As you may know, October is Breast Cancer Awareness Month, which is why I want to address a very important topic: screening mammograms. Since the pandemic began, there has been a sharp decline in preventative medical care due to concerns surrounding COVID-19.
Many people chose to push back routine medical appointments for fear of contracting the virus. Furthermore, for approximately two months last spring, all screening mammograms were postponed in Minnesota (and in many other states in the country) during the stay-at-home order.
With the COVID-19 pandemic, we know that there is always a possibility of contracting the virus in any public setting. With that said, skipping an important cancer screening is risky, too. Breast cancer screening is the most reliable way to detect breast cancer at an early stage, when the disease is more likely to be smaller and easier to treat.
As a breast reconstruction specialist, I am concerned that we will start seeing more advanced stages of breast cancer because people are not getting screened and diagnosed early. Delaying a screening mammogram for one or two months is unlikely to be dangerous, but postponing it for 6-12 months is enough time to allow a cancer that could have been caught early to grow and spread, making it more difficult to treat and potentially impossible to cure.
When should you start getting annual screening mammograms? Most guidelines from medical expert associations recommend starting at age 40. In addition, women at high risk for developing breast cancer should begin screening at an earlier age.
But did you know that since 2015, the American Cancer Society modified their guidelines and now recommends that women with an average breast cancer risk can start annual screening mammograms at age 45 instead of age 40? It is important to be aware of these differences to help you make informed decisions about your health.
When trying to decide whether or not to postpone your annual screening mammogram, consider your own health risks. Answering the following questions should help you make a safe decision given your specific circumstances:
What is your personal risk of developing breast cancer?
- Do you have any family members who were diagnosed with breast cancer?
- Are you aware of a genetic predisposition for breast cancer in your family, such as a BRCA gene mutation?
- Do you feel a lump in one of your breasts?
What is your risk for complications if you were infected with COVID-19?
- Do you have any medical conditions, such as a chronic lung disease like emphysema, or a heart disease that make you more vulnerable to COVID-19?
If you have answered “yes” to at least one of the above questions on breast cancer risk, or if you feel a lump in one of your breasts, your risk of developing breast cancer likely outweighs the risk of catching COVID-19 while you are getting your screening mammogram.
Conversely, if you are at average risk for breast cancer and answered “no” to all the questions on breast cancer risk, but if you are at high risk for developing complications from COVID-19, it is probably safe to delay your screening mammogram (especially if you had one in the previous year), as long as you clear this with your primary care doctor.
Screening mammograms are currently available in Minnesota with enhanced safety protocols in place to keep patients and employees healthy, including screening for COVID-19 symptoms, wearing face masks, hand sanitizing, physical distancing to ensure a six-foot distance from others, and disinfection of equipment between exams. Most facilities also have extended hours to avoid crowded waiting rooms.
If you are concerned about going to a hospital to obtain your mammogram, it is important to note that these tests are also available in different facilities outside of hospital settings, including radiology or imaging centers. Talk to your healthcare provider about your risk for breast cancer and the best screening option for you.
Dr. Valerie Lemaine, M.D., M.P.H., is a top-ranked, board-certified plastic surgeon in private practice in Edina, MN. She received her M.D. from University of Montreal, Canada, where she also completed her plastic surgery. She obtained her M.P.H. from Columbia University, NY, USA. She also completed a reconstructive microsurgical fellowship at Memorial Sloan-Kettering Cancer Center in New York City. Dr. Lemaine then accepted a staff position at the prestigious Mayo Clinic (Rochester, MN) where she worked as a plastic surgeon, taught and published clinical research. In 2018, she transitioned to private practice and joined Plastic Surgery Consultants and Minnesota Oncology.