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(Mammography, Breast X-ray)
A mammogram is an x-ray examination of the breast. It is used to detect and diagnose breast disease in women who either have breast problems such as a lump, pain, or nipple discharge, as well as for women who have no breast complaints. The procedure allows detection of breast cancers, benign tumors, and cysts before they can be detected by palpation (touch).
Mammography cannot prove that an abnormal area is cancer, but if it raises a significant 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 30 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.
The development of digital mammography technology allows for improved breast imaging, in particular, for women less than 50 years of age, women with dense breast tissue, and women who are premenopausal or perimenopausal. 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. The procedure for a digital mammography is basically performed the same way as a standard mammogram.
With computer-aided detection (CAD) systems, a digitized mammographic image from a conventional film mammogram or a digitally acquired mammogram is analyzed for masses, calcifications, or areas of abnormal density that may indicate the presence of cancer. The images are highlighted by the CAD system for further analysis by the radiologist.
According to the National Cancer Institute:
X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. Standard x-rays are performed for many reasons, including diagnosing tumors or bone injuries.
X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body structures onto specially-treated plates (similar to camera film) and a "negative" type picture is made (the more solid a structure is, the whiter it appears on the film).
Each breast has 15 to 20 sections, called lobes, which are arranged like the petals of a daisy. Each lobe has many smaller lobules, which end in dozens of tiny bulbs that can produce milk.
The lobes, lobules, and bulbs are all linked by thin tubes called ducts. These ducts lead to the nipple in the center of a dark area of skin called the areola. Fat fills the spaces between lobules and ducts.
There are no muscles in the breast, but muscles lie under each breast and cover the ribs.
Each breast also contains blood vessels and vessels that carry lymph. The lymph vessels lead to small bean-shaped organs called lymph nodes, clusters of which are found under the arm, above the collarbone, and in the chest, as well as in many other parts of the body.
Mammography may be used either for screening or to make a diagnosis. Women older than 25 years should undergo diagnostic mammography if they have symptoms such as a palpable lump, breast skin thickening or indentation, nipple discharge or retraction, erosive sore of the nipple, or breast pain.
A mammogram may be used to evaluate breast pain when physical examination and history are not conclusive. Women with breasts that are dense, “lumpy,” and/or very large may be screened with mammography, as physical examination may be difficult to perform.
Women who are at high risk for breast cancer or with a history of breast cancer may be routinely screened with mammography.
There may be other reasons for your physician to recommend a mammography.
The American Cancer Society recommends the following screening guidelines for early detection of cancer in women who have no symptoms:
In addition, the following guidelines by age are recommended:
Consult your physician regarding the screening guidelines that are appropriate for you.
You may want to ask your physician about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of x-rays, so that you can inform your physician. Risks associated with radiation exposure may be related to the cumulative number of x-ray examinations and/or treatments over a long period of time.
If you are pregnant or suspect that you may be pregnant, you should notify your physician. Radiation exposure during pregnancy may lead to birth defects. If it is necessary for you to have a mammogram, special precautions will be made to minimize the radiation exposure to the fetus.
Mammograms may be more difficult to interpret in women younger than 30 years of age, due to the increased density of their breast tissue.
Some discomfort may be felt as the breast is compressed against the x-ray plate during the procedure. This compression will not harm the breast, however.
There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.
Certain factors or conditions may interfere with a mammogram. These include, but are not limited to, the following:
A mammogram may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.
Generally, a mammogram follows this process:
While the mammogram itself causes no pain, the manipulation and compression of the breast being examined may cause some discomfort or pain, particularly in the case of a recent injury or invasive procedure such as surgery. The radiologic technologist will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort or pain.
Generally, there is no special type of care following a mammogram. Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.
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