Why regular mammograms and follow-up tests are so critical

If you’re in your early 40s and diagnosed with breast cancer, few people would blame you for having a “Why me?” attitude. But that’s not Erika Johnson’s outlook. Instead, she’s grateful her cancer was found early, because that’s when treatment is more likely to be effective.

“I feel lucky,” says Erika, of Island Lake, Ill. “Thank goodness they found it when they did.”

Erika’s cancer diagnosis and treatment was the result of diligence and persistence – diligence on her part for getting annual mammograms and following up when called back for additional tests and a biopsy. And persistence on the part of a team of Advocate Good Shepherd Hospital radiologists who ordered additional tests when things didn’t look quite right.

Erika had her first screening mammogram in 2014 when she turned 40 years old, and she returned for annual screenings. After her screening in November 2017, a radiologist viewing the images noticed an asymmetry. He compared it with her previous mammogram images, looking for changes in shape and density.

He requested additional views of the left breast, so a diagnostic mammogram and an ultrasound were ordered. As with a screening mammogram, the diagnostic mammogram uses X-ray technology, but the diagnostic mammogram provides more views. The ultrasound uses sound waves that produce even more details on the breast’s internal structure. The asymmetry appeared more prominent, so a magnetic resonance imaging (MRI) of the left breast was ordered.

With a breast MRI, multiple images of the breast are captured, then the images are combined using a computer to generate very detailed pictures. Often, breast MRIs are used for women who have very dense breast tissue. They involve injection of a dye through an IV line in the patient’s arm to enhance the appearance of tissues or blood vessels, making the images easier to interpret.

Separately, an MRI-guided biopsy was ordered. For this type of biopsy, magnetic resonance imaging is used to help guide the radiologist’s instruments to the tumor site. Thanks to that biopsy, the diagnosis was clear. Erika had invasive ductal carcinoma of the left breast. She underwent surgery to remove the cancer, and she received radiation therapy.

While women often hear that annual mammograms are important, Erika’s experience underscores that point. Had she not been diligent about her mammograms, the radiologists might not have been able to detect the subtle changes, which motivated them to pursue additional tests that eventually helped them catch the cancer early and treat her.

“This shows the importance of getting regular mammograms and having them available for comparison,” says Dr. Kevin Kirshenbaum, one of the diagnostic radiologists at Advocate Good Shepherd Hospital. “And for consistency, it behooves the patient to have them at the same place or at least not to bounce around from year to year.”

Our Breast Health Assessment estimates your five-year and lifetime risks of developing breast cancer.