In the second blog of my #BreastCancerAwareness series, we’re talking about mammograms — a.k.a. the best way to screen for breast cancer — and how a mammogram can save your life.
Plus, if you need a mammogram but aren’t insured, keep reading! There are tons of options for you below.
(Heads up: If you haven’t read the first blog, check it out!)
The Importance of Mammograms (and Danger of Missing Them)
I remember hearing my healthcare provider inform me that my mammogram produced abnormal results and simply wondering, “How could that be possible?”
Even during COVID-19, I never missed a screening, and I regularly check my breasts at home for lumps or other indications of a larger problem. Prior to my mammogram this year in March, I didn’t experience anything unusual, so I was certain it would be another run-of-the-mill screening.
I was wrong. So wrong, in fact, that I write to you from the recovery of a preventative double mastectomy — a decision I made to combat my high level of risk for breast cancer. And without that mammogram, I never would’ve known the decisions I could make to save my own life, or at least give me the best chance of a healthful future.
Mammography is the process of using low-energy X-rays to examine breasts and detect areas of abnormality within breast tissue. According to the American Cancer Society (AMC), about 1 in 8 women in the U.S. will develop invasive breast cancer during their lifetime, and mammograms are the only method proven to reduce the mortality rate through early detection.
💡 Finding breast cancer early reduces your risk of dying from the disease by 25% to 30% or more.
With early detection, you can access early (and often less extensive) treatment, which lowers the opportunity for cancer to grow and increases your chances of survival.
If you’re at high risk for breast cancer — you have dense breasts or a family history of breast or ovarian cancer, for example — schedule a mammography screening as soon as you can. Otherwise, doctors recommend women start annual breast cancer screenings with mammograms at age 40. From ages 45 to 54, women should get mammograms every year, then either annually or once every two years after age 55.
Even if you don’t have any risk factors, it’s important not to miss your annual mammograms: About 85% of breast cancers occur in women who have no family history of the disease. Plus, it’s especially critical as you get older. After age 50, the probability of developing breast cancer within 10 years is 1 in 43, then 1 in 28 after age 60. (Whereas the risk is 1 in 68 between ages 40 and 50.)
Despite your understanding of the significance of mammograms, you might still think there’s no harm in missing just one screening. Let me stop you right there and debunk that idea.
For starters, I’ve never ever missed my annual mammogram, but my doctors still identified areas of concern that led me to get a preventative double mastectomy. Additionally, a recent study has further proven just how life-altering one missed mammogram can be.
Funded by the AMC, a large study of almost 550,000 women over a 24-year period found that women who skip even one scheduled mammography screening before a breast cancer diagnosis face a significantly higher risk of dying from cancer.
See how critical these screenings are?
Keep in mind this isn’t the only part of breast health to consider. Because mammograms can correctly identify 87% of breast cancers at early stages, they quite literally save your life. Still, the remaining 13% can go undetected, depending on some risk factors. This means that besides annual high-quality screening mammograms, also having regular clinical breast exams is the most effective way to detect breast cancer early.
The Fallout of Reduced Access to Mammograms During COVID
Robert Smith, Ph.D., senior vice president of cancer screening for the AMC, acknowledges that the organization’s study comes at a critical time, as pandemic-related suspensions of preventative screening services meant “a staggering number of women missed their regular mammogram over the past 12 months.”
Unfortunately, he’s right about the staggering part.
In the first blog of this series, I noted that COVID-19 caused a sharp drop in mammography breast cancer screenings, lowering the number of completed screenings from 56,000 in 2019 to around 27,500 in 2020.
Additionally, Breast Cancer Now estimated that nearly one million people in the UK missed their mammograms when breast screenings were paused in March 2020.
In the U.S., research shows that the decline was especially severe among women of color and those living in rural areas, who are already a highly at-risk population that consistently falls between the cracks of health equity.
So, where does all of that leave us?
Because of the reduced number of completed mammograms in 2020, Breastcancer.org reports that in 2021, an estimated 281,550 new cases of invasive breast cancer are expected to be diagnosed in U.S. women, along with 49,290 new cases of non-invasive breast cancer.
While we can’t turn back the clock and undo the harsh effects of the pandemic on millions of communities, we can learn from these disparities and work to improve access to health services — as the drastic drop in mammograms wasn’t only due to unavailable services.
A new study shows that there were greater declines in screenings among women who were covered by Medicaid or had to pay out-of-pocket than those with commercial or government-run insurance programs.
Besides that, Ofer Amram, the study’s lead author, says financial consequences of the pandemic, such as lost jobs or pay cuts, may have significantly impacted the ability of underserved populations to afford mammograms, copays, deductibles, or even transportation to appointments.
“Health care providers need to double down on efforts to maintain prevention services and reach out to these underserved populations, who faced considerable health disparities even before the pandemic,” said Amram in a news release.
Back into a semblance of normalcy, doctors are only now starting to understand the full scope of the pandemic’s disproportionate toll on marginalized communities.
For example, chief of breast surgery at Lenox Hill Hospital Dr. Paul Baron says, “Many of us who treat breast cancer often see patients who first found a breast mass before April 2020 and are showing up now … for evaluation of what turns out to be a cancer that is advanced due to delays in seeking health care.”
Folks, as I speak to you from the recovery of a difficult decision I made to take care of myself, I urge you to do the same.
👉 If you had a cancer screening booked over the last 10 months and missed it because of the pandemic, speak to your doctor ASAP about re-booking it. As clinics have resumed their pause on preventative procedures during the pandemic, they’ve had to wade through a serious backlog of people who need a range of cancer screenings.
Free or Reduced-Cost Mammogram Screening Options
Money shouldn’t be a reason that stands in the way of our health.
I’m grateful to have had (and still have!) access to the information and resources I needed to learn about my breast cancer diagnosis and treat it — and the mission of my work is to break down the barriers to health care to help others access this basic human right.
Whether or not you’re local to Denver, here are some national, statewide, and community resources you can use to schedule your next mammogram:
🎗 HealthONE Breast Care at The Medical Center of Aurora which is offering mammograms for $93 or $133, depending on whether you get a 2D or 3D screening. (Please note: After the appointment, you’ll receive a radiology bill for $143.)
🎗 The Susan G. Komen Foundation is a breast cancer organization with affiliates in more than 100 U.S. cities, and its network is the nation’s largest private funder of community-based breast cancer screening and treatment programs. You can find available nearby resources and low-cost options, or you can call the breast care helpline.
🎗 Denver Health’s Women’s Wellness Connection is a grant provided by the Colorado Department of Public Health and Environment with funding from the CDC, which allows Denver Health to provide no-cost breast and cervical cancer screenings to qualified women. Click the link to learn more.
🎗 The CDC’s National Breast and Cervical Cancer Control Program provides breast and cervical cancer screenings and diagnostic services to low-income qualified uninsured and underinsured women across the U.S. Click the link to learn more.
🎗 Free Mammograms is a site that’s scoured the web to create the most comprehensive lists of free medical clinics to help uninsured or low-income women across the country. (View the Denver list for free mammograms!)
🎗 The National Breast Cancer Foundation says it partners with medical facilities across the country to provide free mammograms and diagnostic breast care services to underserved women! Find a facility near you.
🎗 Your Local Imaging Center. This may seem archaic, but it’s worth a shot to call around to your local imaging center during Breast Cancer Awareness Month. Many of them observe the month by offering reduced rates! If you need a starting point, search for a local mammography center on the FDA website.
As you check out these options, here’s one more thing to note: if you’re age 50 or older, the Affordable Care Act requires your insurer to cover screening mammograms every two years with no co-payment.
You know this by now, but it bears repeating: Mammograms save lives.
Remember that they can’t detect every type of cancer, so besides getting them regularly, work with your doctor to get clinical breast exams and any necessary imagining if you notice any change in your breasts.
These kinds of changes include any lumps, thickening or hardening of your breasts, liquid leaking from your nipple or changes in the appearance of your nipple.
As you prepare for your appointment, and even after you have one, be sure to conduct your own breast exams every month. They’re quick and easy to do, and they can help you detect any abnormalities to further explore with your care provider.
Use this graphic from the Jordan Breast Cancer Program to help you try it:
Stay tuned for the next blog of this series! If you missed the first one, read it now.
Meet Dr. Savita Ginde
Dr. Savita Ginde is an advocate and thought leader for reproductive health and served as Chief Medical Officer of Planned Parenthood of the Rocky Mountains for over 13 years. And, until very recently, she served as the Chief Healthcare Officer for STRIDE Community Health Center where she oversaw all of STRIDE’s healthcare services and led their COVID-19 vaccination efforts.