A mammogram is an X-ray of the breast. It is used to detect and diagnose breast disease in women. Mammography cannot prove that an abnormal area is cancer, but if it raises a suspicion of cancer, tissue will be removed for a biopsy. Tissue may be removed by needle or open surgical biopsy and examined under a microscope to determine if it is cancer.
Mammography has been used for about 40 years, and in the past 15 years technical advancements have greatly improved both the technique and results. Today, dedicated equipment, used only for breast X-rays, produces studies that are high in quality but low in radiation dose. Radiation risks are considered to be negligible.
What are the different types of mammograms?
According to the National Cancer Institute:
Screening mammogram. A screening mammogram is an X-ray of the breast used to detect breast changes in women who have no signs of breast cancer. It usually involves two X-rays of each breast. Using a mammogram, it is possible to detect a tumor that cannot be felt.
Diagnostic mammogram. A diagnostic mammogram is an X-ray of the breast used to diagnose unusual breast changes – such as a lump, pain, nipple thickening or discharge, or a change in breast size or shape. More pictures are taken than during a screening mammogram.
A diagnostic mammogram is also used to evaluate abnormalities detected on a screening mammogram. It is a basic medical tool and is appropriate in the examination of breast changes, regardless of a woman's age.
The development of digital mammography provides electronic images of the breasts that can be enhanced by computer technology, stored on computers, and even transmitted electronically in situations where remote access to the mammogram is required.
How is mammography performed?
X-rays of the breast are different than those used for other parts of the body. The breast X-ray does not penetrate tissue as easily as the X-ray used for routine X-rays of other parts of the body. The breast is compressed by the mammogram equipment to spread the tissue apart. This allows for a lower dose of radiation. Compression of the breast may cause temporary discomfort, but is necessary to produce a good mammogram. The compression only lasts for a few seconds for each image of the breast. A breast health nurse or X-ray technologist usually takes the X-rays, but the resulting films are read and interpreted by a radiologist, who reports the results to your doctor.
What conditions does a mammogram show?
Calcifications, which are tiny mineral deposits within the breast tissue. There are two categories of calcifications:
Macrocalcifications. Coarse calcium deposits that usually indicate degenerative changes in the breasts, such as:
Microcalcifications. These are tiny (less than 1/50 of an inch) specks of calcium. When many microcalcifications are seen in one area, they are referred to as a cluster.
Masses, which may occur with or without associated calcifications, and may be due to different causes, including:
Cyst. A noncancerous collection of fluid in the breast. It cannot be diagnosed by physical exam alone or by mammography alone. Either a breast ultrasound or aspiration with a needle is required. If a mass is not a cyst, then further imaging may be needed.
Benign breast conditions. Masses can be monitored with periodic mammography, but others may require immediate or delayed biopsy.
Who should get a screening mammogram?
Peoples Health recommends the following screening guidelines for early detection of cancer in women who have no symptoms:
Age 35-39 – One time to establish a baseline
Age 40-51 – At least every two years
Age 52-74 – Annually
Age 74+ – Per agreement between physician and patient
Talk to your doctor about your personal breast cancer risk and the screening guidelines that are best for you.
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