Know your risk: Navigating breast cancer screenings

We are nearing the end of Breast Cancer Awareness Month and coincidentally every October I go in for my annual mammogram. This is something I've been doing now since my mid-30s all because of my family history. So I went to BreastLink in Tarzana and this time you're coming with me because maybe you're apprehensive about getting your first mammogram yourself or maybe you're curious about what the whole process is like. So here we go. The first step in getting your mammogram is the most boring but one of the most important. Filling out your family history form. What we worry about is any heritable genetic risk of developing the disease. You have a history of the disease on your father's side. He's right. My dad's mother and her father both had breast cancer. Later in life, both my biological grandparents on the same side died from pancreatic cancer. In your case, you're at an elevated risk, meaning you're above the 20% lifetime risk threshold of developing the disease. That means I qualify for extra screenings, which I'll get to in a second. Let's start though with the mammogram. Right this way. All right. All right, see ya. Hello, I'm Jen, you're Haley? Yes, so we're gonna do a mammogram today. We'll start off with the right breast first. Yep, so the mammogram, a little awkward, sure. Twist your shoulders this way, lay your arm that way. Make small talk like you're not topless, okay, but painful? Here we go, go ahead and hold your breath. Not at all. Can you go ahead and have you take a seat? Sure. My next stop is a bit more involved. One of those extra screenings I mentioned, a breast MRI. The MRI is a very sophisticated, time-intensive, and resource-intensive imaging study. It can take up to 40 minutes to actually complete the exam. It starts with an IV. Have you been told that I have good veins? You do, I see it. We give you contrast through an IV, a contrast agent. And basically what that contrast agent does is it travels wherever blood flows. So it gives you an idea of where blood is flowing in the breast. Breast cancer needs oxygen. It needs blood to survive, sustain itself, and to ultimately spread. So we look for that blood flow as a marker for disease. I probably should take off some. Yes, totally. Jewelry comes off, blankets and headphones go on, and into the MRI machine we go. Here we go. It's loud. Lots of clanging and beeping, but clearly that didn't stop me from falling asleep. All right, Jennifer, I noticed a little bit of heavy breathing. Just try your best to relax the breathing. Let's look at the blood vessels. Now for the results, which typically come back in a couple of days. We're going to start by taking a look at the mammogram. This is our bread and butter screening utility. What's very helpful in having a mammogram, and thank you for being so consistent with getting your yearly mammograms, we have a comparison to look for. So that allows us an ability to look for changes over time within the breast tissue. And thankfully, everything has remained stable. So everything's looking great on the mammogram. So now that we've covered the mammogram, let's get into the MRI. Keeping in mind, blood flow is a marker for disease. So on the scan, if you don't see a bright spot, that's generally a good thing. This is a healthy breast. Both breasts are looking healthy and normal. So that's a very reassuring thing for me as a breast imaging radiologist, because I can comfortably hang my hat on this exam knowing that you are free of disease. And with artificial intelligence on the horizon, that kind of early detection could get even earlier. What we've noticed having applied artificial intelligence to our imaging studies over the past three years is that we're detecting breast cancers at a much higher clip. We're detecting 21% more cancers with artificial intelligence than what we were doing prior to implementing artificial intelligence. That's significant. Significant. It's a huge advancement for us in our field of radiology, but more importantly, detecting diseases that will ultimately save more lives. Wow. Okay, so depending on your family history, you can begin getting supplemental, those extra MRI screenings at age 25, as early as then. mammograms at age 30, and a general rule, if you have a first degree relative, so like a mother or a sister who had breast cancer, then you start screening 10 years earlier than the age they were when they were diagnosed. I know it's a lot to take in. No, this is so helpful. And you showing the process, you know, as for someone who's never gotten a mammogram, it really helps to see what it entails. Yeah. We've got a lot of questions about, is it painful? And I can tell you in no way are either of them painful i think the most the worst part of all of it was i couldn't wear deodorant at all that day um and that was probably worse for you than it was for me i remember that day but you felt you like you fell asleep in the in the actual i did i fell asleep in the mri is that okay you can just oh yeah okay but they do remind you so i would say like the trickiest part of it is the breathing right making sure that you're oh yeah you're calming your nervous system down enough to where they can get a good image and so you're not moving around too much and of course it's the lungs it's the breasts so so important my grandmother my mom's mom passed away from inflammatory breast cancer so my mom and my aunts have been really good about getting mammogram and now you know that's right in my family history so it's important to go and get out of that season yes and for men you have to get prostate yeah yeah prostate screening and the And the prostate cancer screening is, um, you've, you've done this before, right? But I'm also at elevated risk too, because it's like you said, first, uh, first degree relative, first degree relative. So my twin brother had prostate cancer. So yeah, we had a doctor here a couple of weeks ago talking about prostate cancer screenings. And I told him and he has the look on his face. He was like, you really, you really need elevated screenings frequently. Yes. That are, that are, by the way, I should mention this covered by insurance when you qualify to know. very helpful yeah yeah yeah and so many insurances cover your women's wellness exam and those screenings so you know you have them with your plan don't blood testing to genetic testing yeah the regular mammogram is mammogram is i say regular but the mammogram is covered at whatever age you're at whatever age you you need to start depending on your family history or your actual age and that is in most cases 45 insurance right and if you don't have family history with uh breast cancer is it 45 for your mammogram i i don't want to speak out yeah i'm guessing and then i a colonoscopy is what age now too oh god all i know i thought it was 50 but did it go down i think that also yeah i don't i don't want to talk out of turn so yeah i would look that up for sure definitely we're definitely getting closer to those ages that's all i know they're getting either we're getting closer or they're coming down maybe both