Mammography

Mammography, commonly referred to as a mammogram, is an advanced medical imaging procedure that utilizes low dose ionizing radiation to visualize and evaluate breast tissue. It helps detect tumors and other abnormalities within the breasts.

The various types of mammography techniques include:

• Digital mammography, which involves the use of electronics to convert the X-rays into digital images.
• Computer-aided detection (CAD), which highlights areas of abnormal density, mass, or calcification.
• 3D mammography, which uses multiple images of the breasts from different angles to create a set of 3D images.

Indications   

A mammogram may be recommended for screening or diagnostic purposes.

• Screening Mammography: This study helps detect breast cancer or abnormalities within the breast at an early stage before signs and symptoms are noticed by the patient or detected on physical examination by the doctor. This ensures the condition can be addressed early, when it is most curable and breast conservation is more likely.
• Diagnostic Mammography: This study helps to further evaluate abnormal clinical findings such as breast pain or a lump in the breast.

Preparing for Mammography

The following precautions are recommended when preparing for a mammogram:

• Schedule the mammogram one week after your period as some women experience breast tenderness around the time of their menstrual cycle.
• Inform your doctor of any problems in your breasts, hormone use, prior surgeries, and personal or family history of breast cancer.
• Do not use deodorant, lotion, or talcum powder on your breasts or underarms as they may appear on the imaging study as areas of calcification.
• Provide any prior mammograms to your radiologist as they might be needed for comparison with the current study.

Mammography Procedure

The mammography procedure involves the following steps:

• You are provided with a gown and asked to remove clothing and jewelry from the waist up.
• You are asked to stand next to the mammography machine.
• Your breast is placed on a movable platform that is adjusted to suit your height.
• A technician will position your arms and head to obtain an unobstructed view of the breast.
• A clear plastic plate will be used to press your breast against the platform and spread out the breast tissue. This is done to achieve adequate X-ray penetration into the breast tissue and prevent image blurring due to movement.
• You are required to stand still and hold your breath as the images are taken and change your position between images. Routine views are a top-to-bottom view and angled side view.

After the Mammogram

You may be asked to wait after the procedure while the technician checks the quality of the images obtained. If the images are blurry due to technical reasons, the procedure will be repeated. The entire procedure is usually completed within 30 minutes. Following this, you can return to your routine activities of daily living. The radiologist will examine the images and send the results to your doctor, who will discuss the findings with you.

Risks and Limitations

A mammogram is a safe procedure; however, the possible risks and limitations include:

• Risks associated with radiation exposure
• False positive or false negative results on rare occasions requiring additional testing to validate findings.
• Mammograms of young women or older women with dense breast tissue might be difficult to interpret
• Some very small tumors might not be detected

Benefits of Mammography

The benefits of mammography include the following:

• Produces less ionizing radiation than a standard X-ray
• Reduces risk of death from breast cancer
• Can detect different types of breast cancer such as invasive ductal and lobular cancer

Summary

Mammography is a safe, non-invasive imaging study that plays a critical role in detecting breast cancer. Most women with an average risk for breast cancer are recommended to have a screening mammogram every 1-2 years from the age of 40 onward.