Breast cancer screening
Breast health experts at Seattle Cancer Care Alliance (SCCA) provide breast cancer screenings and can help you figure out which screenings are right for you based on your age, health, risk level, and other factors.
Screening tests are done on a regular schedule in women without any breast cancer symptoms. They identify signs that might otherwise go unnoticed.
That’s important because the earlier we detect the disease, the better. Women with smaller, early-stage breast cancer have more treatment options and a better chance for a cure.
Why choose SCCA for screenings
The breast cancer screening tests we recommend—mammography and, for some women, breast MRI—are based on the best scientific evidence, like all the care SCCA provides.
- SCCA is recognized as a Breast Imaging Center of Excellence by the American College of Radiology.
- You can feel confident about being screened at SCCA because the expert technologists and radiologists who perform and interpret your tests specialize in breast imaging exclusively. Our radiologists are UW Medicine doctors.
- We use leading-edge technology, like 3D mammography, and are actively engaged in research to improve breast cancer early detection with imaging.
- To put your mind at ease, you have the option to select an appointment where we’ll give you the results of your screening the same day.
- If your radiologist recommends a biopsy to check tissue that might be abnormal, we offer same-day biopsy services.
Screening mammograms are the most common and most studied screening test for breast cancer. They save lives by identifying cancers early.
- A mammogram uses X-rays to produce images of your breast so a radiologist can see abnormalities that may be too small for you or your health care provider to feel.
- At SCCA, we use the most advanced mammographic technology, called 3D mammography or digital breast tomosynthesis.
- 3D mammography takes many pictures of your breast at once. This means better odds of finding true cancers early and fewer false alarms (suspecting cancer in tissue that’s actually healthy).
- Once you have a mammogram, you may learn you have dense breasts. As this information may be confusing, here is information on breast density and what you should know.
We offer four convenient locations:
- SCCA Women's Center at SCCA South Lake Union
- SCCA Mammogram Van (various locations)
- UW Eastside Specialty Center
Screening mammograms detect breast cancer in the great majority of women who have the disease but don’t feel a lump in their breast. By detecting cancer before it can be felt, mammograms save lives.
- SCCA doctors recommend women 40 or older have a screening mammogram every year if they are at average risk for breast cancer.
- This matches guidelines from the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers, including SCCA.
This recommendation is not right for everyone.
- If you are at higher-than-average risk, you may need screenings earlier and more often.
- Some women may choose to start screening later or be screened less often.
Organizations like the American Cancer Society and the United States Preventive Services Task Force differ on the age to start screening and whether to have screenings every year or every two years.
- What is most important is that you have screenings regularly at an interval that matches your risk, values, and preferences.
- Your health care provider or an expert at the SCCA Women’s Center can assess and explain your risk and help you decide on the screening schedule that’s right for you.
For most women, the benefits of getting a mammogram outweigh the risks. But, like all tests, mammograms have some risks:
- Most breast cancers can be seen on mammograms, but some cannot. If you have breast concerns, talk with your doctor or breast health specialist about your symptoms. It is important to do this even if you just had a mammogram that did not show any problems.
- A mammogram can result in a "false alarm." A false alarm is when a mammogram shows a possible problem that turns out to not be cancer after more tests are done. These tests may include more imaging exams or having a small tissue sample (biopsy) taken for testing in the lab.
- At SCCA and UWMC, false alarms occur for less than 10 percent of women (fewer than 10 out of 100 women). This is better than the average rate for health care facilities in the U.S.
An expert trained in breast imaging will read and interpret your images. SCCA and UWMC radiologists who read mammograms are certified by the American Board of Radiology and have received extra training in breast imaging. Our radiologists exceed the national criteria for excellence.
SCCA offers 3D mammography, also called digital breast tomosynthesis or DBT, as our standard mammographic screening exam for all patients. This state-of-the-art technology allows doctors to examine your breast tissue in greater detail, one layer at a time.
With 2D (conventional) mammography, one image of your breast is taken from above and one is taken from the side. 3D mammography takes many images of your breast from both angles and uses high-powered computing to convert them into a stack of layers, or “slices,” each only 1 millimeter thick.
This means your radiologist can see breast cancers more clearly and provide a more confident assessment. 3D mammography might reduce your need for follow-up tests of tissue that is actually normal but could seem abnormal on a 2D image.
Getting a 3D mammogram is much like getting a 2D mammogram. A specially trained technologist will position your breast on a special platform and compress it under a paddle. The X-ray arm will sweep over your breast, taking multiple images.
Breast magnetic resonance imaging (MRI)
Breast MRI is a powerful tool for detecting breast cancer and planning the best treatments for women newly diagnosed with the disease. MRI is an important additional screening test for some women. A breast MRI uses strong magnetic fields, rather than X-rays, to image the breast. It can help detect breast cancers that are harder to see on a mammogram.
- In general, a screening breast MRI is useful, along with a mammogram, if you are at higher risk of developing breast cancer.
- SCCA radiologists are experts at obtaining high-quality breast MRI images and identifying which women will benefit the most from MRIs.
- We also conduct breast MRI research and clinical trials that examine how to best use this technology.
SCCA offers screening breast MRI scans to women who are at high risk for developing breast cancer to help find signs of cancer that mammography and ultrasound can miss.
Like the National Comprehensive Cancer Network, we recommend women have an annual screening breast MRI, along with a mammogram, if any of these is true:
- You have a lifetime risk for breast cancer of at least 20 percent. (Doctors have tools to calculate your risk.)
- You had radiation therapy to your chest between the ages of 10 and 30.
- You have a genetic predisposition to breast cancer.
If you have newly diagnosed breast cancer, a breast MRI may help doctors select the most effective treatments for you. MRIs can also be useful to monitor how well a treatment is working. Your team of SCCA experts can talk with you about whether to have a breast MRI and how it might help.
SCCA radiologists are experts at obtaining high-quality breast MRI images and identifying which women will benefit most from MRIs. While breast MRI is used primarily to screen women at high risk and to evaluate women who have known breast cancer, we are researching its use in other types of patients.
Other breast imaging tests
SCCA experts constantly assess the latest scientific evidence about the best ways to screen for breast cancer, so you can be certain the benefits outweigh the risks for any test we offer.
Mammography and MRI are the most proven ways to detect breast cancers with imaging.
You may hear about other imaging tests being used or studied to screen women with dense breasts. None of these other tests have been proven to save lives. That’s why doctors at SCCA do not routinely recommend them for most women.
These are the most common screening tests you may hear about other than mammography and breast MRI:
- Screening ultrasound: Ultrasound is an excellent tool to better look at a lump or a suspicious area found on a mammogram. But it is generally not as useful for screening women who do not have symptoms. That’s because it causes many more false alarms (suspicious areas that turn out not to be cancer) compared to the number of actual cancers it detects. At SCCA, we use screening ultrasound mainly for women who are at high risk and cannot have an MRI due to other medical issues.
- Molecular breast imaging, including breast-specific gamma imaging (BGSI) (also called scintimammography) and positron emission mammography (PEM): Compared to mammography, these technologies expose women to higher radiation doses, which may carry health risks. Though some centers already offer BGSI and PEM, more research is needed to determine how we should use these tests.
- Abbreviated or FAST MRI: This shorter version of breast MRI may help detect cancer in women with dense breasts when used along with mammograms. We are actively studying this technology to determine who might benefit.
- Contrast-enhanced mammography: Injecting a contrast agent into your bloodstream before your mammogram might help detect cancer. The contrast agent, which lights up in the image, collects more easily in areas with unusually high blood flow, like tumors. We will be studying this type of test.
- Thermography: SCCA does not offer thermography examinations, in accordance with the Food and Drug Administration’s recommendation against its use as an alternative to mammography.
Breast self-exam and awareness
You can help detect breast cancer by being aware of how your breasts normally feel and seeing your health care provider about any changes you notice. Many breast cancers today are self-detected.
In the United States, for every 10 women diagnosed with breast cancer:
- Six were diagnosed because they had a screening test, like a mammogram, that detected abnormal tissue, even though they had no signs or symptoms.
- Four were diagnosed because the woman or her health care provider felt a lump or noticed another sign or symptom and had it evaluated.
Call SCCA’s Breast Health Clinic or your regular health care provider for an appointment. We have breast specialists familiar with the whole spectrum of breast concerns, from benign to malignant, who can help you sort out what your symptoms might mean.
Along with having a clinical evaluation, you may need:
- Imaging tests, like a mammogram or ultrasound
- Other diagnostic tests like a biopsy to remove a small sample of cells and check them under a microscope
Most breast changes that you or your health care provider can feel are not cancer. If you feel worried, remember it’s normal for your breasts to change at different times in your menstrual cycle or for other completely harmless reasons. Take a deep breath, and then see a health care provider for an evaluation.
Clinical breast exam—where your health care provider looks at and feels your breasts for signs of cancer or other health issues—is a common and normal part of a general physical exam, such as an annual wellness check-up. If your provider doesn’t automatically include a breast exam, it’s OK to ask them to do it.