American Medical Association Family Medical Guide - American Medical Association [106]
The pelvic examination
During a pelvic examination, a doctor examines the pelvic organs by hand to feel for any abnormalities of the uterus, ovaries, and fallopian tubes.
Many laboratories perform genetic tests on Pap smears to identify specific strains of the human papillomavirus (HPV) that are known to increase a woman’s risk of cervical cancer. If the results of your Pap smear show that you have been exposed to a cancer-causing strain of HPV, your doctor may recommend that you have more frequent Pap smears or a colposcopy.
You should have your first Pap smear when you are planning to become sexually active or by age 18. To help prevent cervical cancer, see your doctor regularly—every year or as often as your doctor recommends—for a Pap smear, which makes early detection of cervical dysplasia (see page 874) possible. A Pap smear can help prevent cancer by detecting highly treatable precancerous changes in the cervical cells, which can then be destroyed at an early stage.
Mammograms
A mammogram is a low-intensity X-ray that provides a picture of the internal structure of the breast. Digital mammography records the X-rays in computer code rather than on X-ray film. Mammograms are used as a screening test for breast cancer in women over 40 to detect cancers at an early stage, when they are generally easier to treat and more likely to be cured. Diagnostic mammograms are used to evaluate breast changes such as lumps, pain, or nipple discharge and to look more closely at abnormalities found on a screening mammogram. Although lung cancer kills more women each year, breast cancer is the most common cancer in American women, especially those between ages 50 and 69.
Most doctors recommend that women have a baseline screening mammogram at about age 40 and then have mammograms every 1 to 2 years. For women who are at increased risk of breast cancer (see page 857)—such as those who have a family history of breast cancer (especially in a mother or sister)—a doctor may recommend starting regular mammograms at a younger age. You can obtain a high-quality mammogram at a breast clinic, the radiology department of a hospital, a private radiology office, or at a doctor’s office.
Detecting breast tumors early
In general, the earlier breast cancer is detected and treated, the higher the chances for a cure. The average size of cancerous tumors found by chance is significantly larger than the average size of tumors found on a regular mammogram or with regular or infrequent breast self-examinations.
Having a mammogram
For a mammogram, each breast is compressed between two plastic plates on the mammogram machine. The technician will position your breast to flatten it as much as possible between the plates to get a good image and to spot abnormalities more easily. Once the breast is compressed, a low-intensity X-ray is taken. Screening mammograms usually take two images of each breast—one from the top and one from the side. The procedure takes about 10 to 15 minutes.
All mammography facilities in the United States must meet stringent standards established by the Mammography Quality Standards Act (MQSA), be accredited by the Food and Drug Administration (FDA), and have annual inspections to ensure their safety and reliability. Before making an appointment for a mammogram, ask if the facility has an up-to-date MQSA certificate. You can call the National Cancer Institute at 1-800-4-CANCER (1-800-422-6237) to find a qualified facility in your area. If you are menstruating, schedule your mammogram