Mammogram vs CT Scan - 1265126

Wed, 07/23/2014 - 18:13

My question concerns the need for mammogram when I am getting a high density CT scans of the chest every 3 months.

Because I am on a wait and watch with BAC LC, I am monitored for growth every 3 or 4 months. I recently had a resection of the right apex of the top lobe and am doing very well. Because I had all that going on, I postponed my usual mammogram done in April.

Do I need to now schedule a mammogram? I don't want to have unnecessary tests, but will certainly schedule one if the CT doesn't supersede it.

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Dr West

The CT scan doesn't completely obviate it. However, it's very unlikely that the mammogram will pick up anything that is a serious threat over the next 5 years or more if it isn't picked up by exams or other scans you've been getting. If anything, it's most likely to pick up a minimally threatening breast cancer that may or may not ever become an issue over the next 10-20 years. It's usually quite appropriate to prioritize the real problems a person is known to have, especially something like an advanced breast cancer, over the theoretical concern of a likely less threatening issue a person isn't known to have. I would consider preventive screening tests to only make sense if a patient's lung cancer is so indolent it doesn't require treatment.

-Dr. West


Dr. West, I read your response with great interest. I had my last mammogram a year ago and am about to schedule this year's. I was wondering the same thing. I just had a clear chest/abdomen CT and clear brain MRI in June. Would there be any added benefit to a mammogram now? If you remember, I did have a small breast cancer 2.5 years ago. Would that change things?

Dr West

I really can't speak to individual circumstances, since that shades toward medical advice. However, we can at least offer the principles that should guide such a decision.

While not wanting to minimize breast cancer, the majority that are detected are not life-threatening over a time line of a few years. If a person has a lung cancer or other medical issue(s) that are more immediate threats over the next year or few years, it doesn't make much sense to worry about a very low risk of a less threatening problem. On the other hand, if someone is potentially cured of their cancer chance cancer, it makes sense to do all preventive screening.

It's best to discuss individual circumstances with your own doctor.

Good luck.

-Dr. West