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Q&A with Dr. Allison Edwards

For Breast Cancer Awareness Month, we asked Sesame's Medical Advisor Dr. Allison Edwards your questions about breast cancer, risk assessment, mammograms, and more.

What you need to know this Breast Cancer Awareness Month.

Q: How often should I be screened for breast cancer?

Dr. Edwards: The US Preventive Services Task Force - the organizing body that provides general screening recommendations to doctors - recommends that a woman receives a mammogram (screening for breast cancer) every other year from the age of 50 onward. According to the USPSTF, screening before the age of 40 is an individual decision based on health history and family history of breast cancer.

Other organizations, such as the American College of Obstetricians and Gynecologists, the American Cancer Society, and the National Comprehensive Cancer Network recommend women begin screening for breast cancer biannually between the ages of 40-45. These organizations, however, also note that this is a decision for the individual.

It’s important to remember that these are screening guidelines: they apply to women who don’t have a personal history of breast cancer and who aren’t actively concerned about a lump or any other breast concern that anything needs to be checked out.

Q: Should I get a 2D or 3D mammography exam?

Dr. Edwards: The FDA approved the use of digital breast tomosynthesis in 2011 but studies haven’t definitively shown that 3D is always going to be better for everyone. There are a lot of factors going into this. 2D mammography is lower cost, widely available, and has a lower radiation dose than 3D mammography. 3D mammography has been found to decrease the risk of needing to re-screen or call a woman back to the office for further imaging but does run at a higher price. It’s still unclear which modality is better at preventing death from breast cancer, which is the whole point of breast cancer screening! Stay tuned for more as time goes on.

Q: How do I determine my risk of breast cancer?

Dr. Edwards: With the advent of new technologies and sciences, we are learning more and more about the genetics that play into breast cancer. The genetic mutations that are most widely studied and linked to breast cancer are BRCA1 and BRCA2, which cause 5-10% of breast cancers. With 90-95% of breast cancers not attributable to these mutations, we have to revert back to simply examining the family history of a woman to provide the best recommendations for breast cancer screening.

Most breast cancers are not linked to a hereditary (I.e. inheritable) mutation. Because of this, even if you have a family member who has had breast cancer, your clinician will likely recommend screening with mammograms just like any other woman with average risk. That said, if you feel you have a strong family history of breast cancer, are at higher risk, or are experiencing any concerning symptoms, you should consult with your clinician about how to best move forward in your women’s health journey.

Frequently Asked Questions


What is a mammogram?

Mammograms are one of the primary tools that doctors use to detect breast cancer in patients. They play a key role in ensuring that cancers are caught early - before they spread and while they are still easily treatable.

Mammograms take x-rays of the breasts to screen for cancer, as well as for other abnormalities, like cysts, calcifications, and fibroadenomas. Screening mammography is one of the primary tools that doctors use to screen patients for breast cancer.

The American College of Radiology (ACR) and the Society of Breast Imaging (SBI) recommend that all women should "have a risk assessment at age 30 to see if a screen earlier than age 40 is needed."

What are the types of breast exams you can get?

Health care providers use breast exams and mammograms to detect cancer in breast tissue before symptoms occur. There are a few ways in which you can get tested:

Mammogram: A screening mammogram is a low-dose x-ray that takes two or more x-rays of each breast to check for tumors and abnormalities.

Breast ultrasound: If abnormalities are found during your mammogram, your doctor may request a breast ultrasound, which uses sound waves to see the breast tissue in real-time. A breast ultrasound is a useful option for women with dense breasts.

Breast tomosynthesis (3-D mammography): Uses x-rays and computer technology to create a 3-D image of the breast. 3-D mammography is another useful option for women with dense breasts.

Contrast-enhanced digital mammography (CEDM): Combines 3-D mammography with a contrast dye to better detect breast cancer in those who are high-risk or who have dense breasts.

Breast MRI: Uses radio waves and magnets, along with a computer to create a detailed image of your breast. This is a great option for those who have previously had breast cancer and would like to avoid the radiation from a regular mammogram.

Self-exam: This is an at-home exam where you check your breasts for any unusual lumps or thickening of the skin. Learn how to perform a self-exam here.

What are the benefits of mammography?

Early detection is crucial in catching breast cancer and starting treatment before it spreads. Studies show that regular diagnostic mammograms have helped reduce the number of breast cancer deaths in women - particularly among women over the age of 50.

Mammograms are highly effective at screening not just for breast cancer, but also for rarer types of tumors like invasive ductal and lobular cancers. Mammograms catch cancers early. In some cases, if the cancer is still early-stage, you may not even need radiation or chemotherapy for treatment.

Now, health care marketplaces like Sesame make it easier than ever to book a mammogram and save up to 60% off imaging services. Sesame offers quality care with real, licensed doctors Fargo, ND for upfront, cash prices - no insurance required.

When should a woman start getting mammograms?

It depends. The American Academy of Family Physicians recommends women age 50 and older get a screening every 2 years. The American College of Radiology recommends that women ages 40 and above should get a breast exam once a year. The American Cancer Society, however, notes that "among average-risk women, clinical breast examinations to screen for breast cancer is not recommended."

Talk with your doctor about your breast exam options.

Looking for a doctor? Need a referral? Sesame can help! With Sesame's affordable, upfront pricing, you can select a service and know what you'll pay before you book your visit. Yep, it's really that simple.

What are 3D mammograms?

3-D mammograms are another tool that doctors use to screen for breast cancer and abnormalities. 3D mammography combines multiple x-ray breast imaging slides to create a multi-dimensional picture of the breasts.

Digital mammography is a great option for women with dense breast tissue. It detects a wider range of cancers than traditional mammograms and reduces the likelihood that you'll need to schedule follow-up appointments for further diagnostic imaging.

Looking for a 3D mammogram? No need to go through an insurance company to get the healthcare you deserve. Connect with a real, licensed doctor in Fargo, ND for one affordable, upfront price. Book your next mammogram on Sesame to save up to 60% - no insurance needed.

What are the risk factors for breast cancer?

There are several different factors that could put you at a higher risk of breast cancer. According to the CDC, you may be more likely to develop breast cancer if the following apply to you:

Personal and family history: If anyone in your immediate family has had breast cancer, then you may be at higher risk and should consider regular mammography visits.

Dense breasts: There is more connective tissue in dense breasts, increasing the likelihood that you could develop breast cancer.

Gene mutations: Genetic mutations in genes such as the BRCA1 and BRCA2 may put you at a higher risk of breast cancer.

Aging: Most cases of breast cancer involve women above the age of 50.

Previous radiation therapy: Women who have previously received radiation therapy in the chest before the age of 30 have a higher risk of developing breast cancer later down the line.

Breast cancer screenings are one of the best tools for early detection. Book a mammogram with Sesame. No insurance. No copay. No nonsense. Just simple, affordable care.

Should I get a mammogram during the pandemic?

If you’re at high risk or have acute symptoms, the risk of putting off a mammogram is higher than the threat posed by COVID-19 at outpatient facilities taking every imaginable precaution to keep staff and patients safe.
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