Get the Best -- You Deserve It
A mammogram is only as good as the person taking the X-ray and the person reading it. Look for a center that specializes in breast imaging. If that's not an option, request that a copy of your films be sent to the closest university medical center, where a doctor with the most experience can double-check your mammogram.

Get the Right Follow-Up Test
Although a mammogram is the screening test of choice for breast cancer (and the one most insurance plans cover), several recent reports are directing certain groups of women toward other tests. The breast ultrasound is one of them, and it's used in conjunction with the mammogram, not in place of it. It may be particularly important for women who have dense breast tissue. Dense breast tissue appears white on a mammogram, the same color as an abnormality, making an accurate assessment difficult for the radiologist. And since breast tissue becomes less dense after menopause, it is often younger women who need to be most concerned about obscured tumors. Ask your radiologist or even the technician performing your mammogram about the density of your breast tissue and whether an ultrasound would ensure the most thorough exam. (Your density level may have been noted on prior reports, which is one reason why it's important to keep medical records organized and accessible.)
The New England Journal of Medicine and the American Cancer Society made big news this year when they reported that magnetic resonance imaging (MRI) can find tumors that regular mammograms miss. This may be especially important, once again, for women with dense breast tissue or for those with breast implants. An MRI can also better detect missed tumors in a woman's breast after she is diagnosed with cancer in the other breast. The American Cancer Society recommends that women with a new diagnosis of breast cancer get an MRI of the other breast to help determine the best treatment options. In all of these cases, you'll need to check with your insurer to see if it covers the cost of the test. You should also ask the radiologist if he has had experience reading breast MRI. Because this is a new approach, some radiologists cannot yet read the tests with the most knowing eye.

Talk About It
Although modern mammography has been available since 1969, breast cancer was largely a taboo subject until 1974, when First Lady Betty Ford candidly told the nation about her battle with the disease. But even now, 33 years later, many people still refuse to talk or think about it. Indeed, another of the most common reasons women give for not getting a mammogram is that they "just didn't think about it." It's worth asking the women in your family if they are doing everything they need to do.

October is National Breast Cancer Awareness Month. You will hear many stories that are sad and many that are triumphant, and I hope they will all be inspiring. I also hope you don't forget them. I've never forgotten Ms. Smith.