Mammograms

A mammogram is an x-ray of the breast that is used to detect abnormalities in the breast, particularly breast cancer. (Read about "Breast Cancer") The American College of Obstetricians and Gynecologists (ACOG) says mammograms can detect breast abnormalities before you can actually feel them. Although different organizations have offered different advice on the exact timetables for mammograms, mammograms remain one of the most effective tools for detecting breast cancer in its earliest, most treatable stage.

There are different ways mammograms are used:

• Screening mammograms - Screening mammograms are done on a regular basis, compared to your previous mammogram, and used to check for potential abnormalities.
• Diagnostic mammograms - A diagnostic mammogram is done when you or your doctor detect a suspicious lump or other problem.

Currently, the U.S. Preventive Services Task Force (USPSTF) says the strongest evidence of mammography's benefit and reduced mortality from breast cancer is among women ages 50-74. USPSTF also says there are some risks associated with mammography (false-positive results that lead to unnecessary biopsies or surgery), but that these risks lessen as women get older. The American Cancer Society (ACS) recommends women be given the option of yearly mammograms starting at age 40 and women age 45 to 54 should get mammograms every year. At age 55, ACS recommends that women can switch to every other year if they choose. Screenings are recommended to continue as long as a woman is in good health and has a continued life expectancy of at least 10 years. Special circumstances - such as a family history of breast cancer - may indicate a need for earlier mammograms. (Read about "Family Health History") Each woman should discuss her personal needs with her doctor or healthcare provider.

When you go for a mammogram, you will stand in front of a special x-ray machine. (Read about "X-rays") The person who takes the x-rays, called a radiologic technologist, places your breasts (one at a time) between two plastic plates. During a mammogram, the breast is compressed, in order to produce a clear x-ray. Some women find this procedure less uncomfortable if they schedule a mammogram right after their period, when the breasts are less tender. Often, two pictures are taken of each breast - one from the side and one from above. Options include:

• Traditional mammography - In traditional mammography, the x-rays are manually reviewed by a radiologist.
• Computer aided detection (CAD) - In computer aided mammography or computer aided detection, a computer program is used to evaluate the mammogram as well, to find areas that might require additional review.
• Digital mammography - Digital mammography uses a computer to collect and display the x-ray images. This allows the technician to contrast different areas and highlight potential problems. Digital mammography can be helpful in women with dense breast tissue. Digital mammography also allows for 3D imaging.
• 3D mammography - In 3D mammography, multiple digital images of the breast are taken from different angles. The images are converted into a stack of very thin layers or slices. These layers or slices can be viewed individually or they can be combined to create a three-dimensional image. Computer software is used to create the 3D image from the slices. From the patient's point of view, the experience is comparable to traditional mammography.

ACS says you shouldn't wear deodorant, cream or powder under your arms on the day when you get a mammogram, as they can interfere with the quality of the mammogram. If you have breast implants, be sure to tell your mammography facility that you have them when you make your appointment.

Mammograms allow the doctor to have a closer look for breast lumps and changes in breast tissue. (Read about "Breast Diseases and Conditions") Mammograms can show small lumps or growths that a doctor or woman may not be able to feel when doing a breast exam. (Read about "Breast Self-Examination") When reading a mammogram, doctors look for abnormalities, as well as changes from previous mammograms.

ACS also recommends that women at high risk for breast cancer should get magnetic resonance imaging (MRI) scans along with their yearly mammogram. (Read about "MRI - Magnetic Resonance Imaging") Women should discuss their risks with their healthcare provider.

Related Information:

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