Navigating with Confidence: Your Rights, Your Questions, and Your Breast Health
You wouldn’t let a mechanic work on your car without explaining what they’re doing—so why do so many of us sit quietly through medical appointments and leave with more questions than answers? March is Women’s History Month, making it an ideal time to honor the women who championed patient rights by actively exercising your own.
Here’s the truth: your breast health isn’t something that simply happens to you—it’s something you take an active role in. That involvement begins with understanding your options, asking questions, and making informed decisions based on your individual circumstances, not on population statistics or one-size-fits-all recommendations.
When Guidelines Conflict: Understanding Why Screening Recommendations Differ
If you’ve ever felt unsure about when to begin mammograms or how often to schedule them, you’re not alone. Different organizations provide varying guidelines, and it can easily feel like you’re hearing mixed messages.
The U.S. Preventive Services Task Force (USPSTF) updated their recommendations in 2024 and now recommends biennial (every two years) screening for all women ages 40–74. This is a change from their previous guidance, which recommended that women in their 40s make individual decisions about screening.
The American College of Radiology (ACR) and Society of Breast Imaging (SBI) recommend annual screening starting at age 40 for women at average risk, continuing as long as a woman is in good health.
So which is right? Here’s what you need to understand: both are based on evidence, but they’re weighing different factors. The USPSTF focuses on population-level outcomes and aims to minimize false positives and unnecessary biopsies across large groups. The ACR and SBI focus on individual patient outcomes and early detection, emphasizing that finding cancer early—when it’s most treatable—saves lives.
At CRL Women’s Imaging, we follow ACR and SBI guidelines because we believe in maximizing early detection for you as an individual. Research shows that 40% of the years of life lost to breast cancer occur in women diagnosed in their 40s. Annual screening finds more cancers at earlier, more treatable stages. When we find cancer at Stage 0 or Stage I, the five-year survival rate is 99%. That’s not a statistic—that’s your daughter’s wedding, your grandchildren’s graduations, your retirement adventures.
“Every woman deserves personalized care based on her unique risk factors and circumstances,” says Dr. Jillian Karow, Medical Director of CRL Women’s Imaging. “Our job isn’t just to perform mammograms—it’s to partner with women and their providers in understanding their individual risk and creating a screening plan that makes sense for their life. When patients ask questions and advocate for themselves, it helps us provide the most personalized, targeted care possible.”
Your Legal Rights: What Minnesota Law Requires
Understanding your rights is empowering, especially when it comes to your healthcare. In Minnesota, you have specific legal protections regarding breast imaging.
Breast Density Notification: Minnesota law requires that if you have dense breast tissue (which about 40–50% of women do), your imaging facility must notify you. This notification explains that dense tissue can make mammograms harder to read and is itself an independent risk factor for breast cancer. You have the right to this information and the right to discuss supplemental screening options with your healthcare provider.
Access to Your Records: You have the right to obtain copies of your mammogram images and reports. This is especially important if you change healthcare providers or get a second opinion.
Informed Decision-Making: You have the right to understand what type of imaging technology is being used (2D vs. 3D mammography), why additional testing might be recommended, and what your results mean in the context of your personal risk factors.
Understanding YOUR Personal Risk: Beyond Population Statistics
When you read that “1 in 8 women will develop breast cancer in their lifetime,” that’s a population average. But you’re not a population—you’re an individual with your own unique set of risk factors. Understanding your risk is essential to making informed screening decisions.
Personal risk factors include:
- Family history: Having a first-degree relative (mother, sister, daughter) with breast cancer, especially if diagnosed before menopause
- Genetic mutations: BRCA1, BRCA2, PALB2, ATM, CHEK2, and other genes that increase cancer risk
- Personal history: Previous breast biopsy showing atypical hyperplasia or lobular carcinoma in situ (LCIS)
- Breast density: Dense breasts independently increase risk by 1.5–2 times
- Chest radiation: Radiation therapy to the chest before age 30 (often for Hodgkin’s lymphoma)
- Reproductive history: Early menstruation (before age 12), late menopause (after age 55), first pregnancy after age 30, or never having children
Here’s something important to understand: most women who develop breast cancer have no family history of the disease and no known genetic mutations. That’s why screening is recommended for all women starting at age 40—not just those with obvious risk factors.
However, understanding your combination of risk factors helps determine whether you should start screening before age 40 or whether additional screening like breast MRI may be beneficial.
Risk assessment tools, which may include the Tyrer-Cuzick or Gail models, can help estimate your personal risk level. These questionnaire-based calculators ask about factors like your age, family history, reproductive history, and previous breast biopsies to calculate your estimated lifetime risk. While they can’t predict whether you specifically will develop breast cancer, they can help you and your healthcare provider determine whether you qualify as “high risk” (lifetime risk greater than 20%), which may warrant additional screening measures like supplemental breast ultrasound or MRI.
It’s important to note that family history matters on both sides. BRCA mutations, for example, can be inherited from either your mother’s or father’s side of the family. If you have male relatives diagnosed with breast cancer or a strong history of ovarian cancer in your family, genetic counseling may be recommended.
Questions You Should Feel Empowered to Ask
Knowing what to ask is one of the most powerful tools you have. For questions about your personal risk factors, family history, or whether additional screening is right for you, bring those to your primary care provider—they’re your best resource for those conversations. For general questions about what to expect during your mammogram or how results are delivered, our team at CRL Women’s Imaging is happy to help.
Before your mammogram:
“What type of mammography do you use—2D, 3D, or both?” At CRL Women’s Imaging in Edina, we offer both 2D and 3D mammography; however, 3D mammography (Digital Breast Tomosynthesis) is our standard of care. This advanced technology provides a significantly higher level of imaging detail that 2D mammography simply cannot achieve. By capturing multiple thin image slices of the breast, 3D mammography improves visibility through dense tissue and enhances our ability to detect breast cancer earlier and more accurately. For these reasons, we prioritize 3D mammography to provide our patients with the most advanced and reliable screening available.
“Is there an additional cost for 3D imaging?” Most insurance plans now cover 3D mammography with no additional cost for screening, but it’s always good to check with your specific plan.
“How will I receive my results, and what’s the typical timeline?” At CRL Women’s Imaging, results are typically available within 1–3 business days through your patient portal or slightly longer by mail.
About your results (ask your provider):
“What is my breast density category?” “What does that mean for how well the mammogram can detect cancer in my tissue?” “What is my BI-RADS category, and what does that mean for follow-up?”
The CRL Women’s Imaging team is here to help you understand your results. For a detailed explanation of BI-RADS categories, see our article, “Beyond the Results Letter: Understanding Your Mammogram Report,” or call us with questions.
About your personal risk (ask your provider):
“Based on my personal and family history, what is my risk level?” “Should I consider genetic counseling?” “Do I qualify for high-risk screening protocols like supplemental breast ultrasound or MRI?” “For women considered high-risk, should I start mammograms before age 40?”
If additional imaging or biopsy is recommended:
“Why are you recommending this?” “What are you looking for?” “What are my options?” “What happens if I choose to wait and monitor instead?”
At CRL Women’s Imaging in Edina, we offer same-day biopsy scheduling when possible, and we use upright stereotactic biopsy technology for greater comfort during the procedure.
You deserve to understand your care every step of the way. If medical terms feel confusing or you’re wondering why something is being recommended, asking questions is always welcome. When you understand your options, you can make healthcare decisions with confidence.
This Women’s History Month: Use Your Rights
The women who came before us fought for the right to participate in our own healthcare decisions. They fought for informed consent, for access to our medical records, for the right to ask questions without being dismissed. This March, honor them by actually using those hard-won rights.
Schedule your mammogram if you’re due. Have questions about your personal risk, breast density, or whether additional screening makes sense for you? Bring those to your primary care provider—they’re your partner in building a screening plan tailored to your health history. Inquire about genetic counseling if your family history indicates it may be warranted.
Your breast health isn’t something that happens to you—it’s something you participate in. And that participation starts with knowledge, continues with the right questions asked of the right people, and flourishes when you partner with a healthcare team that respects your autonomy and values your voice.
Take up space in that exam room. Your health is worth it.
Have questions about your personal breast health or risk factors? Your primary care provider is your best resource for those conversations. If you’re ready to schedule your mammogram or have questions about what to expect during your visit, our team at CRL Women’s Imaging is here to help.
Next month, we’re continuing the conversation with a practical guide to navigating dense breast tissue, insights regarding insurance coverage, and making the most of every appointment. Stay tuned.
About CRL Women’s Imaging
CRL Women’s Imaging is a leader in outpatient imaging and designated a Breast Center of Excellence by the American College of Radiology (ACR). Our team of board-certified breast imagers and certified technologists in mammography and ultrasound are committed to providing high-quality, compassionate care that women can trust.