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What is Mammography?

Mammography is a diagnostic technique that uses x-rays to create an image or mammogram of the breast that helps to detect lumps or signs of breast cancer. Women who are at a high risk of breast cancer or young women with symptoms of breast cancer are advised to get a mammogram done. It is performed as a screening as well as a diagnostic procedure.

  1. Why is Mammography performed?
  2. How do you prepare for Mammography?
  3. How is Mammography performed?
  4. What do Mammography results mean?

A mammogram that helps detect cancer is a 'screening mammogram'. It involves two or more images or x-rays of each breast. Along with detecting tumours that cannot be felt, screening mammograms also help identify minute calcium deposits in breasts that might denote the presence of breast cancer.

A mammogram that is performed after discovering the signs of breast cancer like lumps in the breast, breast pain, nipple discharge or change in breast shape or size is called a 'diagnostic mammogram'.

Both types of mammograms are performed using the same machine. However, the time taken and the total dose of radiation is higher for diagnostic mammography as multiple images from different angles of the breasts are necessary. Therefore, a diagnostic mammogram can view breast tissue that is not visible on screening mammogram under special conditions such as the presence of breast implants.

Performing mammography regularly helps detect breast cancer at an early stage and allows early initiation of treatment to stop the spread and progression of cancer.

Women should not undergo mammography during or one week before their periods as breasts become swollen and/or tender during this time. Do not apply powders, perfumes or deodorants on the day of the test as they may show as white patches in a mamogram. Wearing a top with bottoms will be more convenient than wearing a dress, as you will have to undress till the waist for this test.

  • Women will be asked to take off their shirt and inner garments like bra before the test.
  • They will be asked to stand in front of the x-ray machine and place their breast on a platform.
  • The technician will secure the position of breasts on the machine and allow a transparent plastic plate from above to press the breast against the platform. This will keep the breast still and flatten it while the x-ray is being taken.
  • The steps are repeated to view the breast from the side as well. In all, four images of a breast are taken.
  • The whole procedure may be repeated if the images generated are not appropriate or clear enough.
  • Some women might experience discomfort due to the pressure on breasts.

Although the risk of harm is low in this procedure as minimal doses of radiation are used, there is a small risk of cancer if repeated x-rays are taken.

Women should inform the technician if they are pregnant or suspect a pregnancy as radiation exposure can harm the growing foetus.

Every woman’s mammogram looks different as breasts vary in size and shape. Radiologists use a scoring system named BI-RADS or breast imaging, reporting and data system, to evaluate a mammogram. BI-RADS scores are from zero to five and are interpreted as follows:

Normal results:

  • Score 0: Another mammogram might be required before a score can be provided.
  • Score 1: No abnormalities observed in the image. Routine screenings should be continued.

Abnormal results:

  • Score 2: Presence of benign conditions like cysts. Routine screenings should be continued.
  • Score 3: Presence of some abnormality that is not cancer. A mammogram should be repeated within 6 months.
  • Score 4: Presence of some abnormality that might be cancer. A biopsy might be necessary.
  • Score 5: Presence of an abnormality that highly indicates cancer. A biopsy will be required.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. This information is purely from an educational point of view and is in no way a substitute for medical advice by a qualified doctor.

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References

  1. National Institute of Biomedical Imaging and Bio engineering [internet]. Bethesda (MD); US Department of Health and Human Services; Mammography
  2. Office on women's health [internet]: US Department of Health and Human Services; Mammograms
  3. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Mammograms
  4. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; What Is a Mammogram?
  5. American College of Radiology, Radiological Society of North America; Mammography
  6. Women's health care physicians: The American College of Obstetricians and Gynecologists; FAQ: Gynecological problems