Mammogram

1 What is a Mammogram?

An X-ray image of your breast used to screen for breast cancer is called mammogram which plays a key role in helping decrease breast cancer deaths and for early breast cancer detection. To spread out the breast tissues, your breasts will be compressed between two firm surfaces during the mammogram.

An X-ray will capture the black and white images of your breasts wherein it will be displayed on a computer and examined by your doctor to check for signs of cancer. This can be used either for diagnostic purposes or for screening. Based on your age and risk of breast cancer is how often you should have a mammogram.

2 Reasons for Procedure

To detect tumors and other abnormalities are the main reasons for the X-ray imaging of mammogram.

This can be used either for diagnostic purposes or screening in evaluating a breast lump:

  • Diagnostic mammography – this is used to check for breast changes such as breast pain, breast lump, nipple thickening, nipple discharge or unusual skin appearance as well as abnormal findings.
  • Screening mammography – the main goal is to check cancer before clinical signs are noticeable and to detect breast abnormalities and breast changes in women who have no signs and symptoms.

Consult your doctor about the benefits and risks of undergoing a mammogram.

There are general guidelines on when to begin screening mammography:

  • Women with a high risk of breast cancer – doctors recommend that before age 40 you should do mammograms if you have a high risk of breast cancer and he may recommend MRI with mammogram if you have a family history of breast cancer.
  • Women with an average risk of breast cancer – mostly women begin mammograms every one to two years if they reached the age 40. Women with an average risk of breast cancer should begin their mammograms in their 40s according to the American Cancer Society while the U.S. Preventive Services Task Force advised women to begin their mammograms by the age of 50.

3 Potential Risks

The risks and limitations of mammograms include:

  • Mammograms are not always accurate – the skill of the radiologist and the part of the technique used will result in the accuracy of the procedure, sometimes it may result in false0negative or false-positive mammograms with risk factors such as your breast density or age.
  • Mammograms expose you to low-dose radiation – the benefits of regular mammograms outweigh the risks posed by the amount of radiation for most women.
  • Mammograms in younger women can be difficult to interpret – a dense breast tissue can obscure signs of cancer because breasts of younger women contain more ligaments and glands compared to older women, as you age your breast will only have fewer glands and it will become fattier which will make it easier to detect and interpret changes on mammograms.
  • Having a mammogram may lead to additional testing - about 10 percent of mammograms require additional testing or additional imaging tests such as ultrasound, and biopsy which is  a procedure to remove a sample of breast tissue for laboratory testing. Ask the radiologist to compare your current mammogram with any previous mammograms if you are told that your mammogram is abnormal because most abnormal findings detected on mammograms aren't cancer.
  • Not all tumors found by mammography can be cured – this happens because some types of cancers grow rapidly, aggressive and spread early to other parts of your body.
  • Screening mammography cannot detect all cancers – mammograms can miss 1 in 5 cancers in women because cancer may be in an area which is difficult to detect or may be small when you used mammography such as your armpit.

4 Preparing for your Procedure

To prepare for mammogram:

  • Choose a certified mammogram facility – the facility that you are going to have your mammogram should be certified by the Food and Drug Administration so it will have the certain standards.
  • Schedule the test when your breasts are not tender – this occurs when you are not yet menopause or during the week after your menstrual period because your breasts might be tender the week before and the week during your period.
  • Do not use deodorant before your mammogram – avoid using deodorants, powders, antiperspirants, perfumes, lotions or creams on your breasts or under your arms because this can cause confusion for metallic particles will be visible in your mammogram.
  • Consider an over-the-counter medication – if you think that you will feel uncomfortable you can take medicines an hour before the procedure like aspirin such as acetaminophen (Tylenol) or ibuprofen (Motrin IB, Advil).
  • Bring your prior mammogram images if you have one so the radiologist can compare them with the new one.

5 What to Expect

Here’s what you can expect before, during, and after your mammogram procedure.

Your doctor will ask you to change into a hospital gown and will ask you to remove your jewelry and clothes from the waist up.

You will stand in front of an X-ray machine specially designed for mammography then the technician will place one of your breasts on a platform and raises or lowers the platform to match your height.

He will also help you position your head, torso and arms to allow an unobstructed view of your breast.

Your breast will be pressed lightly against the platform by a clear plastic plate and pressure will be applied for a few seconds to spread out the breast tissue. Do not worry because this pressure is not harmful to your breast, but you may find it uncomfortable or even painful.

Speak up if you feel any discomfort. To decrease blurring from movement and minimizes the dose of radiation needed, the pressure will still hold your breast. Your breast must be compressed to even out its thickness and permit the X-rays to penetrate the breast tissue.

Your doctor will ask you to stand still and hold your breath throughout the procedure. You will be asked to wait while the images are checked by the technician. You may have to repeat the test if the technician found some errors.

This procedure will take up about 30 minutes. You can go back to your normal activities afterwards. Federal law requires mammogram facilities to send your results within 30 days in the United States.

6 Procedure Results

Understanding the results of your mammogram will be made possible by your doctor.

Mammograms are black and white images of your breast tissue which can be produced during mammography. A radiologist who specializes in imaging techniques will interpret and evaluate the images and will send and report the findings to your doctor.

The radiologist looks for evidence of cancer or noncancerous or benign conditions that may require additional testing, follow-up or treatment.

Some of the possible findings may include:

  • Lumps or Masses
  • Calcium deposits or Calcifications in tissues and ducts
  • New dense area that appeared since your last mammogram
  • Dense areas appearing in only one breast or one specific area on the mammogram
  • Distorted tissues

Calcifications can be the result of cell debris, cell secretions, inflammation, and trauma. Microcalcifications are tiny regular deposits that can be related to cancer. Larger, coarser areas of calcification may be caused by aging or by a benign condition such as fibroadenoma.

If calcifications appear worrisome, the radiologist may order additional diagnostic images with magnification though breast calcifications are benign.

Dense areas can indicate cancer and that the tissue that is more glandular than fatty that can make calcifications and masses more difficult to identify or differentiate from the normal glandular tissue.

Additional testing may be required if your radiologist has some concerns or issues regarding your mammogram.

Some of the possible additional testings are:

  • Magnification or Compression views
  • Biopsy of the breast tissue
  • Magnetic resonance imaging
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