Mammography, an imaging scan technique for the breasts, examines the breasts using X - rays and plays a crucial role in the screening and detection of breast cancer. Radiologists, doctors specialized in analyzing imaging tests, carefully review the captured images to look for signs such as lumps, masses (tumors), changes in breast size or shape, and other indications that might suggest cancer.
Typically, healthcare providers recommend that individuals start having mammograms every one to two years from the age of 40 as a means of breast cancer screening.
The core objective of mammography is to detect breast cancer. Research indicates that regular mammograms can reduce the breast cancer mortality rate among people aged 40 to 74. Consequently, healthcare providers commonly suggest that women who have reached the age of 40 undergo this examination annually or biennially.
Although breast self - examination is an important part of maintaining breast health, mammography is undoubtedly the most effective cancer screening tool currently available. It can detect early - stage breast cancer before cancer cells spread to other parts of the body, thus enabling patients to start treatment as early as possible and improving their prognosis.
Currently, the US Preventive Services Task Force recommends that women aged 40 to 74 with an average risk of breast cancer receive breast screening every other year. Prior to this recommendation, the task force had suggested starting regular screening at the age of 50. Lowering the screening age has been shown to reduce breast cancer deaths by 20%.
Healthcare providers may suggest breast screening at the age of 40. This examination is for people with no signs or symptoms of cancer, aiming to screen for cancer and achieve early detection. Breast screening can detect tumors and tiny calcium deposits (called microcalcifications), which may also be early signs of breast cancer.
If any signs of breast cancer are present, a doctor may recommend a diagnostic mammogram. The purpose of a diagnostic mammogram is to determine whether cancer is present. Common symptoms of breast cancer include: breast lumps, breast pain or soreness, thickening of the breast skin, nipple discharge, and changes in breast size or shape.
2 - D Mammography
Two - dimensional (2 - D) mammography screens the breasts by taking X - ray images. During the examination, a mammography technologist (a technician specialized in performing mammograms) places the breast between two plates and then takes images to be sent to the radiologist.
3 - D Mammography
Three - dimensional (3 - D) mammography, also known as digital breast tomosynthesis, can produce more detailed images compared to 2 - D mammography. It uses an X - ray machine that rotates around the breast, making it easier to take pictures from multiple different angles. 3 - D mammography is more sensitive and can detect more cases of cancer. If there are signs or symptoms of breast cancer, or if the breasts are dense, a doctor may recommend this type of examination.
In the past, mammogram images were stored on film. Nowadays, healthcare providers in the United States commonly use digital mammography, where images are stored electronically. This not only facilitates sharing of images with radiologists but also improves image quality.
Before having a mammogram, there is no need to follow a special diet or stop taking any medications. Upon arrival at the medical facility, you will need to fill out paperwork asking about your medical history. If you are pregnant or may be pregnant, it is essential to inform the healthcare provider. If you have breast implants, you should also let them know, as they may obscure part of your breast tissue, making it more difficult to detect cancer. Additionally, remove any jewelry or metal items before the examination to prevent them from showing up on the X - ray images.
Before the mammogram, the mammography technologist will show you the equipment and explain the procedure. You will be asked to remove your clothes above the waist and put on a front - opening hospital gown. The technologist will not give you any painkillers, sedatives, or anesthetics before the examination. The entire mammogram usually takes only a few minutes.
When the examination starts, the technologist will ask you to stand in front of the X - ray machine. They will assist you in placing one breast on a plastic plate, and then another plastic plate will press down firmly to flatten the breast. This step is crucial as it can prevent the breast from moving, improve the image quality, and ensure that the X - ray beam has a shorter path of travel, reducing the amount of radiation you receive during the imaging scan.
After taking the frontal picture, the technologist will press the breast with the plastic plate again to take a side view. After finishing with one breast, the process will be repeated for the other breast. It is important to note that when the breast is flattened or compressed, you may feel significant pressure. Many people find the mammogram uncomfortable, and some may experience mild pain during the examination. Each image takes only a few seconds to complete. If you need to take a break during the test, you can inform the technologist.
After the mammogram is completed, you can get dressed and leave the appointment site. Mammography is an outpatient procedure, so you can drive home on your own after the examination. The results of the mammogram usually take a few days to a few weeks to come out. You will generally receive a phone call or be asked to come for a follow - up visit to discuss the results. If the mammogram results are abnormal, the healthcare provider may recommend further examinations, such as additional mammograms.
Although mammography is safe for most people, like all medical scans and procedures, it does carry certain risks, as follows:
False - positive Results
A false - positive result occurs when the radiologist sees an abnormal area on your mammogram image, but you do not actually have cancer. This may lead to your undergoing additional tests unnecessarily, and learning about the abnormal result can also cause significant anxiety. False - positive results are more common in younger people, those with dense breasts, those taking estrogen supplements, and those who have previously had a breast biopsy. It is estimated that in the United States, more than 50% of people who have been screened for breast cancer at least once a year for 10 years will experience a false - positive result at some point.
Over - diagnosis and Over - treatment
Mammography is highly effective in detecting cancer. It can sometimes detect very small cancers and ductal carcinoma in situ (a disease that affects the cells of the milk ducts in the breast). In most cases, these conditions may never cause symptoms or affect your life, resulting in potentially unnecessary cancer treatments.
False - negative Results
A false - negative result means that the mammogram result is normal even though breast cancer is present. It is estimated that screening mammograms miss about 20% of breast cancer cases. Dense breast tissue can make it more difficult to detect tumors, and false - negative results also occur more frequently in younger people.
Radiation Exposure
Mammography is an X - ray examination that uses a small dose of radiation to take images. Although the risk is low, repeated X - ray examinations can increase the risk of cancer. The average radiation dose of a mammogram is 0.4 millisieverts (mSv). Each year, Americans receive about 3 mSv of radiation from the natural environment.
Undergoing a mammogram can be worrying, but learning about it in advance can help with preparation. Here are some key points:
Examination Location
Mammography is an outpatient procedure. You can make an appointment at a breast clinic, a hospital radiology department, a private radiology office, or your healthcare provider's office. You can also have the examination done from a mobile mammography unit. The US Food and Drug Administration (FDA) requires all mammography locations to meet certain standards. To find an FDA - approved facility, call 1 - 800 - 4 - CANCER (1 - 800 - 422 - 6237).
Scheduling the Examination
Remember that your breasts are most sensitive before and during your menstrual period. They may feel tender and swollen. If possible, schedule the mammogram after your period.
Dress Code
During the mammogram, you will be asked to remove your clothes above the waist. It is best to wear trousers, shorts, or a skirt instead of a dress. Do not use any deodorant or perfume during the examination, and do not wear jewelry.
Food and Drinks
You can eat and drink normally before and after the mammogram.
Medications
You can continue to take your regular medications before and after the mammogram.
Items to Bring
In most cases, you only need to bring your insurance card and ID to the appointment. If your insurance does not cover the mammogram or you do not have insurance, the clinic may ask you to pay a copayment. In this case, it may be helpful to bring a payment method.
Emotional Support
Call in advance to ask if the facility allows visitors. If you choose to bring a loved one, keep in mind that they will likely be asked to stay in the waiting room during the mammogram.
Cost and Insurance
Most insurance plans cover the cost of mammograms. All plans under the Affordable Care Act (ACA) must cover mammograms for women aged 40 and older every one to two years. Medicare covers the cost of annual mammograms for people aged 40 and older with no copayment.
Depending on the facility where you have the mammogram, the results usually come back within a few days to a few weeks after the examination. After the radiologist examines the images and writes a report, it will be sent to your primary healthcare provider. If the results are normal, your provider will notify you by phone, through the electronic medical record, or by letter.
If the results are abnormal, the doctor will call you to discuss the next steps or schedule a follow - up visit. They may recommend other tests, such as another mammogram or a breast ultrasound.
When interpreting the mammogram results, the radiologist will carefully examine the images to look for high - density areas that appear white. These areas may be cancerous. On an X - ray, fatty tissue appears dark and transparent, allowing the radiologist to examine the breast tissue through it. Dense breast tissue has less fat and appears white on a mammogram, making it difficult to distinguish normal tissue from cancerous tissue. If you have been told in the past that you have a lot of dense tissue in your breasts, be sure to inform the mammogram technologist during the examination.
When you receive the report with the results from your healthcare provider, it may provide one of the following outcomes:
Normal Result
A normal result means that the radiologist did not see any areas that look like cancer.
Abnormal Result
An abnormal result means that the radiologist found signs of cancer or other abnormalities. Your healthcare provider will discuss the next steps with you, such as scheduling a follow - up mammogram.
Indeterminate Result
An indeterminate result means that the radiologist cannot determine whether there are any areas of concern on your mammogram image. Your healthcare provider will discuss the next steps with you, which may include having another mammogram or other types of imaging tests.
Although mammography can be intimidating, it is an important method for early detection of breast cancer. Understanding what to expect and how to prepare is crucial. If you have any concerns, it is advisable to contact your healthcare provider before the mammogram to get your questions answered.
