October is National Breast Cancer Awareness Month. According to the National Cancer Institute, 200,000 American women were diagnosed with breast cancer in 2003. In 2001, over 40,000 women died of the disease.  

A mammogram is the best way to diagnose breast cancer at its earliest stages (when treatment and recovery are more likely).  It is the most accurate test for breast cancer, and can detect tumors before they can be felt manually with the fingers.  

The American Cancer Society recommends a yearly mammogram screening for all women age 40 and over. The National Cancer Institute, and the American Medical Women's Association both recommend a mammogram every one to two years for women in their forties.  

A mammogram is, quite simply, an X-ray picture of the breasts. It is used to detect tumors and cysts, and may help establish whether a growth is cancerous or not. Mammograms are used to screen healthy women for cancer; as well as to evaluate a woman who has symptoms of a breast disease such as a lump, breast pain, or discharge. It is estimated that 90 to 95 percent of breast cancers are detected with mammography.The overall risk factors for the test are low. The level of radiation received during a mammogram is very small. If you are pregnant, a lead apron will be used to protect your abdomen.  

Woman being tested are asked not to wear deodorant, perfume, powders, or ointments under the arms or on the breasts during the exam, because these substances could affect the quality of the X-ray images. You will be asked to remove all jewelry from around your neck. Notify your health care provider if you are pregnant or breast-feeding.  

In order to get the best picture possible, one breast at a time is compressed on the X-ray plate. Flattening the breast tissue enhances the quality of the picture. However, this flattening may cause some discomfort during the test. X-rays will be taken from several angles. You may be asked to hold your breath while each picture is being taken.  

Depending on the results of your mammogram, your physician may use an ultrasound to further examine the breast tissue. When findings indicate the possibility of cancer, a biopsy is performed to determine if the area is benign or cancerous.   While a mammogram is the best way to detect breast cancer, it isn't the only one. Clinical breast exams (where a physician palpates with the fingers) and breast self-examinations are both important for breast cancer screening. According to the American Cancer Society, all women over age 20 should perform monthly self-exams. In addition, women over 20 should receive clinical breast exams every three years; women over 40 should receive them every year.  

The recommendations from organizations such as the American Cancer Society or the American Cancer Institute are general ones. Women should discuss their personal situation with a health care professional in order to determine an individualized plan of care. Certain risk factors, such as a family history of breast cancer, age, and menstrual history will cause recommendations to vary from person to person.  

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Dr. Fey is a family practice physician at Raiter Clinic in Cloquet.