Long Beach Breast
Cancer Coalition
P.O. Box 844
Long Beach, NY 11561

Phone: (516) 897-1344



Reasons for Mammography
Possible Procedures
Going For A Mammogram
Mammography Checklist

Get a No-Cost Mammgram

If you are uninsured or underinsured, you may be eligible for a mammogram and a pap smear at no cost to you.

If you live in Nassau County call the Nassau Health Care Corporation’s Breast and Cervical Cancer Screening Program for more information.

(516) 572-3300 (English and Spanish spoken)

If you live in Suffolk County call the Women’s Health Partnership.
(631) 436-5262 (English and Spanish spoken)


Mammography screening is an essential part of a breast health program, and is presently the best means available for the early detection of breast cancer. Since the majority of breast cancer diagnoses are in women 50 and older, medical experts and the major scientific advisory boards agree that by age 50 all women should be going for annual screening mammograms.

However, some of those same experts express a different viewpoint when recommending screening for women between the ages 40 to 49. The American College of Obstetricians and Gynecologists (ACOG) and the National Cancer Institute (NCI) suggest women in their 40s, at average risk, get screened every 1 to 2 years with the proviso that they discuss individual risk factors with their health care provider prior to deciding whether to follow an annual or semi-annual screening schedule. The American Cancer Society (ACS) recommends women begin having yearly mammograms at age 40. Regardless of the screening schedule decided upon, the end result should be an initial mammogram by age 40 (African-American women and women at high risk should discuss with their physician whether to have a baseline mammogram at age 35 or earlier).


Reason for Mammography

The reasoning behind going for regular mammograms is based on two simple facts: 1) every woman is at increased risk for breast cancer as she ages, even without a family history of the disease; and the strongest argument for getting a regular mammogram is 2) its ability to detect breast cancer up to two years before it becomes palpable. With early diagnosis women have the advantages of both more conservative treatment and a better chance for survival.

Detecting a mass on a mammogram doesn’t guarantee a cancer diagnosis. In fact, approximately 85 percent of all breast lumps are benign and are often the result of poor nutrition; smoking or inhaling second-hand smoke; alcohol consumption; excessive caffeine consumption; or hormones, with symptoms becoming more noticeable just prior to menstruation.

Cysts and fibroadenomas are the two most common benign breast masses. Cysts are moveable, fluid-filled lumps that may be tender to the touch or quite painful depending on their size and location. Women with cysts are often referred to as having fibrocystic breasts, “lumpy breasts”, or the misnomer “fibrocystic disease” — it’s a condition not a disease.

Fibroadenomas are smooth, marble-like breast tumors that show up clear on a mammogram. Most commonly found in women in their 20s and 30s, fibroadenomas range in size from microscopic to several inches, and should be monitored for change on a regular basis. Two instances where removal is advisable are when they grow large enough to distort the breast’s shape, and when detected in middle-aged or older women to rule out breast cancer.


One or more of the following procedures
may be done to rule out a malignant mass.

  • Sonogram
  • Fine needle aspiration biopsy
  • Core biopsy
  • Surgical biopsy

In instances where the lump is not clearly definable a physician may schedule a sonogram, a non-invasive method of determining whether the lump is solid or fluid-filled. A technician performs this procedure using ultrasound equipment. If the lump turns out to be solid the doctor may want to aspirate it in the office, or send the woman to a surgeon more familiar with performing fine needle aspiration. During the procedure some cells and/or fluid are drawn from the lump into a thin needle syringe, and sent for analysis. Should both the sonogram and fine needle aspiration prove to be inconclusive, then further scrutiny would necessitate either a core needle biopsy, where a piece of the lump or a portion of the breast tissue is removed with a larger needle, or a surgical biopsy, — almost always performed as a outpatient procedure — where either part of the lump or the entire lump is removed for analysis.

The breast tissue of menstruating women — whether young, middle age, or close to menopause — shows up denser on a mammogram than the tissue of postmenopausal women. This density is due to the abundance of milk glands, ducts, ligaments, and fatty tissue in the breasts and appears as cloudiness on the mammogram, making it more difficult for a radiologist to interpret. In certain instances a mass is seen on a mammogram, but cannot be clearly identified as benign or malignant. This opens up the possibility of either a false negative or false positive reading. Both situations arise more frequently in pre-menopausal women. A false negative reading occurs when it’s decided that a breast lump located on a mammogram is benign and no further testing is done, leaving the cancer untreated. A false positive occurs when an area of the mammogram is read as abnormal although no breast cancer is present. As you might surmise, a false negative can result in inadequate treatment for a mass that calls for further medical attention. On the other hand, a false positive might necessitate a woman undergo one or more procedures in order to verify if a lump is cancerous when it’s actually benign.

In spite of these failures, the NIH estimate mammography locates 75 percent of breast cancers in women in their 40s versus 90 percent in older women. Therefore, it’s advisable to err on the side of caution. Have that mammogram!

Many women look forward to getting older and entering menopause, gladly relinquishing the burden of their monthly period. With the cessation of menstruation, women’s bodies undergo a number of physiological changes. Some of these changes become evident in the breast tissue, including a decrease in density, and an increase in fatty tissue. The good news is these changes make it easier to differentiate between normal and abnormal tissue, and consequently increase the effectiveness of a yearly mammogram in diagnosing whether a breast tumor is present.

Unfortunately, a major problem exists — getting women to go for their mammogram, especially menopausal and postmenopausal women who are at greater risk. Women offer a variety of excuses to avoid going for a mammogram (you may even have voiced a few yourself) they include:

- Health care provider didn’t suggest it
- Fear it will be painful
- Fear of finding a lump
- Fear of radiation exposure
- Lack of health insurance
- Lack of time
- Lack of transportation
- Lack of child care
- No perceived risk
- No family history
- Communication barriers

Some of the obstacles listed are poor excuses for non-compliance. The remaining barriers can be overcome. Every state and county has clinics and women’s health care centers (many affiliated with local hospitals) that will accommodate women dealing with a lack of health care coverage, transportation or child care; limited financial resources; or communication barriers. While no one would like to hear those ominous sounding words, “you have breast cancer”, the remaining reasons are simply invalid excuses for rejecting a protocol that offers the peace of mind women feel upon learning they don’t have breast cancer.

Alternative resources for information on free mammograms are county departments of health, state medical societies, local breast cancer coalitions, the American Cancer Society, the NCI’s Cancer Information Service, or other health and cancer affiliated organizations.

Awareness of the age at which women are at greatest risk is not enough. The medical establishment cannot tell us who will get breast cancer — even women with known genetic abnormalities or first-degree relatives with the disease may never receive a diagnosis themselves. For that reason, we each need to do whatever we can to reduce our risk and increase our chances for early detection. Because going for a mammogram on a regular basis after the age of 40 is advantageous, it’s clearly in the best interest of every woman to do so.

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Going For A Mammogram

Now for a brief rundown on what to expect when you go for a mammogram. Though each facility varies the procedure slightly, they will usually begin by sending you to a dressing room to remove your blouse and bra and replace it with a cotton cover-up that opens in front. You will then be escorted into the room containing the mammography machine, and asked to remove one arm from the cover-up to facilitate the procedure. The radiologic technologist will then position your breast for the mammogram. The machine contains two parallel shelves, one stationary and the other moveable. The upper shelf is lowered to compress the breast tissue, and the breast is x-rayed. The same procedure is repeated for the other breast. Typically, two pictures are taken of each breast, one with the shelves in a horizontal position, and the other with the shelves oriented vertically. The entire procedure takes approximately 20 minutes.

The actual breast compression may cause discomfort, but fortunately the time elapsed for each picture is only a few seconds. Don’t worry if you’re told additional pictures are required. Occasionally, they are needed if the entire breast tissue was not visible on the x-ray, or if a particular area needs further scrutiny — this doesn’t automatically signal the presence of breast cancer. Upon completion of the mammograms you may be asked to remain in the waiting room for a short time until the results are determined. Keep in mind, facility procedures and the services they provide vary. While some facilities provide the results immediately, others choose to notify patients by mail. A clinical breast exam (CBE) may or may not be given. If you don’t receive a CBE on the day of your mammography appointment, follow up and schedule one with your gynecologist or a trained health care provider shortly thereafter.

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Mammography Checklist

Okay, now you’re ready to schedule your mammogram. Before making the appointment be sure you’re familiar with the following information:

1) The facility should have American College of Radiology (ACR) accreditation. All mammography facilities are required, through the Mammography Quality Standards Act (MQSA), to display certification from the FDA containing the facility name and the approval period of time. Certification means the facility has met the strict standards required for the equipment, record keeping, reporting, and the employees involved in the screening process. Prior to scheduling an appointment ask whether the facility is FDA certified, and look for the certification and the equipment expiration date on display.

2) The individual providing the mammogram should be a certified radiologic technologist, an individual who is properly trained to perform this task.

3) Many women — particularly those with cystic (lumpy) breasts — find their breasts are tender, swollen, and sensitive to the touch prior to menstruation. That’s why it’s advisable to schedule a mammogram 7 to 10 days after menstruation begins. Women on HRT should determine which days of the month are most appropriate, or ask their health care provider. While mammography may produce some discomfort, it shouldn’t be painful. If the procedure causes sharp pain, don’t hesitate to inform the technologist.

4) If you have breast implants it’s important to advise the facility staff when scheduling your mammogram. If the facility won’t accept patients with implants ask for the name of one that does. When arriving for your appointment, remind the staff that you require a technologist specially trained to x-ray women with implants. The technologist will then be certain to x-ray as much of your breast tissue as possible.

5) A mammogram’s clarity can be altered by any of the following — caffeine, powder, perfume, or deodorant. It’s best to avoid caffeine for several days prior to your appointment, and not to use any powder, perfume, and deodorant on mammography day. If you are uncomfortable with the idea of having to disrobe completely when going for a mammogram, wear a two-piece outfit.

6) The physician reading the mammogram should be a certified radiologist accredited by the ACR. Your regular health care provider, or gatekeeper, is not necessarily the best person for the job. It requires someone with extensive training in this area with the ability to recognize critical changes. Having the mammography films read by someone with this expertise is especially important for women with dense breast tissue, where irregularities are more difficult to discern.

7) After receiving the results, if you have any doubt about what you have been told, don’t hesitate to take your mammograms, along with a copy of the written report of the results, and go for a second opinion. Though facilities may provide copies of mammography films, if requested, they’re required to give you the originals (Effective April, 1999 New York State legislation requires that all mammography facilities provide original films upon request. In addition, the facility cannot charge the patient for copies they make for their own files. Check your own state laws to see if there’s similar legislation). Keep in mind, if you’re not given the results at the time of your visit, the 1999 reauthorization of the MQSA, requires that mammography facilities send women their screening results, written in layman’s language, within 30 days or less. If an area requiring further scrutiny is identified you should be contacted by the facility within 5 working days or less.

8) Once you begin having regular mammograms return to the same facility each year, unless you have a specific reason for not returning, like having moved since your last visit. When changing facilities, bring the originals of prior mammograms to the new location. These will be compared with the newest pictures, and serve to assist the physician in recognizing important changes in the breast tissue. If you go for a second opinion, bring your original films because the clarity will be much better than copies.

9) You can either schedule your next mammography appointment before you leave, or ask to be sent a reminder card. It’s always a good idea to mark your calendar with a reminder when you get home. It’s suggested you call to schedule your appointment a minimum of six months prior to when you need it since you may find that you are unable to get an appointment when you need it.

Keep in mind that when circumstances demand it each of us must advocate for our own needs. If you are told your mammography results indicate no problem areas, but intuitively you feel something is wrong, take the films and go for a second opinion. If your health care provider doesn’t cover costs for a second opinion (the majority of health insurance carriers do pay for a second opinion), check with your county Department of Health, and the other resources mentioned above for the names of facilities that provide either low or no-cost service. The bottom line is that you need to do whatever is necessary in order to receive the best health care possible.

Breast Self Examination: Personal Care





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