Breast self-examination and routine clinical breast exams by your health-care provider are important screening tools. Another such tool is mammography (ma-MAWG-ruh-fee), a highly sensitive X-ray screening test to help detect cancerous breast cells and lumps. Mammography uses low levels of radiation to create an image of the breast, called a mammogram, on film or paper. Mammography can often detect a breast lump up to several years before it can be felt manually; it can also sometimes find cancerous cell changes that occur even before a lump develops (Aldridge et al., 2006). With earlier detection of breast cancer, a decrease in mortality and an increase in breast-conserving treatments are possible. The American Medical Association, the American Cancer Society, and the National Cancer
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Institute recommend yearly mammograms for women age 40 and older, including those who have previously had breast cancer (Houssami et al., 2011; Kaelin et al., 2006).
Besides mammograms, additional testing methods are used, and others are under development. Magnetic resonance imaging (MRI) uses magnetic fields to create images of body tissue and blood flow and can produce a more detailed image of breast tissue to clarify inconclusive findings (Hudepohl, 2011; Kingsbury, 2007a). Pregnant or lactating women, women at high risk, and those with dense breast tissue can use ultrasonography as a supplemental test (Singh et al., 2008). Researchers are evaluating and testing additional screening and diagnostic methods, including genetic tests (Laino, 2008). Currently, the best method for early detection of breast cancer is a combination of monthly manual selfexams, routine exams by a health-care practitioner, and mammography as recommended.
It is especially important for lesbians to be conscientious about scheduling regular exams and mammograms; they tend to be screened less often than heterosexual women because they do not have birth control medical appointments. Lesbians may also avoid health-care services rather than confront the insensitivity and ignorance of some medical practitioners (Hammond, 2006; Heck et al., 2006). Many lesbians report that past negative experiences have made them less likely to seek services when they have a problem (Makadon, 2006).
In 5-10% of women, breast cancer can develop from flaws in a gene that is now detectable. Women with this gene flaw have up to an 85% chance of developing breast cancer and may have an increased risk for ovarian cancer (Pluta & Golub, 2011; Metcalfe et al., 2008). Women now have the opportunity to decide whether to use drugs for cancer prevention or to have a preventive mastectomy.