Prevention

Breast cancer screening

Seattle Cancer Care Alliance (SCCA) does more than treat breast cancer. We also focus on finding this disease early, when it is easier to treat. Screening tests are done on a regular schedule for people with no breast cancer symptoms. These tests identify signs that might otherwise go unnoticed. 

Regular screenings are important because the earlier we detect the disease, the better. People with smaller, early-stage breast cancer have more treatment options and a better chance for a full recovery and a long, healthy life. 

You can choose to have an appointment where we give you your imaging results the same day. If your radiologist recommends a biopsy to check tissue that might be abnormal, we offer same-day biopsies as well.

Call (206) 606-7800 to request a screening mammogram or breast MRI.

SCCA breast health experts provide screening tests and can help you decide what is right for you. This depends on your age, health, risk level and other factors. The screenings we recommend — 3D mammogram and sometimes breast MRI (magnetic resonance imaging) — are based on the best scientific evidence. We also lead important clinical trials to improve screening. 

Breast imaging you can trust
Breast imaging you can trust

The SCCA technologists and radiologists who perform and interpret your screenings specialize in breast imaging. Our radiologists are certified by the American Board of Radiology. They have extra training in breast imaging and exceed national standards. 

SCCA is recognized as a Breast Imaging Center of Excellence by the American College of Radiology. We do research to improve early detection of breast cancer with imaging. 

Mammogram

Mammograms — the most common and most studied breast cancer screenings — save lives by finding cancers early.

A mammogram uses X-rays to take images of your breast. With these images, a radiologist can see abnormal areas that may be too small for you or your health care provider to feel.

At SCCA, we use the most advanced technology for mammograms. It is called 3D mammography or digital breast tomosynthesis. We offer 3D mammography as our standard screening for all patients. It gives your radiologist a detailed, layer-by-layer picture of your breast.

Mammograms are the foundation of breast cancer screening. They detect cancer in the large majority of people who have the disease but do not feel a lump in their breast. 

We also use mammograms to help diagnose breast cancer in people with signs or symptoms and to check the results of breast cancer treatment.

Who needs a screening mammogram?

SCCA physicians 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 people may choose to start screening later or to be screened less often.

Organizations like the American Cancer Society and the United States Preventive Services Task Force have different recommendations on the age to start screening and how often to have screenings (every year or every two years).

Here is what is important: Have screenings regularly on a schedule that matches your risk and preferences. Your health care provider or an SCCA expert can assess and explain your risk. We can help you decide on the screening schedule that is right for you.

What is 3D mammography?

3D mammography is a way to take many pictures of your breast at once so physicians can see your breast tissue in detail. This improves the odds of finding true cancers early. It also leads to fewer false alarms (suspecting cancer in tissue that is healthy).

Getting a 3D mammogram is much like getting a 2D (conventional) mammogram. A specially trained technologist positions your breast on a platform. They compress your breast under a paddle. Then an X-ray arm sweeps over your breast, taking multiple images. 

2D mammography takes one image of your breast from above and one from the side. 3D mammography takes many images from both angles. It uses high-powered computing to convert the images into a stack of layers, or “slices.” Each layer is only 1 millimeter thick.

With these layers, 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 normal but could seem abnormal on a 2D image.

What are the risks?

For most patients, the benefits of getting a mammogram outweigh the risks. But, like all tests, mammograms are not completely risk-free.

Most breast cancers can be seen on mammograms, but some cannot. If you have breast concerns, talk with your physician or breast health specialist. This is important even if you just had a mammogram that did not show any problems.

A mammogram can also result in a false alarm, showing a possible problem that turns out not to be cancer after you have more tests, like other scans or a biopsy.

At SCCA and UW Medical Center, false alarms happen for fewer than 10 in 100 patients. This is better than the average rate for health care facilities in the United States.

Mammograms should not be painful. If you feel any pain, let your technologist know so they can reposition your breast. 

Mammograms require the use of a small amount of radiation. This level of radiation is very safe. It is smaller than the amount you would get in your daily life over two months. 
 

Does breast density matter?

When you have a mammogram, you may learn you have dense breasts. Breast density refers to the amount of normal, non-fatty tissue seen in a mammogram. There are four levels, from almost all fatty tissue to extremely dense tissue with very little fat. If your breasts are in the two higher levels, they are considered dense. 

Keep in mind that there is no “normal” amount of breast density. About half of patients who get a screening mammogram have dense breasts, and half do not.
There are two main reasons that breast density matters:

  • Cancer can be harder to see in mammograms of dense breasts.
  • Density has been linked to a higher risk of getting breast cancer. (But density alone has only a small impact on breast cancer risk.)

If you have dense breasts, SCCA breast health specialists will talk with you about your breast density and what it means for you. 

Locations and contact

Call (206) 606-7800 to request an appointment at SCCA South Lake Union or the SCCA Mammogram Van.

Call (206) 598-5800 to request an appointment at all other locations.

Breast MRI

Breast MRI is useful for screening, along with a mammogram, if you are at higher risk of breast cancer.

A breast MRI uses strong magnetic fields, rather than X-rays, to create an image of your breast. It can help detect breast cancers that are harder to see on a mammogram. This makes it a powerful tool, in addition to mammography, for some patients. 

SCCA offers screening breast MRI to people who are at high risk. The goal is to help find signs of cancer that mammography and ultrasound can miss. Our physicians also use breast MRI to plan the best treatment for people who are diagnosed with cancer.
 

Who needs a screening breast MRI?

MRI is a powerful tool to detect breast cancer early. But it is not right for everyone. This is because an MRI can raise suspicions, which lead to more tests and procedures, about spots that turn out not to be cancer.

Like the National Comprehensive Cancer Network, we recommend you have an annual screening breast MRI, along with a mammogram, if any of these are true:

  • You have a lifetime risk for breast cancer of at least 20 to 25 percent. (Physicians 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 (meaning, a family history of,) breast cancer.

SCCA radiologists are experts at knowing which patients can benefit the most from breast MRIs and at getting high-quality breast MRI images.

We are also researching abbreviated MRI. It is faster than regular MRI and appears to be better than 3D mammography at finding cancer in people with dense breasts. In the future, it could become another screening option.

If you are not sure of your breast cancer risk and wonder if you need breast MRI, ask your health care provider or an expert at the SCCA or UW Breast Health Clinics.

Call (206) 606-6487 to request an appointment at the SCCA South Lake Union Breast Health Clinic.

Call (206) 668-6746 to request an appointment at the UW Medical Center – Northwest Breast Health Clinic.

Location and contact

We offer breast MRI at SCCA South Lake Union or UW Medical Center – Northwest. 

Call (206) 606-7800 to request an appointment at SCCA South Lake Union.

Call (206) 598-5800 to request an appointment at UW Medical Center – Northwest.

Other breast imaging 

SCCA experts constantly review the latest scientific evidence about which screenings work best. 

We want to be certain the benefits outweigh the risks for any breast imaging we recommend for you. 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 for screening. Examples include screening ultrasound or molecular breast imaging (such as scintimammography). None of these other tests has been proven to save lives. This is why physicians at SCCA do not routinely recommend them as screenings for most patients.

Breast exams 

Physical exams, done either by a health care provider or on your own, are another tool to help find breast changes that might signal cancer.

Clinical breast exam

A clinical breast exam is a physical exam of the breast and underarm lymph nodes that is done by a physician, physician assistant or nurse practitioner (such as your primary care provider or OBGYN). This is typically recommended on a yearly basis.

Breast self-exam

You can help detect breast cancer by being aware of how your breasts normally feel and look. Some breast cancers are self-detected, meaning people feel or see something unusual in their own breast.

There is no one right way to examine your breasts. We encourage you to regularly inspect and feel your breasts so you know what is normal for you and what is new or different. 

You should seek attention from a medical provider if:

  • You feel a new or different lump or thickening in your breast, especially if it lasts more than a month in the same spot.
  • You notice changes in the appearance of your breasts, such as dimpling of the skin, redness of the skin or nipple discharge.

If you or your provider have concerns about a breast lump or other breast abnormality, request an appointment for a consultation and examination with a breast specialist. Call the Breast Health Clinic at SCCA South Lake Union at (206) 606-6487 or UW Medical Center – Northwest at (206) 668-6746.