Should a have an ultrasound or mammogram?

Question

I felt a small something on my left breast. I'm not sure if it's a lump. I have been observing it for 3 months now. I was hoping that it would go away after my period.. but it's still there. I am 24 with no family history of breast cancer. Should i go to a doctor first or have an ultrasound/mammogram? Is there a low cost doctor and ultrasound that I can go to in NY? I am not an immigrant or citizen. I have no insurance.

Answer 1

Before having a mammogram or breast ultrasound, you will need a doctor's referral.  A imaging facility cannot do a mammogram anyone who has breast abnormalities, without a doctor's order. So that has to be your first step.  After the age of 35, a woman can have a screening mammogram (meaning she does not have any signs or symptoms) every year, without a referral.  

There are programs to help low income & uninsured women who have GYN issues and problems find affordable doctor's care.  Most of the programs, which pertain to the breast, are designed for older women, but they may be able to refer you to programs designed for your age group.  Here are some resources for finding low cost mammograms.  I am sure they can point you in the right direction.

****Call your local chapter of the American Cancer Society (number in your phone book) or the national toll-free number, 1-800-ACS-2345. The ACS will be able to tell you about any low-cost or free mammography programs offering screening to women unable to pay for it themselves.

****Call your State Department of Health (number in your phone book). Every state now has a Breast and Cervical Cancer Early Detection Program funded by the US Centers for Disease Control and Prevention. This program offers screening to qualifying women unable to pay for it themselves.

****Call the YWCA's ENCOREplus Program for access to low-cost or free mammograms. To find which YWCA facilities offer this service and if you are eligible, call 1-800-95EPLUS or your local YWCA.

****Call the National Cancer Institute at 1-800-4-CANCER for the names of FDA-certified, accredited mammography facilities in your area. If you explain your financial situation, some mammography facilities are willing to work out a lower fee or payment schedule that will make the test more affordable. Ask the facility if they are willing to discuss these options with you.

Even if a younger woman had a lump, most doctors will order an ultrasound before a mammogram, because most breast lumps, in young women, are cysts. Cysts are not cancer, do not become cancer and can come and go with the hormonal fluctuations of your menstrual cycle. An ultrasound is a very good way to diagnose a breast cyst. If the mass felt is not a cyst, then we would do a mammogram. So, even if you have symptoms, a mammogram is really not the best imaging study for you.

A young woman has dense breast tissue. Dense tissue appears white on the x-ray film....and so do all signs of breast cancer (both masses/lumps or calcifications). You cannot see white pathology through white, dense normal tissue. It is like trying to see a white volleyball in the snow in a photograph. So, for young women, mammography is not very accurate.

Also, dense breast tissue requires a higher dose of radiation to get an adequately penetrated image. Whenever we do any imaging study involving radiation, we must be reasonably sure that the benefits outweigh the risks of the procedure. In your case, the dose of radiation that would be delivered to your breast has a certain risk. If the chance of getting any benefit from this radiation dose is so low, then the overall benefit does not outweigh the risk.

Answer 2

since you're 24 with no strong family history, usually doctor won't allow u to have mammogram since radiosensitivity of the breast in women under 35 is possibly greater than in older women

for younger women, ultrasound is the screening modality used (or maybe mri) to determine whether ur lump is cyst of solid mass.

if anything suspicious, only then mammogram will be performed

however, mammogram is the last modality they will use for younger women

it is advisable that you should consult with a doctor first before u do anything

i don't know about the cost in NYsince i'm from asia

however mammogram & ultrasound is definitely cheaper than mri