Mammography: X-ray exam to detect breast cancer
Mammography: X-ray exam to detect breast cancer
Mammography is an X-ray exam designed to detect breast cancer at an early stage.
Breast cancer is the second-leading cause of death from cancer among women in the United States, following lung cancer. In 2005, an estimated 211,000 new cases of breast cancer will be diagnosed and more than 40,000 women will die of the disease.
However, great strides in early detection and improved treatment have decreased breast cancer deaths. Mammography plays a key role in early detection. Through mammography, your doctor can detect breast cancer nearly one to three years before you might actually feel a lump in your breast.
What is mammography?
Mammography is X-ray imaging of your breasts designed to detect tumors or other abnormalities. Mammography can be used either for screening or for diagnostic purposes in evaluating a breast lump.
At what age should you begin screening mammography?
Experts don't agree on the frequency with which women should have regular mammograms. The American Cancer Society recommends that women age 40 and older have a screening mammogram every year, while the National Cancer Institute recommends that women age 40 and older have one every one to two years.
Your doctor can recommend a screening mammography schedule for you. Some general guidelines for when to begin screening mammography include:
Because breast cancer screening involves more than just mammography, here are some additional recommendations on clinical breast exams and breast self-exams.
How do you prepare for mammography?
Schedule the test for a time when your breasts are least likely to be tender. They're often least tender during the week after your menstrual period. Your breasts are most likely to be tender the week before and the week during your period.
A few weeks before the test
The day of the test
Taking an over-the-counter pain medication, such as aspirin, acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others), about an hour before your mammogram might ease the discomfort of the test.
How is mammography done?
At the testing facility, you're given a gown and asked to remove neck jewelry and clothing from the waist up. It's a good idea to wear a two-piece outfit that day.
For the procedure itself, you stand in front of an X-ray machine specially designed for mammography. The technician places one of your breasts on a platform that holds the X-ray film and raises or lowers the platform to match your height. The technician helps you position your head, arms and torso to allow an unobstructed view of your breast.
Your breast is gradually pressed against the platform by a clear plastic plate. Pressure is applied for a few seconds to spread out the breast tissue. The pressure isn't harmful, but you may find it uncomfortable or even painful. If you have too much discomfort, inform the technician.
Your breast must be compressed to even out its thickness and permit the X-rays to penetrate the breast tissue. The pressure also holds your breast still to decrease blurring from movement and minimizes the dose of radiation needed. During the brief X-ray exposure, you'll be asked to stand still and hold your breath.
After images are made of both your breasts, you may be asked to wait while the technician checks the quality of the images. If the views are inadequate for technical reasons, you may have to repeat part of the test. The entire procedure usually takes less than 30 minutes. Afterward, you may dress and resume normal activity.
Results of mammography
Mammography produces mammograms — black-and-white images of your breast tissue on X-ray film. A radiologist interprets the images and sends a written report of the findings to your doctor.
The radiologist looks for evidence of cancer or noncancerous (benign) conditions that may require further testing, follow-up or treatment.
Possible findings include:
Calcifications can be the result of cell secretions, cell debris, inflammation, trauma, previous radiation or foreign bodies. Tiny, irregular deposits called microcalcifications may be associated with cancer. Larger, coarser deposits called macrocalcifications may be caused by a benign condition such as fibroadenoma — a common noncancerous tumor of the female breast — or by aging or injury. Most breast calcifications are benign, but if calcifications appear worrisome, the radiologist might order additional diagnostic images with magnification.
Breast calcifications on mammogram
Calcifications are small calcium deposits in the breast that show up as white spots on a mammogram. Round, well-defined, larger calcifications (left column) are more likely to be noncancerous (benign). Tight clusters of tiny, irregularly shaped calcifications (right column) may indicate cancer.
Risks and limitations of mammography
Mammography isn't foolproof. It does have some limitations and potential risks:
If your mammogram does show that you have breast cancer, you and your doctor can discuss treatment options and decide on the best course of treatment for you.
New methods for viewing and interpreting mammograms are being developed. Promising technology may improve radiologists' ability to more accurately detect breast cancer in its earliest stages. Among newer methods being explored are:
Regardless of whether your mammography facility uses digital mammography or computer-aided detection, you can expect the general procedure to remain the same when you get your next mammogram.
Last Updated: 11/30/2005
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