You've probably heard the word "mammogram." Maybe a friend or relative of yours has had one. Or maybe your doctor has told you to have one. Many people get a little scared and nervous when they hear the name. But what exactly is a mammogram? What does it look for? Is it something to be afraid of? Let's talk about all this in detail, very simply, today.
What exactly is a mammogram?
Simply put, a mammogram is a special X-ray test that examines the tissue in your breasts. It uses very low levels of radiation. It's like getting an X-ray when you break a bone in your arm or leg, but it's done with a machine specially designed for breasts.
Doctors use this mammogram test for two main reasons:
1. Screening Mammogram: This is done to look for early signs of breast cancer before any symptoms appear. Just like we take precautions before we develop an illness.
2. Diagnostic Mammogram: If you have symptoms such as a new lump in your breast, pain, nipple discharge, or a change in the skin of your breast, this test is done to find the cause.
Think about it, aside from skin cancer, breast cancer is the most common type of cancer in women. According to some data, 15% of newly diagnosed cancers are breast cancer. Early detection of this disease can save your life. If breast cancer is detected early, the five-year survival rate is as high as 99%! So, this mammogram is like the gold standard for catching changes in breast tissue before they become cancerous.
Are there different types of mammograms?
Yes, there are two main types of mammograms:
- Digital mammography in 2D: This involves taking pictures of one of your breasts from two sides (usually top to bottom and side to side).
- Digital mammography in 3D (digital breast tomosynthesis): This is the latest technology. In this, your breast is compressed once, and the machine moves in an arc, taking several X-ray images. These images are then combined by a computer and created into "slices". This allows doctors to see your breast tissue in three dimensions (3D). This increases the accuracy of the examination.
Can a mammogram definitely detect cancer?
Here's something to understand: A mammogram can help detect cancer, but it cannot definitively say that it is cancer.
Even if a mammogram shows abnormal breast tissue, it does not confirm whether it is cancer. Instead, a mammogram is an essential tool that helps doctors decide whether you need further testing, such as a breast biopsy. A breast biopsy is the only way to tell for sure whether the tissue is cancerous or not.
What age should you have a mammogram?
In general, the US Preventive Services Task Force recommends that all women between the ages of 40 and 75 have a mammogram every two years . However, other medical associations may have slightly different recommendations. It's best to talk to your doctor about what's best for you.
However, if you are at high risk of developing breast cancer, you may need to have mammograms before age 40, or more often. Your doctor may also recommend additional tests, such as a whole breast ultrasound or a breast MRI (magnetic resonance imaging).
Your doctor can do a breast cancer risk assessment to find out if you are at high risk. If you have any of the risk factors below, talk to your doctor about when you should start getting annual mammograms:
- If you have had breast cancer before.
- If someone in your family (mother, sister, daughter) has had breast cancer or ovarian cancer.
- Inherited genetic mutations, for example, the `(BRCA1)` and `(BRCA2)` genes.
- If you have certain non-cancerous (benign) breast conditions, for example, atypical ductal hyperplasia.
- If your breasts are dense.
Occasionally, men may also be at higher risk due to family history. In such cases, mammograms are also recommended for them. However, on average, only about 1 in 100 breast cancers develop in men.
How often should I have a mammogram?
This depends on your risk level. If you have an average risk of developing breast cancer, you should have a mammogram every one to two years starting at age 40. If your risk is high, you may need to start earlier or have it more often. Talk to your doctor about a mammogram schedule that's right for you, based on your medical history and other factors.
How does a mammogram work?
A mammogram uses an X-ray machine specifically designed for breast tissue. The X-rays emitted by this machine have a lower radiation dose than X-rays used to examine bone.
During a mammogram, your breast is placed on a support plate that is attached to the X-ray machine. Then, the technician gently presses your breast with another paddle. The X-rays from the machine pass through your breast and hit a detector on the other side. This detector sends electronic signals to a computer to create a digital image. These images are called mammograms.
You may wonder why the breasts are compressed like this. There are several reasons for this:
* Keep your breasts still. If they move, the pictures may be blurry.
* Flatten the shape of the breast, allowing the X-rays to travel a shorter distance to the detector. This allows for a lower radiation dose and improved image quality.
Who does the mammogram?
A mammogram is performed by either a radiology technologist or a mammographer. They have special training to do this safely and accurately. Then, a radiologist, a specially trained doctor, looks at and analyzes the mammogram images. He or she sends the results to your doctor, who then tells you about them.
How do you prepare for a mammogram?
There are a few things you should keep in mind when booking a mammogram and on the day of it:
- Tell your doctor if you are breastfeeding, pregnant, or think you may be pregnant . He or she will tell you the best time to have a mammogram, or start with an ultrasound.
- If you are still menstruating , do not have a mammogram the week before or during your period. Your breasts may be more sensitive during these times, making the examination more difficult.
- If you have breast implants or have recently had a vaccine, please mention this when booking your mammogram.
Follow these steps on the day of your mammogram:
- Follow your normal routine - eat, drink, and take your usual medications.
- Do not use deodorant, perfume, lotion, or body powder. These products can interfere with the accuracy of the X-ray images.
- For the test, you will have to remove your clothing above the waist. Instead, you will be given a gown or cloth to wear.
What to expect when having a mammogram?
These are the steps that occur during a mammogram:
1. You will have to remove all clothing and jewelry above the waist. You will be given something that looks like a hospital gown that is open in the front.
2. You will stand in front of the mammography machine. The technician will ask you to remove one breast from the gown.
3. Place your breast on the breast support plate.
4. The technician will then gently press your breast against the support plate with a plastic paddle. You may feel some discomfort or pressure during this pressing. If you cannot tolerate the pressure, tell the technician. They will then make adjustments accordingly.
5. The machine takes pictures while you hold your breast.
6. If you have two breasts, do the same for the other breast.
7. Once the machine has finished taking pictures, the test is over. You can get back into your clothes and leave.
Most people can go about their normal activities after having a mammogram.
Does a mammogram hurt?
Some people feel uncomfortable during a mammogram because the breast tissue is compressed. Others may feel pain. The good news is that a mammogram is a test that takes just a few minutes, and the discomfort doesn't last long. If you feel any severe pain, tell the technician right away.
The level of discomfort you feel depends on several factors:
- The size and density of your breasts.
- How tight you want your breasts to be.
- Whether you are about to have your period, or are on your period days.
- The skill of the radiological technician.
- Your ability to stay relaxed and maintain your posture so that you can take good pictures.
How long does a mammogram take?
A screening mammogram usually takes about 15-20 minutes . A diagnostic mammogram can take longer because the doctor may need to take additional images.
Are mammograms safe?
Mammograms expose your breasts to a small amount of radiation. However, the benefits of mammography far outweigh the potential harm from radiation exposure.
If you may be pregnant, tell your doctor and technologist. Although mammograms are safe during pregnancy, doctors may recommend postponing screening mammograms if you are not at high risk of breast cancer and are pregnant.
How long does it take to get mammogram results?
You will usually get your mammogram results within a few days . However, this can vary from place to place. Often, radiologists will compare your most recent mammogram with previous mammograms. Once they have finished reviewing your mammogram, they will send the results to you and your doctor.
If you don't receive your results within a month, contact your doctor or the place where you had your mammogram.
What are the results of a screening mammogram?
You will receive a simple, easy-to-understand letter with basic information about your results. It may tell you whether your results are normal or if you need to come back for additional images. Your mammogram report will also include information about your breast density . This is how much fibrous and glandular tissue there is in your breasts compared to fatty tissue. This information is now required by law to be included in your report. If you have any questions about your results, don’t be afraid to ask your doctor.
Breast Imaging Reporting and Data System (BI-RADS)
Radiologists and doctors use a standard system to describe findings on screening and diagnostic mammograms. It's called BI-RADS . This system divides the results into categories from 0 to 6. This system gives you your category, finding, and explanation (including your risk of cancer).
What is a normal mammogram?
A normal mammogram means that the radiologist did not find any problems or abnormalities in your breasts on the images. If your mammogram is normal, it is important to continue to have mammograms at the intervals recommended by your doctor. Screening mammograms are most useful when the radiologist can compare them with your previous ones and find changes in your breasts.
What is an abnormal mammogram?
If a mammogram shows one or more suspicious areas, the radiologist will often recommend additional specialized mammogram images – or other imaging tests, such as a breast ultrasound or a breast biopsy.
If you get an abnormal mammogram, your doctor will talk to you about what to do next. An abnormal result doesn't necessarily mean you have cancer. So don't panic and follow your doctor's advice.
How accurate is mammography?
Mammography is 85% to 90% accurate . Mammograms have become increasingly capable of detecting breast abnormalities before you can see or feel them. However, it is still possible for a mammogram to miss some abnormalities.
If you notice anything suspicious while doing a breast self-exam at home, or if you develop a new breast symptom, it is very important to contact your doctor immediately.
Do breast implants interfere with mammograms?
For people who have had silicone or saline breast implants, it can be difficult for radiologists to see all of their breast tissue and potential problems on a regular mammogram due to the scar tissue that results.
To help the radiologist see as much of the breast tissue as possible, in addition to the four standard images taken during a screening mammogram for people with implants, two additional images are taken of each breast. These additional images are called Implant Displacement (ID) views .
During ID scans, the technician gently presses your breast implant against your chest wall, pulls your breast forward over it, and then compresses your breast. This allows for better images of the front of each breast.
It is very important to tell your technician that you have breast implants when you book your mammogram and on the day of the mammogram.
Take-Home Message
Mammograms are an essential test for early detection of breast cancer. They also help monitor noncancerous breast conditions over time. The test can be a little uncomfortable, and you may feel a little nervous waiting for the results. However, it is very important to get your mammograms at the recommended age and at the recommended intervals, depending on your risk of developing breast cancer.
If you have any questions about your breast cancer risk or the mammogram process, talk to your doctor. They are there to help you. Don't be afraid, be informed, and be healthy!
` Mammogram, Breast Cancer, Women's Health, X-Ray, Cancer Screening, Health Checks, BI-RADS
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