Mammogram – Why and How?

A mammogram is a special breast exam which projects the image of the inner breast tissues onto a film or a digital image. This procedure, called mammography, helps to get a clear view of the structures inside the breast. Even the very small tumors or cysts can be seen with a mammogram.

The Need for a Mammogram

A mammogram not only shows tumors, cysts and calcifications but also cancer, which cannot be found on breast self-examination. Usually, cancer can be felt by self-examination or examination by your doctor once it becomes large enough. However, a mammogram can detect the smallest cancers at a very early and and often curable stage.

Kinds of Mammograms

Screening Mammogram

A screening mammogram is done to detect cancer in women that could not be identified on breast self-examination or examination by the doctor.

Diagnostic Mammogram

A diagnostic mammogram is done to help confirm a diagnosis of cancer where a lump has already been detected on self-examination or by a doctor’s exam.

How Often Should You Have a Mammogram

Most healthy women do not need a mammogram until age 40. However, certain women are more likely to have breast cancer and should have a mammogram on a regular basis along with the breast self-examination as well as doctor’s exam. The following shows recommendations on how often you need a mammogram.

  • All women should have a baseline mammogram between the ages of 35 to 40.
  • After the age of 40, you should have a mammogram every year.
  • Women with a family history of breast cancer or who have  been diagnosed with breast cancer, should have a mammogram earlier or more often than as mentioned above.
In addition to mammograms:
  •  You should have a clinical breast exam (done by your doctor) every 3 years in your 20s and 30s and every year beginning at age 40
  • It’s important  to know how your breasts normally look and feel and to report any  changes in your breast promptly to your doctor. Breast self-exam is an option starting in your 20s.

Women with a family history, a genetic tendency, or certain other factors for breast cancer – should be screened with MRI in addition to mammograms. The number of women falling into this category is less than 2% of all women in the US.) Talk with your doctor about your health history and whether ask if you should have additional tests or begin test an earlier age than recommended above.

How to Prepare for a Mammogram

1. Cosmetics like powder, cream, oil, deodorant should not be used before the procedure as they might cause shadows and distort the image causing you to have the mammogram redone.
2. Wear two-piece clothing like pants or skirt and a shirt or that opens up the front to make undressing easier.
3. Make sure all of your previous mammogram results have been sent to the facility where you are having your current mammogram so the radiologist has them for comparison.
4. There are no diet restrictions for mammogram; products than contain caffeine should be avoided by women sensitive to caffeine as this might make the breast tender.
5. Don’t schedule a mammogram when your breasts are painful or tender. Breasts tend to be tender during the mentrual cycles (your period). Mammograms should also be avoided during the pre and post ovulatory period and premenstrual period. The best time for a mammogram is one or two weeks after your period.

The Mammogram Procedure

A mammogram is a simple, quick and easy procedure. You will be asked to remove all clothing or jewellery from your waist up. Then to stand in front of  special mammography machine. The breast is placed between two plastic “plates” and then plates then press together to flatten the breast. The flattening of the breast is done to get a clear image of the inner breast tissues. The compression of the panels on the breast can cause discomfort, but it is over quickly.

Usually two pictures are taken of each breast — craniocaudal view — where the picture is taken from above; and the mediolateral view where the picture is taken from the side. The radiologist may want more views taken if:
• your breasts are large.
• you have had breast augmentation or reduction.
• there is a breast implant.
• a previous mammogram showed an area of concern.

Risks of Having a Mammogram

Mammography is a very safe procedure. Any radiation used is a very small amount. However, it might have an effect on an unborn fetus. So,  women who are pregnant or are trying to conceive should tell their doctor and and the radiologist before having a mammogram.

Another possible risk is in women with implants. Due to the pressure of the plates pressing on the breast, the implant can be damaged. In such cases, surgery will be needed to remove the damaged implant.

Mammogram Results

• Normal — A normal mammogram means there are no malignant tissue changes seen in the breast and no breast cancer. In a normal result, mammograms are recommended every year. When a lump has been detected on self-examination, the radiologist may ask for an ultrasound to confirm the results.
• Abnormal — An abnormal mammogram shows a cyst, tumor or cancer. In an abnormal result, the radiologist may order for more tests to confirm the result. If cancer is suspected, a biopsy is recommended to confirm the cancer. After confirmation, the cancer can be treated with surgery, radiotherapy, chemotherapy and/or hormone treatment depending on the kind and aggressive nature of breast cancer found.
• Inaccurate — Though a rare case, an inaccurate mammogram may be found in women with breast implants, where the liquid of the implant or the surrounding scar tissues distort the picture. There are two types of “bad” results – false-positive and false-negative results. A false-positive mammogram shows the presence of cancer when in fact cancer is not there. In these cases a followup ultrasound, fine-needle aspiration or biopsy can be done to confirm the presence of cancer. A false-negative mammogram gives a normal result even though cancer is present. False positives happen mostly in younger women because of the density of the breast tissue, which makes it hard to interpret the mammogram.

A mammogram is an easy and safe procedure to determine breast cancer; usually done without  complications. Breast cancer detected at an early stage can be often be treated saving many lives.

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