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What is a mammogram?
Regular mammography (X-ray breast imaging) helps in detecting breast cancer early, sometimes up to three years before a breast lump is noticeable in self-exam. Women should start getting a mammogram every year at age 45, assuming they have no risk factors that would require earlier screening, but may dial back to every couple years after 55 when the peak statistical risk of breast cancer has passed.
Mammography (mammogram) is X-ray imaging of the breast using low-energy X-rays. It is a screening and diagnostic tool used to examine the breast for the early detection and diagnosis of breast cancer. Together with monthly breast self-examinations and clinical examination, mammograms are crucial in the early diagnosis of breast cancer.
Regular mammography helps in detecting breast cancer early, sometimes up to three years before it appears as a lump in a breast self exam. Your doctor may recommend you to start doing breast self-examination and yearly mammography if you have a personal or family history of breast cancer.
What are mammography recommendations by age?
The American Cancer Society's recommendations on when to undergo mammography or consult a doctor regarding breast cancer screening include:
- Women who are 40-44 years of age have the choice to start annual breast cancer screening with mammograms if they wish to do so.
- Women who are 45-54 years of age should get mammograms every year.
- Women who are 55 years and older should switch to getting mammograms every two years or can continue yearly screening.
- Doctors do not recommend screening mammograms for women younger than 40 years, but they advise women with a known mutation in the breast cancer gene to begin screening at 25 years. They initiate screening in women with a family history of breast cancer 10 years earlier than the age at which their relative was diagnosed with cancer.
- Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.
- All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening.
Screening mammography vs. diagnostic mammography
What is screening mammography?
A doctor could advise screening mammography as a routine test to detect any breast changes in women who have no signs or symptoms of breast cancer. It usually involves two X-rays of each breast. Using a screening mammogram, it is possible to detect a tumor that cannot be felt.
What is diagnostic mammography?
A doctor advises diagnostic mammography for diagnosing unusual breast changes, such as a lump, pain, nipple discharge or thickening, or a change in the breast shape or size. A diagnostic mammogram is also used to evaluate abnormalities detected in a screening mammogram. Diagnostic mammography is more extensive than screening mammography and is appropriate in cases where breast changes are suspected, regardless of a woman's age. It usually involves more X-ray exposure to get views of the breast from various positions.
How is mammogram procedure performed?
Preparation for mammography:
- Patients should avoid the use of perfumes, deodorants, powder, cream, and ointment in the armpits 24 hours before the test.
Procedure for mammography:
- During mammography, the radiologist places the patient’s breast on a flat support plate.
- Then, they compress the patient’s breast with a parallel plate called a paddle. The compressor pushes the breast down to flatten the tissue. This provides a clearer picture of the breast.
- An X-ray machine produces a small burst of X-rays that pass through the breast to a detector located on the opposite side.
- The detector could be a photographic film plate that captures the X-ray image on film or could transmit electronic signals to a computer to form a digital image. The images produced are called mammograms.
- In typical mammography, the radiologist takes top and side views of each breast. They may take additional views if they are concerned about a suspicious area of the breast or if something needs further attention or is not clear.
Digital mammograms allow for improved breast imaging, especially for women who are younger than 50 years and have denser breast tissue than older women. Digital mammography provides electronic images of the breasts that are immediately visible and can be enhanced by computer technology and stored on computers.
What are the risks of mammography?
Because mammography uses X-rays to produce breast images, patients are exposed to a very small amount of radiation during the procedure. However, the risk from this exposure is extremely low. For most women, the benefits of regular mammography outweigh the risks of radiation exposure.
Radiation exposure during pregnancy may lead to birth defects. If it is necessary for a pregnant woman to have mammography, special precautions must be taken to minimize radiation exposure to the fetus. She will typically have to wear a lead apron during the procedure.
Some discomfort may be felt because the breast is compressed against the X-ray plate during the procedure. However, this compression will not harm the breast.
Doctors do not advise mammography for pregnant or breastfeeding women. If necessary, they may advise other safer screening methods such as an ultrasound.