MEDICAL PROCEDURES
Mammogram
What is a mammogram?
A mammogram is an x-ray test that produces an image of the inner breast tissue on film. This technique, called mammography, is used to visualize normal and abnormal structures within the breasts. Mammography, therefore, can help in identifying cysts, calcifications, and tumors within the breast. It is currently the most effective way to detect early breast cancer . Breast self- examination (BSE) on a monthly basis and examination by a doctor are still important, but physical examinations typically find breast cancers when they are much larger than those detected by mammography. While mammography can discover a small cancer in a curable stage it not foolproof. Ten to fifteen percent of breast cancers are not identified by mammography and these cancers are found by physical examination. It is essential for a woman to perform monthly BSE and have a breast examination by her doctor in addition to the mammogram in order to most effectively screen for breast cancer. For more information, please see the Breast Cancer article of MedicineNet.com.
The American Cancer Society and the American College of Surgeons currently recommend that a woman obtain her first baseline mammogram between the ages of 35 to 40. Between the ages of 40 to 50 a mammogram should be done every other year. After the age of 50, a mammogram should be repeated yearly. Women who are at high risk for developing breast cancer may need to obtain mammograms earlier than these recommendations and at more frequent intervals.
What are the risks of mammography?
Because x-ray procedures use radiation, there is some risk of radiation's effects to the body cells. The amount of radiation that is administered in mammography is exceptionally low and is approved by national and international regulatory agencies as well as the National Department of Health and Human Services. However, patients who are pregnant or may be pregnant are advised to notify their requesting practitioner and radiology staff, because radiation can pose a risk to the developing fetus.
How is a mammogram performed?
A brief history and any specific problems related to the breast, such as pain or a palpable lump (one that is felt), is obtained prior to the mammogram. A small x-ray marker may be taped on the breast overlying the palpable lump. This will help in determining whether any other special mammogram views need to be done beyond the standard views. All jewelry and clothing in the chest and breast area are removed prior to the mammogram. The patient's breasts are then placed on a firm flat x-ray surface and a gentle, but firm pressure is applied to the breast using a mammogram compression device. This compression can cause a degree of discomfort in some women, but it is usually a painless procedure. The compression of the breast is very important in obtaining quality mammograms. The compression spreads the breast tissue out so that the x-rays display the inner breast tissue with good resolution. If compression is not used, the mammograms may be blurry, breast tissue may not be well delineated, and small lesions can be missed.
Generally, two x-rays are obtained of each breast. More views may be obtained if the breasts are large, the woman has had a breast augmentation, or there is an area on the initial mammography views that needs to be further examined. Special magnified or localized mammograms of a specific area of the breast can then be done. A radiology technologist is responsible for performing the mammogram. Once the x-ray pictures are taken, they are developed and examined by a radiologist (a doctor who specializes in the interpretation of x-rays). In most mammogram centers, these radiologists have also had extra training in interpreting mammograms.
How does a patient receive the results of the mammogram?
The results of the mammogram can be given to the patient either by the radiologist at the completion of the mammogram or by the patient's doctor who ordered the mammogram. In many cases, it will be by both doctors. In some cases, the patient will receive a card in the mail with the results of the mammogram. The report of the mammogram generally takes a few days to reach the referring doctor by mail. However, when there is a suspicious area on the mammogram, this information is usually relayed directly to the referring doctor by phone so that further evaluation of this area can be done expeditiously. A patient should call the doctor if she has not received the results of a mammogram in a reasonable period of time. The patient should not just assume the mammogram was normal.
What if the mammogram is abnormal?
If you are told that your mammogram is abnormal or that there is a "spot" on your mammogram, do not panic. An abnormal mammogram does not mean you have cancer. The overwhelming majority of abnormal mammograms are caused by a benign process. In some cases, it may just be an area of thicker or more dense breast tissue, a cyst, or a benign lump such as a fibroadenoma. When a mammogram detects a suspicious area, the patient may be advised to obtain further mammograms of that area, to have an ultrasound of the breast, to see a specialist in diseases of the breast (this is usually a general surgeon), or to have a biopsy performed of the suspicious area.
A breast biopsy is the removal of a piece of breast tissue so that it can be examined under a microscope. The biopsy can be performed surgically, in which an incision is made and the area removed, or it can be done as a stereotactic core biopsy. Stereotactic core biopsy is a technique of removing samples of the suspicious area without the need of traditional surgery. In this technique, the doctor, with the aid of a special mammogram machine and a computer, can identify precisely the abnormality in the breast and then obtain very thin core samples of breast tissue with a special needle. This biopsy test is done with only a local anesthetic in the area of the needle puncture and is generally painless.
Fortunately, most of these breast biopsies will be benign. While mammography is not sufficiently accurate to diagnose or exclude breast cancer alone, it is currently the best method available to screen for breast cancer. Since its more widespread routine use, breast cancers are found when they are significantly smaller and more curable. More women are surviving breast cancer as a result of mammography and early cancer treatment. Continued use of routine mammography should be encouraged until a better alternative in breast cancer detection has been found. For more information, please visit the Breast Cancer article of MedicineNet.com. - Mammograms are images of the breast tissue produced on x-ray film.
- Mammograms are the most effective way to detect early breast cancer.
- Monthly breast self-examination and regular doctor examination are combined with mammogram for optimal breast cancer screening.
- An abnormal mammogram does not necessarily mean cancers, other tests including biopsy may be performed for confirmation.
- A normal mammogram does not exclude the presence of cancer.
For further information about Mammograms, please visit:
Potential Benefits & Risks of Mammograms (http://mammography.ucsf.edu/inform/index.cfm)
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