Yes, you should get a mammogram, but ask your radiologist if you have dense breast tissue. If the answer is "no," then I believe that should be sufficient. If the answer is "yes," then the mammogram probably is not the best diagnostic tool. Ask -- no, insist -- on a different diagnostic tool, such as an MRI or ultrasound.

One thing you should do every month is do a self-exam on your breasts. That is one of the best things you can do to know your breasts. Hospitals will have instructions on how to do this.

I am not a doctor, so I can only give you my opinion as a former breast cancer patient who, at age 39, found her own tumor, even when a screening mammogram missed it due to my dense breast tissue. After I found a slight dimple on my right breast, I went back to my gynecologist, and he prescribed a diagnostic mammogram, and my tumor was found, but it took a lot of pairs of eyes to find it still. Even in my 40s, my breast tissue was too dense, and doctors had a lot of trouble seeing what was going on.

My oncologist recommended an MRI followup, as well as regular mammograms.

I'm not trying to scare you at all, and I am glad you are being so active in your own medical self-advocacy. I was told I was too young to get cancer. That proved untrue. So keep being vigilant about your health care.

For information about self-advocacy, check out my profile and my blog column, "Calling the Shots," at www.bethlgainer.blogspot.com.

It's true that not every woman should get a breast MRI, but if breast tissue is so dense that a mammogram cannot be an effective diagnostic tool, then it seems another diagnostic tool would be called for.

I know MRIs are expensive and there is a need to keep the costs of tests down, but if a mammogram is not effective, I don't see an alternative.

I'm speaking from my experience. A mammogram missed a 1.7-centimeter tumor. I agree that a breast center is a good way to go, as that's how my tumor was found. Even the breast radiologist couldn't find my tumor easily with a specialty mammogram at the breast center.

It took many pairs of eyes to find it.

For years afterward, I would get a mammogram plus an MRI so I didn't "fall through the cracks" as my oncologist put it.

The controversy on mammograms' usefulness can go on and on. In some cases, mammograms miss tumors; in others, mammograms find cancers. I agree that a mammogram's usefulness depends a lot on the individual.

However, -- and this is near and dear to my heart -- what concerns me most is that young women are slipping through the cracks and dying of breast cancer because there are limited screening options available to them. Dr. Neely's point is well-taken; why don't we allocate some funding into research on screening tools for young women?

My guess is that breast cancer is still perceived as an older person's disease, even though there are many, many young women diagnosed.

I agree that you need to have an outstanding medical provider in place to guide you as to the best screening tool for you. I have a great oncologist who knew that mammograms weren't effective for me, so each year, he wrote an order for an MRI.

Yes, mammograms and MRIs can lead to scares that turn out to be benign, but isn't this the case with any screening tool?

In the end, it is up to you, the patient, to ensure you get the right screening tools in place. You need to insist on getting the proper medical screening. Having an excellent doctor in place who is willing to advocate for you is the key.

Don't be afraid to fire a doctor who is not on board with your own self-advocacy. Then again, a doctor who disagrees with you can still be an excellent doctor -- as long as he or she explains why he/she disagrees and has valid reasons for doing so.