By Steve Blanchard - July 17, 2020

Most of us are limiting our travel to the threshold of our front door these days in an effort to maintain social distancing and protect our families. While admirable and encouraged by public health officials, there is such a thing as too much isolation, particularly when it comes to cancer screenings.

Fears of contracting the coronavirus in healthcare settings have prevented some people from seeking necessary screenings and treatment. With cancer being such a complex set of diseases, it’s important to remember that prognoses are influenced by the timing of diagnosis and intervention.

“It is a delicate balance,” Dr. Bethany Niell, section chief of breast imaging at Moffitt Cancer Center. “But Moffitt has taken steps to protect our patients and staff and make breast cancer screenings obtainable for all who want or need them.”

"Moffitt has taken steps to protect our patients and staff and make breast cancer screenings obtainable for all who want or need them."

- Dr. Bethany Niell, section chief of breast imaging at Moffitt Cancer Center

For instance, all Moffitt team members and patients are required to wear face masks while on campus and temperature checks are performed on all patients and team members entering the cancer center’s buildings.

“We also maintain social distancing in all of our waiting and dressing rooms and don’t allow visitors to enter the building unless absolutely necessary,” said Christy Smallwood, manager of diagnostic imaging at Moffitt. “We also have implemented increased cleaning of the building and rooms by our environmental services department.”

Approximately 1 in 8 women will develop breast cancer during her lifetime. When it is found early, the prognosis is usually good with appropriate treatment. One of the first lines of defense in the fight against breast cancer is a screening mammogram. Fear of the unknown can be a big deterrent to regular screenings, so knowing what to expect can encourage patients to seek the treatment and appointments they need.

Breast cancer screening mammogram appointments last about a half hour, according to Niell. Half of that time is usually split between paperwork and the actual mammogram. At Moffitt, screening mammograms are performed with digital breast tomosynthesis, which is sometimes called a 3D mammogram. Screening with tomosynthesis finds more cancers and decreases the chance that a woman will be recalled for additional imaging. Mammography results are communicated to patients with a mailed letter from the breast radiologist.

“If a patient feels a new breast lump, they should make a prompt appointment with their healthcare provider,” Niell said.

Here are five things to know about mammograms:

1. What is a screening mammogram?
   Screening mammograms decrease breast cancer deaths by detecting cancers when they are still small. A screening mammogram is used to check for possible signs of breast cancer in patients who do not have any noticeable symptoms. It is performed with a machine that is specifically designed to create detailed X-ray images of breast tissue using compression and small doses of ionizing radiation.

Mammograms often reveal solid tumors, fluid-filled cysts and fatty masses that are otherwise unnoticeable, as well as clusters of calcium called microcalcifications that may or may not be cancerous.

2. Who should have a screening mammogram?
   Moffitt physicians recommend women with an average risk of breast cancer begin screening mammography at age 40.

If a screening mammogram shows an abnormality, a physician will typically order additional testing, such as more mammogram images or images produced by breast ultrasound or magnetic resonance imaging. If further testing reveals a suspicious finding, a physician may recommend a biopsy to remove a small sample of cells from a suspicious area to check for the presence of cancer.

A prescription isn’t necessary for women 40 and older, but may be required for those under 40.

3. What can I expect?
   Most appointments for a mammogram last approximately 30 to 60 minutes. You’ll be asked to change into a wrap in a private dressing area. An x-ray technologist will then position each of your breasts in a mammogram machine, one at a time. While your breast rests on a fixed plate for support, an upper plate will gently compress it, which will allow for a more detailed image. The technologist will use the machine to generate several images of each breast. Some women find the compression to be a bit uncomfortable, but it typically does not hurt. If you’re concerned about discomfort, you can take an over-the-counter medication such as Tylenol an hour or two before your mammogram.

You should receive your mammogram results within a few days. Patients are encouraged to ask their referring providers about how they will receive the results. Some providers will call regardless of whether the results are negative (normal) or positive (abnormal), while others only call if a mammogram reveals something out of the ordinary.  Mammography results are also communicated to patients with a mailed letter from the breast radiologist.

4. How do I prepare for a mammogram?
   In order to have the best experience and get the most accurate results, Moffitt experts recommend:

• Scheduling an appointment during the week after your menstrual period to minimize discomfort
• Not wearing deodorant, antiperspirant, lotion, perfume and talcum powder to ensure the most accurate results
• Wearing a loose-fitting top that you can easily remove and put back on
• Not wearing earrings, necklaces or wear jewelry that you can easily remove before the test

5. Does Moffitt Cancer Center offer screening mammograms?
   Yes, Moffitt offers screening mammograms at the Richard M. Schulze Family Foundation Outpatient Center at McKinley Campusand Moffitt at International Plazalocations. Patients who have had previous imaging done outside of Moffitt are asked to bring a copy of the images on a CD for comparison.