You may or may not be a fan of making New Year’s resolutions. Or you might say they don’t work.

Wait! While you could be right, there is good news for you!

A recent study on New Year’s resolutions found that approach-oriented goals are more successful than avoidance-oriented goals.^[1] What does it mean? If your goal is to start a healthy habit, you might be more successful than trying to stop an unhealthy habit.

How can you use this insight to your advantage?

By pledging this year to a simple but lifesaving ritual of annual screening mammography.

If you are a healthy woman above 40 years of age, annual screening mammography is highly recommended for you. About 50% of breast cancers develop in women with no identifiable risks other than gender and age.^[2]

If you are younger than 40 but in a higher risk category with dense breasts, a family history of breast cancer, or personal history of breast disease, etc., you might be advised to start early with routine screening mammography.

Why make mammography your New Year’s resolution?

• First, breast cancer is India’s most common women’s cancer now.^[3] Earlier it used to be cervical cancer. Not anymore.

• Second, there is no way to prevent breast cancer. Early detection – when it’s too small to pose any serious threat to your life and treating it – is the best protection.

The gold standard for early detection of breast cancer is mammography.^[4]

Why not other modalities such as breast self-examination, ultrasound, or MRI?

• Breast self-examination is not recommended by most medical organizations across the world^[5] because it does not help early detection. By the time the lump is big enough to be felt by your or your doctor’s hands, it’s already too big, and too late.

• Ultrasound is more useful for further diagnosing a suspicious finding than for regular screening because it can neither capture the whole image of the breast nor see deep like a mammogram.

• MRI’s high cost and lower ability to correctly exclude women without breast cancer prohibit its routine use for screening.^[6]

How do you benefit if you never missed your annual mammogram?

• Annual screening mammograms can substantially reduce your stress & medical expenses: Just like car insurance premiums, spending a small amount on mammography every year may help you save 30% to over 100% of the treatment costs of breast cancer compared to the women who are diagnosed with advanced-stage breast cancers⁷. You may avoid the need for chemotherapy, removing the entire breasts, etc., with early detection with mammography.

• Breast cancer deaths are reduced by 30% to 50% with annual screening mammography performed on all women beginning at age 40 years.^[7]

How to select an appropriate center for your mammogram?

You deserve access to the best of technology & facilities when it’s time for your annual mammogram.

Here are three easy steps to help you navigate well in choosing the right Mammography Centre, whether it’s in a hospital, a diagnostic lab, or a breast clinic:

1. Does the centre have digital mammography or only the old, film-based analogue mammography?

Mammography technology has made rapid progress in recent years to enable speedier and more comfortable mammograms at much lower radiation doses than ever before.

In the older analogue mammography, the films were used to capture images. Remember the old cameras with film roles? Something like that.

In the newer digital mammography, the image is directly captured by the computer, which can be magnified, enhanced, etc., for further evaluation when needed.

There are more advantages of digital mammography machines over analogue machines.

• The cancer detection rate is significantly higher (21% more) in digital mammography than analogue.^[8]

• Much less radiation (averaging 22% lower) is used by digital mammography vs analogue.^[9]

• Digital imaging is faster than analogue which means a woman’s breasts are compressed for less time.

• Digital images are immediately available for the doctors. There is no waiting time for film development.

2. Is 3D Mammography available at the centre?

• The latest 3D mammography machines in the digital mammography family are designed to deliver the fastest and the highest resolution mammograms, with more comfort, and at the lowest radiation dose within the allowable limits.

• Studies have shown that 3D mammography significantly helps in early breast cancer detection, enabling the detection of more cancer cells^[10], and significantly reducing recall rates^[11] for any additional tests.

• 3D mammography is especially useful in high-risk women, i.e., including those with:

• Changes or lumps in the breasts
• A family history of breast or ovarian cancer^[12]
• Dense breast tissue (nearly half of all women above the age of 40 have dense breasts)^[13]
• A previous diagnosis of breast disease

3. Does the centre have other relevant capabilities for mammography?

• Radiologists are specialist medical doctors who study your mammograms and interpret the scans for you. Usually, the website of the centre will have detailed information about the doctor’s qualifications, experience, advanced training or fellowship in radiology, etc. This may give you a good idea about the professional expertise at the Centre.

• Mammography is only an imaging test that has no cuts, pricks, or admission to the hospital, etc. You can either take a prior appointment or walk in if the centre advises so for mammography that usually takes only a few minutes excluding waiting time. Within those few minutes too, your breast tissue will be compressed only for less than 10 seconds in the latest 3D Mammography machines to take clear images and avoid recalls.

• Most health plans cover the cost of mammography if you are insured for diagnostic tests. Even if not, the cost of mammography is negligible compared to the benefits it provides.

If you are eligible for breast screening either by age (40 years and above) or due to high-risk factors such as family history (in which case even if you are younger than 40 years), make your New Year’s Resolution now! Subscribe to an Annual Screening Mammography plan right away– A simple ritual that can save your life!

1. Oscarsson M, Carlbring P, Andersson G, Rozental A. A large-scale experiment on New Year’s resolutions: Approach-oriented goals are more successful than avoidance-oriented goals. Brown JC, ed. PLOS ONE. 2020;15(12): e0234097. doi: 10.1371/journal.pone.0234097
2. https://www.who.int/news-room/fact-sheets/detail/breast-cancer Accessed 16 Sep 2022
3. Mathur P, Sathishkumar K, Chaturvedi M, et al. Cancer Statistics, 2020: Report from National Cancer Registry Programme, India. JCO Global Oncology. 2020;6(6):1063-1075. doi:10.1200/go.20.00122
4. https://www.webmd.com/breast-cancer/features/mammography-still-gold-standard-for-breast-cancer. Accessed on 19 Dec 2022.
5. https://www.mayoclinic.org/tests-procedures/breast-exam/about/pac-20393237. Accessed on 19 Dec 2022.
6. Elmore JG, Armstrong K, Lehman CD, Fletcher SW. Screening for breast cancer. JAMA. 2005;293(10):1245-1256. doi:10.1001/jama.293.10.1245
7. Feig S. Comparison of Costs and Benefits of Breast Cancer Screening with Mammography, Ultrasonography, and MRI. Obstetrics and Gynecology Clinics of North America. 2011;38(1):179-196. doi: 10.1016/j.ogc.2011.02.009
8. Hambly NM, McNicholas MM, Phelan N, Hargaden GC, O’Doherty A, Flanagan FL. Comparison of Digital Mammography and Screen-Film Mammography in Breast Cancer Screening: A Review in the Irish Breast Screening Program. American Journal of Roentgenology. 2009;193(4):1010-1018. doi:10.2214/ajr.08.2157
9. Hendrick RE, Pisano ED, Averbukh A, et al. Comparison of Acquisition Parameters and Breast Dose in Digital Mammography and Screen-Film Mammography in the American College of Radiology Imaging Network Digital Mammographic Imaging Screening Trial. AJR American journal of roentgenology. 2010;194(2):362. doi:10.2214/AJR.08.2114
10. Skaane P, Bandos AI, Gullien R, et al. Comparison of Digital Mammography Alone and Digital Mammography Plus Tomosynthesis in a Population-based Screening Program. Radiology. 2013;267(1):47-56. doi:10.1148/radiol.12121373
11. Rose SL, Tidwell AL, Bujnoch LJ, Kushwaha AC, Nordmann AS, Sexton R. Implementation of Breast Tomosynthesis in a Routine Screening Practice: An Observational Study. American Journal of Roentgenology. 2013;200(6):1401-1408. doi:10.2214/ajr.12.9672
12. https://www.canceraustralia.gov.au/sites/default/files/publications/breast-cancer-risk-factors-review-evidence/pdf/rfrw-breast-cancer-risk-factors-a-review-of-the-evidence_1.15.pdf  Accessed 16 Sep 2022
13. https://www.cancer.gov/types/breast/breast-changes/dense-breasts Accessed 16 Sep 2022