A mammography is a screening tool used to detect and diagnose breast cancer. Together with regular clinical exams and monthly breast self-examination, mammograms are a key element in the early diagnosis of breast cancer.
According to the National Cancer Institute, nearly 40,000 women will die of breast cancer in 2012. More than 226,000 new cases will also be diagnosed in that same year (NCI, 2012).
Women who are 40 years old and older should have mammograms every one to two years. If you have a personal or family history of breast cancer, your doctor may recommend that you start screenings earlier, have them more often, or use additional diagnostic tools.
If your doctor orders a mammogram as a routine test to check for any cancer or changes, it is called a screening mammogram. In this type of test, the doctor will take several X-rays of each breast.
If you have a lump or any other symptom of breast cancer, your doctor will order a diagnostic mammogram. Diagnostic mammograms are more extensive than screening mammograms. They typically require more X-rays, in order to get views of the breast from multiple positions. The radiologist may also magnify certain areas of concern.
After undressing from the waist up and taking off any necklaces, you will be given a smock or gown that ties in the front. Depending on the testing facility, you may either stand or sit during your mammogram.
Each of your breasts will be placed on the flat X-ray plate. A compressor will then push the breast down, in order to flatten the tissue. This provides a clearer picture of the breast. You might have to hold your breath for each picture. You may feel a small amount of pain or discomfort, but it is usually brief.
During the process, your doctor will be reviewing the images as they are made. He or she may order additional images that show different views if something is unclear or needs further attention. This happens quite frequently and shouldn’t be a cause for upset or panic.
If they are available, digital mammograms are sometimes used. These are especially helpful for women younger than 50 years old, who typically have denser breasts than older women.
A digital mammogram transforms the X-ray into an electronic picture of the breast that can be saved on a computer. Images are immediately visible, so the radiologist does not have to wait for the films to be prepared. The computer can also help your doctor to see images that might not have been very visible on a regular mammogram.
You will need to follow certain guidelines on the day of your mammogram. You cannot wear deodorants, body powders, and perfumes. Also, you should not apply any ointments or creams to your breasts or underarms. These substances can distort the images or look like calcifications, or calcium deposits, so it is important to avoid them.
Be sure to tell your radiologist before the exam if you are pregnant or breastfeeding. In general, you will not be able to receive a screening mammogram at this time, but if necessary, other screening methods like ultrasound can be used.
Images from a mammogram can help find calcifications, or calcium deposits, in your breasts. Most calcifications are not a sign of cancer. The test can also find cysts—fluid-filled sacs that may come and go normally during some women’s menstrual cycles—and any cancerous or noncancerous lumps.
There is a national diagnostic system for reading mammograms called BI-RADS, or the Breast Imaging Reporting and Database System. Under this system, there are seven categories, ranging from zero to six. They describe whether additional images are needed, and whether an area is suspected to be benign (noncancerous) or cancerous lump.
Each category has its own follow-up plan. Actions on the follow-up plan may include gathering additional images, continuing regular screenings, making an appointment for follow-up in six months, or performing a biopsy.
As with any type of X-ray, you are exposed to a very small amount of radiation during a mammogram. However, the risk from this exposure is extremely low. If a woman is pregnant and absolutely needs a mammogram before her delivery date, she will typically wear a lead apron during the procedure.