A mammogram is an X-ray of the breast. It is a screening tool in asymptomatic women, older than 40 years, for early breast cancer.
Mammograms are also used to detect and diagnose breast disease in women experiencing symptoms such as a lump, pain or nipple discharge.
It is the best and most accessible radiographic method available today to detect breast cancer early.
How should I prepare?
Fasting is not necessary, nor are there any other particular dietetic rules in the days before the mammogram.
The menstrual cycle does not affect the quality of the images, but it is better to perform a mammogram when a woman’s breasts are not painful, usually one week after her period.
It is preferable to wear two-piece clothing, such as pants and a top, to simplify undressing.
In the hours before the test, avoid applying cosmetics, oils, creams and especially talc or deodorant.
Give the radiologist all the previous mammograms for comparison.
Inform your doctor of any prior surgeries, hormone use, and family or personal history of breast cancer.
How is the procedure performed?
Mammography is performed on an outpatient basis. The mammogram is quick and easy.
You will be asked to remove all clothing above the waist including jewellery and metal objects.
A radiographer helps you to position one breast at a time on a small flat plate, with an X-ray plate under it, and compress it with a paddle (often made of clear plastic). Your breast is gradually compressed between the plates by the machine for a few moments. This is necessary in order to obtain clear and precise images.
The patient must hold very still and may be asked to keep from breathing for a few seconds while the X-ray picture is taken.
Usually two pictures are taken of each breast, one from above and one from the side. Women worry about whether a mammogram will hurt. For some women, it is just uncomfortable, while others do feel some pain, depending on breast size and pain threshold.
The examination process should take about 30 minutes.
After the mammogram, a doctor (radiologist) will look at your mammogram and see if there are any signs of cancer. If there is any doubt at all, they will call you back for more views or other tests such as ultrasound or a biopsy. A signed report will be send to your primary care or referring physician, who will share the results with you.
If normal, a mammogram can be repeated every 18 months, or according to the judgment of the physician.
If cancer is found, a number of treatment options, including surgery, radiotherapy, hormone treatment and chemotherapy are available. The treatment option must be based on the individual woman and the type and size of breast cancer present.
Like all X-rays, having a mammogram exposes you to some radiation, but only a small amount. For breast screening, the benefits of finding breast cancer early far outweigh the small risk of radiation.
Those patients who have not entered menopause need to make sure they are not pregnant before obtaining a mammogram, due to potential radiation exposure.
For women who have a breast implant, there is an extremely small chance that the pressure placed on the implant during the mammography will cause a rupture or break. If this occurs, a surgical operation may be needed to have the implant removed.
What are the limitations of the procedure?
In a very small number of cases, the accuracy of the mammogram is lower than usual:
1. For women with breast implants, the ability of mammography to detect abnormalities lowers because the content of the implant (a gel or a liquid) may block the view.
2. False-positive readings occur when cancer is not present, but a mammogram read is abnormal. Additional views or other tests will then be performed.
3. False-negative findings occur when mammograms appear normal even though breast cancer is actually present.