Breast Cancer Awareness: Mammograms

According to the Centers for Disease Control (CDC), 42,000 women and 500 men die of breast cancer each year. However, detecting breast cancer early dramatically increases survival. The American Cancer Society states that when breast cancer is detected early and is in the localized stage (meaning there is no sign that cancer has spread beyond the breast), there is a 99% 5-year survival rate.

Early detection of breast cancer is the key to successful treatment. Over the years, increased self-screening, regular mammograms, and adjunct therapies such as hormone replacement have dropped breast cancer mortality rates by 46%. There were about 375,900 averted breast cancer cases between 1989 and 2017. To continue this trend, the American College of Radiology recommends an annual mammogram for all women over 40, regardless of symptoms or family history.

However, not everyone gets mammograms at the recommended rate or earlier. One in three women don’t get routine screenings for breast cancer, and 17.6% of women have never self-screened. We surveyed 755 women to learn if, when, and why they self-screen for breast cancer. Find out the five primary barriers that discourage them from regular check-ins — and what we can do about it — below.

• Cost, fear, and pain are the top factors deterring women from getting mammograms.
• 34% of the women we surveyed have had a breast cancer scare.
• 8 in 10 women with breast implants regularly have their OBGYNs screen them for breast cancer.
• The majority of women start screening for breast cancer in their 40s, but almost 10% have never checked.
• 41% of women would start getting mammograms every year — and more than two thirds would start in their 20s or 30s — if they were free.

We reached out to 755 women, asking them about various factors influencing the likelihood that they self-screen for odd lumps on their breasts and seek regular mammograms. Specifically, we asked about:

• Family history of breast cancer
• How often they self-screen and where they do it
• Age when they started to self-screen for lumps
• Actions they would take if they were to detect a lump or other oddity

This survey focused on self-screening and regular mammograms, as regular check-ins can help you catch the signs early, and early detection significantly decreases breast cancer mortality rates. And while men can also have breast cancer, the proportional rarity of the experience meant we focused on women’s experiences.

Self-screening is one of the earliest and easiest ways to detect breast cancer. It helps people remain knowledgeable about their breast health between mammogram visits and quickly notice changes to breast tissue and appearance. Regular and consistent self-screening is integral for optimal breast cancer wellness.

During self-screening, people look for any irregularities in the breast tissue and on the surface of the breast, including:

• Lumps
• Dimples
• Spots
• Signs of irritation
• Thicker skin
• Changes in size or shape
• Nipple changes (including redness, blood, discharge, scaling, or inversion)

Breast tissue can (and regularly does) appear up to the armpit, so just because something isn’t directly on the breast itself doesn’t mean it isn’t a problem. And some people don’t experience any outward symptoms of breast cancer when it develops.

How frequently do women self-screen?

86.8% of the women we surveyed reported having ever self-screened. They reported self-screening at the following rates:

• Annually: 16.7%
• Monthly: 45%
• Weekly: 20.5%
• Daily: 8.6%
• Never: 9.1%

While most women self-screen for breast cancer, there is some variation around how frequently they do or how they report it. When asked if they have ever self-screened, 13.2% of women said that they never have, but when asked about the frequency of self-screening elsewhere in our survey, fewer women (9.1%) reported that they didn't check. Despite this variation, it’s still clear that about 10% of women don’t check themselves for breast cancer.

Next to self-screening, mammograms are an easy tool to discover breast cancer. A mammogram is a series of four X-rays of the breasts. During a mammogram appointment, a technologist asks the patient to place their breast on a plastic plate. Another plate is then firmly placed on top of the breast to hold it in place for the X-ray.

Though stabilizing the breast in this way is essential for imaging accuracy, the experience can be uncomfortable, and some women find it painful. However, though there may be some minor pain and discomfort, those are short-lived. The amount of radiation used to complete the X-ray is minimal and within medical guidelines.

After the X-ray, a radiologist reads your results and reports on their findings within a few days.

Over the last forty years, breast cancer detection and treatment have dramatically improved, with mortality rates steadily decreasing from 1989 to 2017. Our survey found that 66% of women surveyed have never had a breast cancer scare. However, case numbers nationally have increased by 0.5% since 2017.

Although the numbers are promising, there is still room for improvement. Breast cancer is far from eradicated and is still the second leading cause of death among women after lung cancer, posing a prevalent threat. So while two-thirds of women in our survey haven’t had a breast cancer scare, one in three women (34%) have. There is still work to do in early detection, medical screening, and treatment to limit unnecessary pain, suffering, and death.

On average, women are 62 years old when first diagnosed with breast cancer. However, there is a racial discrepancy here: the average age at which Black women receive a diagnosis for breast cancer is 60, and white women receive a diagnosis at the average age of 63.

With a mind toward learning about early detection, we asked when women start to receive their first mammogram. The relative majority of women surveyed (32.7%) got their first mammogram in their 40s, which aligns with standard medical recommendations. Our close second was significantly younger: 28.2% of women got their first mammogram in their 20s, followed by 26.3% receiving a mammogram in their 30s.

Family history and self-screening rates

More than three-quarters of women surveyed are not only aware of breast cancer but also personally know someone who has or has had breast cancer. 32.7% of those were family members, giving our participants an approximately one in three chance of having a family history of breast cancer.

Women with a family history of breast cancer are more aware of their heightened personal risks and self-screen more. Our survey revealed that while this is generally true, there is still a discrepancy between a family history of breast cancer and the likelihood that a woman will monitor her breasts for irregularities:

• 21.7% of women with breast cancer in their family never self-screen.
• 10.1% of those who never self-screen are unaware if they have breast cancer in their family.

We also asked women how they would respond if they found genetic markers for breast cancer during a DNA test, including BRCA1, BRCA2, and PALB2. An overwhelming proportion of women (73.8%) would take immediate action by increasing their screening rate. One in four women who found a genetic mutation would also consider having their breasts surgically removed as a preventative measure.

We were interested in uncovering if breast size affects how often women self-screen. To simplify things, we split women into two groups: large breasts (cup size D or larger) and average breasts (C or smaller). Of the women we surveyed, 306 out of 755 (40.5%) were large-breasted. Most of these women (45.8%) self-screened monthly, but women with average breasts did at similar rates (41.2%). While these numbers are close, women with average breasts are the least likely of any group in our study to check themselves monthly.

The pattern continued when looking at daily intervals. Women with larger breasts self-screened daily more than, but in similar proportions to, women with average breasts (9.4% vs. 6.2%). However, when it came to weekly screening, women with average breast sizes self-screened more frequently than women with larger breast sizes (20.5% vs. 17.6%).

The resulting numbers mean that overall, size does matter when it comes to frequency. Women with larger breast sizes self-screened more frequently than women with average-sized breasts, but not by much.

Influence of breast implants

As people who put conscious thought and energy into their breasts, we also wanted to know if women with breast implants self-screened more frequently than women without them.

45.9% of women with breast implants self-screened monthly. This number is almost identical — 0.1% higher — to the number of women with large breasts who self-screen monthly and within 1% of the survey’s average. This isn’t surprising: breast implants are designed to make breasts larger, and the average breast augmentation lifts women to a large C or small D cup, so there’s a significant overlap in our survey between women with large breasts and women with breast implants. Not every large-breasted woman has implants, but most women with implants are large-breasted.

Women with breast implants pay closer attention to their breast health than women with natural breasts. For example, 27.1% of women with breast implants self-screened once a week, and 12.9% did so daily. 8 in 10 women with breast implants also regularly ask their OBGYN to look for breast cancer during their check-ups.

Likewise, women with breast implants educate themselves more and are more willing to start getting mammograms earlier. 43.5% of women with breast implants start thinking about getting a mammogram in their 20s, whereas only 28.7% of women without breast implants begin to think about mammograms in their 20s.

It appears that breast augmentation augments vigilance as breast implants are correlated with earlier education and awareness of mammograms, more daily and weekly self-examinations for irregularities in breast tissue and appearance, and a tendency towards involving medical professionals in the process of looking for breast cancer.

We wanted to know how women would respond after discovering a lump on their breast and which variables would get in between women and getting a mammogram. Early detection of breast cancer is crucial, as 99% of women who detect breast cancer before it spreads survive. Knowledge is more than just power — it is survival.

Most women in our survey said they would instantly act if they found an unusual lump on their breast. 69.5% of our participants said they would immediately book the earliest appointment with their doctor. Of the women who wouldn't take immediate action (30.5%), the majority would still respond in some way, either by further monitoring the lump to see if it grows or by mentioning it at their next doctor's appointment. Less than 1% would think nothing of an unusual lump.

The data makes it abundantly clear: women will act to prevent breast cancer, and most women self-screen to ensure that they are on top of their breast health. Furthermore, more than two-thirds of women would immediately take action if they discovered anything out of the ordinary, booking an appointment with their doctors immediately.

Though there is still some work to be done in early detection and overall awareness, a lack of awareness is not the biggest reason women do not get an annual mammogram. Instead, the number one reason women don’t get a mammogram is cost, followed by fear and pain. (Awareness is in a meager fourth place.)

How much does a mammogram cost?

Like many parts of our contemporary health care system, price is the number one thing that keeps women from getting mammograms. In the United States, the out-of-pocket cost of a mammogram differs depending on the state and ranges from $100-$350. According to the Affordable Care Act, health care plans are required to fully cover the cost of a mammogram, but this is limited to women over 40.

Since cost is a significant deterrent, we asked women what they would do if cost were not an issue. According to our survey participants, making mammograms free and offering them to women of any age would make women more likely to get a mammogram. 69.4% of women would get a mammogram every six months to a year, and 10.7% would get a mammogram every month if they didn’t have to pay out-of-pocket. That’s over 80% of women accessing a mammogram according to the recommended schedule.

Furthermore, free mammograms make women more likely to start screening before age 40. Though it is clinically recommended that women start getting regular mammograms at 40, only 28.6% of women said they would start getting them in their 40s if the cost was not an issue. Instead, 28.6% of women would begin in their 20s, and 33.6% would start in their 30s. In other words, if they were free, 62.2% of women would start getting mammograms earlier than the national recommendations suggest.

Fear and pain were also powerful motivators that deter women from getting mammograms. We found that 36.6% of women said they were scared of getting a mammogram, and 34% of women said pain was the reason they would not get a mammogram.

Breast cancer can be scary, but you don’t have to weather the storm alone. Several organizations and groups have formed support groups and networks for breast cancer patients, including:

• After Breast Cancer Diagnosis
• American Cancer Society’s Cancer Survivors Network
• Imerman Angels

The famous charity and breast cancer foundation Susan G. Komen has financial assistance opportunities listed on their website to help offset some of the costs of screening and treatment, from the Affordable Care Act to fertility treatment assistance afterward. Cancer Care offers both community support and more options for financial aid, and Cancer.net provides resources to help you get counseling through it.

Men diagnosed with breast cancer have the extra challenge of shedding misconceptions and assumptions about the disease on top of fighting it. Luckily, there are several resources for male breast cancer patient’s community support too:

• BreastCancer.org
• The Male Breast Cancer Coalition
• Sharsheret

No matter who you are or what you’re experiencing when it comes to breast cancer screening, diagnosis, or treatment, know that you’re not alone.

We surveyed 755 women on their experiences regarding self-screening for odd lumps on their breasts, at what age they started thinking about mammograms, if breast cancer runs in their family, and more. This study is especially important to us as October is National Breast Cancer Awareness Month, and we want to provide people of all ages the information they need on breast cancer, mammograms, and other related medical screenings.

Innerbody Research is committed to providing objective, science-based research to help our readers make more informed decisions regarding health and wellness. We invested the time and effort into creating this report to ensure women can access easily understandable material regarding sensitive topics such as breast cancer. We hope to reach as many people as possible by making this information widely available. As such, please feel free to share our content for educational, editorial, or discussion purposes. We only ask that you link back to this page and credit the author as Innerbody.com.

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