Treatment of early stage breast cancer is not only more effective but potentially less disfiguring and toxic. 

For most women, mammography screening should begin at age 40 and be repeated routinely. The National Cancer Institute (NCI), the American Cancer Society (ACS) and many other cancer control organizations agree that mammography screening of women in their 40s is beneficial and supportable with the current scientific evidence. Women are encouraged to discuss their individual pattern of screening with their physician. 

The mammogram should be scheduled for one week after the menstrual period begins, when the breasts will be the least tender. Women are asked to avoid using deodorant and lotions on the day of the mammogram and should wear two-piece clothing to make undressing more convenient. 

The mammogram will be performed by a specially trained radiological technologist. The woman will be asked to undress from the waist up only, and stand next to the "x-ray" machine. Two flat surfaces will then compress each breast for a few seconds. Compression is necessary to produce the best pictures using the lowest amount of radiation possible. It may feel slightly uncomfortable, but the examination should not be painful. 

In 1992, the U.S. Congress passed the Mammography Quality Standards Act to ensure that mammography performed at more than 10,000 facilities throughout the country is of high quality and is reliable. A certificate issued by the U.S. Food and Drug Administration must be displayed prominently at each facility in order to lawfully perform mammography. This certificate serves as evidence that the facility meets quality standards. The U.S. Agency for Health Care Policy and Research has developed the booklet Things to Know About Quality Mammograms. This booklet can be obtained at no charge, in English or Spanish, by calling (800) 358-9295. Information for health care professionals is also available. 

Mammography screening remains the single most effective method to detect breast cancer early. However, no medical test is always 100 percent accurate, and mammography is no exception. Research is under way to improve the technology, which will lead to better accuracy. 

In August 1998, the U.S. Centers for Disease Control and Prevention reported that all but six states require that health insurance policies offer mammography screening reimbursement. Those six states are Hawaii, Mississippi, Oregon, South Carolina, Utah and Wyoming. 

Yes. Medicare covers mammography screening every year for women age 65 and older. Yet, few eligible women utilize this important benefit. To raise awareness of this service the National Cancer Institute (NCI) and the Health Care Financing Administration (HCFA) launched a national media campaign in 1998. A series of publications are available in English and Spanish. 

For more information on Medicare coverage for mammography screening, contact the Medicare toll-free hotline at 1-800-638-6833 or the NCI Cancer Information Service at 1-800-4-CANCER. 

During National Breast Cancer Awareness Month in October, many mammography facilities offer special programs, including extended hours. Many facilities are also willing to offer services at a lower fee or will establish a payment schedule. For the names of accredited local mammography facilities, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER. The YWCA's ENCORE also plus program provides low-cost or free services throughout the United States - call 1-800-95EPLUS or a local YWCA.