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A mammography, or mammogram, is an X-ray of the breast. It’s a screening tool used to detect and diagnose breast cancer. Together with regular clinical exams and monthly breast self-examinations, mammograms are a key element in the early diagnosis of breast cancer.
According to the National Cancer Institute, breast cancer is the second most common cancer for women in the United States, after skin cancer. There are about 2,300 new cases of breast cancer in men each year, and about 230,000 new cases in women each year.
Some experts recommend that women who are 40 years old and older should have mammograms every one to two years. The American Cancer Society recommends regular screening beginning at age 45. 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’s known as a screening mammogram. In this type of test, your 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. If you have breast implants you will probably need a diagnostic mammogram. Diagnostic mammograms are more extensive than screening mammograms. They typically require more X-rays to get views of the breast from multiple positions. Your radiologist may also magnify certain areas of concern.
You will need to follow certain guidelines on the day of your mammogram. You can’t wear deodorants, body powders, or perfumes. Also, you shouldn’t 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’s important to avoid them.
Be sure to tell your radiologist before the exam if you’re pregnant or breastfeeding. In general, you won’t be able to receive a screening mammogram at this time, but if necessary, your doctor can order other screening methods, such as an ultrasound.
After undressing from the waist up and taking off any necklaces, a technician will give you a smock or gown that ties in the front. Depending on the testing facility, you may either stand or sit during your mammogram.
Each breasts fits onto a flat X-ray plate. A compressor will then push the breast down 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 pressure or discomfort, but it’s usually brief.
During the process, your doctor will review the images as they are made. They 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.
Digital mammograms are sometimes used if they are available. 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 saves onto a computer. Images are immediately visible, so your radiologist doesn’t have to wait for the images. The computer can also help your doctor see images that might not have been very visible on a regular mammogram.
As with any type of X-ray, you’re receiving exposure 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.
Images from a mammogram can help find calcifications, or calcium deposits, in your breasts. Most calcifications aren’t 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’s a national diagnostic system for reading mammograms called BI-RADS, or the Breast Imaging Reporting and Database System. In this system, there are seven categories, ranging from zero to six. Each category describes whether additional images are necessary, and whether an area is more likely to have a 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.
Your doctor will review your results and explain the next steps to you during a follow-up appointment.
Written by: Jaime Herndon
Medically reviewed on: Jan 11, 2016: Deborah Weatherspoon, Ph.D, MSN, RN, CRNA
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