Monica Rocco

QUESTION: Mammography -- When should you start screening?

Mammograms do not prevent breast cancer, but they can save lives by finding breast cancer as early as possible.

It is not hard to tell that October is Breast Cancer Awareness Month because everywhere you go you can see pink ribbons reminding us that breast cancer is the most common cancer and the second-leading cause of death for women in the United States. One in eight women will develop breast cancer during their lifetime. Many times this will be a friend, teacher, neighbor or relative.

I still get asked the question regularly, When should I get my first mammogram?

It is important to realize that most (60 percent) patients, who get breast cancer, have no family history. So using risk factors, such as family history alone, can be problematic. Mammography is still the gold standard screening test for breast cancer. They can save your life.

Finding breast cancer early reduces your risk of dying from the disease by 25 to 30 percent or more. Do not be afraid. Mammography is a fast procedure, and discomfort is minimal for most women. The procedure is safe: There's only a very tiny amount of radiation exposure from a mammogram.

Most of us who treat breast cancer patients realize that we should be looking at not only decreasing the death rate but how earlier diagnosis can prevent less aggressive treatment options by finding smaller tumors. A smaller tumor might allow a lumpectomy instead of a mastectomy, which is often a great relief to the patient, especially if she is 40 years old. Sometimes finding a smaller tumor might mean that no chemotherapy is indicated and, not only is the patient happy, but it doesn’t subject them to side effects and saves thousands of health care dollars.

The recommendations for women are the following: Begin self-breast exams in your 20s and report any changes to your physician. The best time to do your exam is one week after you start your period, as this is when the breast should be the least lumpy (under the least amount of hormonal influence).

Women know their breasts better than anyone else and should be able to at least seek medical advice as to whether the lump is worrisome.

A clinical breast exam by health professional, such as physician, nurse practitioner or physician’s assistant, should be scheduled at least once a year.

Screening mammography should beginn at age 40, unless there is a family history, and then the recommendation is for mammography to start 10 years before the youngest relative was diagnosed with breast cancer. (If the mother was diagnosed at age 45, then mammography should start at age 35.)

For women over 75 years of age, the decision to have screening mammography should be based on the health of the patient, risk factors and whether the patient would be willing to undergo treatment if a cancer was found. Yes, I have recommended mammograms in healthy 90-year-olds!

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All the physicians in our community who treat breast cancer agree that mammography saves lives and will continue to follow these guidelines. If you have any questions or would like more information on breast cancer screening, contact our dedicated oncology-trained nurse navigator at 346-3405.

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Our seventh annual Girls Night Out event will feature a panel of experienced female medical professionals. This is a great time to get the facts about early detection, prevention strategies and more. Join us Wednesday at 5 p.m. at the Mission Hope Cancer Center Conference Room. Space is limited, so call 219-4673 to reserve your spot.

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Have a question for Your Cancer Answers, a weekly column produced by Marian Regional Medical Center, Cancer Program? Email it to

Dr. Monica Rocco is a board-certified general surgeon who has devoted her surgical practice to caring for patients with breast disease and providing diagnosis and care before, during and after surgery. She serves as a member of the Marian Regional Medical Center’s specialized surgical staff and oversees the Mission Hope Breast Care Center. She is also the surgical director of Marian Cancer Care. Rocco can be reached at 346-3456.