast tissue (right)

Breast density correlates to a small risk of developing cancer, but the risk increases when a woman has other breast cancer risk factors and dense breasts.  Increased density can also have a masking effect on mammogram images, making it more difficult to detect cancer at an early stage and reducing the mammogram’s accuracy. Still, the first step toward early cancer detection is to have an annual mammogram.

In 2015, Ohio passed a law requiring hospitals and clinics that perform breast mammography to notify patients if their results show dense breast tissue. The law is designed to make women aware of their risk factors and that dense breast tissue could hide abnormalities. Women who learn that they have dense breasts should follow up with their primary care physician to discuss their next steps based on their cancer risk, which is also affected by such lifestyle factors as obesity, tobacco and alcohol use, age of first menstruation, and family history of breast cancer.

Possible next steps include additional screenings, such as breast magnetic resonance imaging (MRI), whole-breast ultrasound, and tomosynthesis, which is a 3-D imaging mammogram that enables radiologists to examine layers of breast tissue and fat in 1-millimeter segments, rather than a flat 2D image, to search for tumors that may be hidden behind dense tissue.

If you’ve been diagnosed with breast cancer, would like a second opinion, would like to speak with a breast cancer specialist or schedule a mammogram, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.

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Stefanie Spielman Comprehensive Breast Center

1145 Olentangy River Road

Columbus, Ohio 43212

614-293-5066 or 800-293-5066 (Mammography: 614-293-0020)