Mammogram: An Overview

What Is a Mammogram?

A mammogram is basically a special X-ray of the breast that uses low radiation. Doctors use it to spot breast cancer early. They'll also order one if you find a lump or have pain, discharge, or skin changes.

Breast cancer is the second most common cancer in women (after skin cancer). It makes up 15% of all new cancer cases in the U.S., but when we find breast cancer early through routine mammograms, the five-year survival rate jumps to 99%. That's why mammograms are so important; they catch changes in your breast tissue before they become cancer.

Why Is It Done?

Mammograms help doctors spot cancer or other changes in your breast tissue.

There are two main types you should know about.

1. Screening Mammograms:

When you feel perfectly fine, there are no lumps, no pain, and nothing unusual. The whole point is catching any problems early, when they're tiny and easier to treat.

So when should you start getting them? If you're a woman with average breast cancer risk, most doctors suggest starting at 40. After that, you'll probably need one every year.

2. Diagnostic Mammograms:

You'd get this if you found a lump, your breast hurts, or your skin looks different. Notice any nipple changes or discharge?

Your doctor might also order one if your regular screening mammogram showed something they want to check out more closely.

Different Types of Mammograms:

There are 2D (two-dimensional) and 3D (three-dimensional) mammograms.

In 2D mammography, your doctor takes images of the breast from two angles; in 3D mammography, your doctor takes multiple X-rays from different angles.

Can a Mammogram Detect Cancer?

Mammograms can detect cancer, but they can't tell you if it's cancer or not.

It gives your doctor an idea of whether additional testing, such as a biopsy (a test to confirm cancer), is needed. Only a biopsy can confirm whether those abnormal cells are cancerous or totally harmless.

At What Age Do You Get a Mammogram?

The U.S. (United States) Preventive Services Task Force says women should get mammograms every two years starting at age 40. Keep going until you're 75. If you're at higher risk for breast cancer, the rules change. You might need to start screening before 40 or get checked more often.

Wondering if you're high-risk? Your doctor can perform a risk assessment to determine it. Here are some things that put you in that category:

• You've had breast cancer before.

• Breast or ovarian cancer runs in your family.

• You carry certain gene mutations (like BRCA1 (breast cancer) or BRCA2).

• You've had some non-cancerous breast conditions.

• You have dense breast tissue.

How Does a Mammogram Work?

A mammogram is a special X-ray just for your breasts. The machine is specifically designed for breast tissue and uses less radiation than the X-rays used for bones.

Here's what happens during the procedure. You'll place your breast on a flat plate, and then another parallel plate (paddle) gently presses down on it.

Why do we compress the breast? It keeps everything still, so we don't get blurry images. It also evens out the breast shape, which gives us much clearer pictures. Plus, it actually reduces the amount of radiation you're exposed to.

The X-rays then pass through your breast tissue to a detector underneath. This creates digital images called mammograms.

How Do You Prepare for a Mammogram?

What you need to know before scheduling your mammogram:

• If you are having periods, try to avoid booking during the week before or during your period. Your breasts can feel tender.

• If you are pregnant, let your doctor know right away. They'll help you figure out the best timing or suggest an ultrasound instead.

• If you are breastfeeding, just pump or nurse right before your appointment.

• If you got breast implants or recently had a vaccine, make sure to mention this when you're scheduling.

On the day of the appointment:

• Eat a healthy breakfast.

• Skip the deodorant, perfume, lotion, and body powder.

What Can You Expect From a Mammogram?

1. During the Test

• During the test, the hospital attendant will give you a gown to change into. You'll need to take off your top and any necklaces you're wearing.

• You'll stand in front of a special X-ray machine designed just for mammograms. A technician will help position one of your breasts on a platform. They'll adjust everything to match your height and make sure your head, arms, and body are positioned just right.

• A clear plastic plate will slowly press down on your breast against the platform.

• During the X-ray, you'll hold your breath and stay as still as possible.

2. After the Test

Once it's done, you should wait a bit while they check the images. Sometimes they need to retake it if something is not clear. The whole thing usually takes less than 30 minutes. Then you can get dressed and head back to your regular day.

What Types of Results Do You Get From a Mammogram?

After your mammogram, you'll get a results report that’s written in plain language, so it should be easy to understand. The letter might say everything looks normal, or it might ask you to come back for more tests.

The report will tell you about your breast density. How much fibrous and glandular tissue do you have compared to fatty tissue in your breasts?

Understanding Your Results: The BI-RADS System

Doctors use something called BI-RADS (Breast Imaging Reporting and Data System) to describe what they see on mammograms. It uses categories numbered 0 through 6. Each number tells you something different about your mammogram findings.

Category	Assessment	Recommendations
0	Incomplete	Seen an abnormal area and advised you to do additional tests
1	Negative	Does not find any abnormality. Require routine screening mammography.
2	Benign	Seen a noncancerous area in your breast. Require routine screening mammography.
3	Probably benign	There is a 98% chance of a noncancerous area, but this has not been proven. Short interval follow-up recommended.
4	Suspicious abnormality	Seen a suspicious abnormality in your breast, but advises a biopsy to confirm it
5	Highly suggestive of malignancy	A high probability of being cancer. A biopsy is suggested.
6	Known biopsy-proven malignancy	Already confirmed cancer through a biopsy. It is used to evaluate the extent of the treatment.

What Does a Normal Mammogram Mean?

A normal mammogram indicates that no abnormality is seen in your breasts. But you have to go for regular intervals as your doctor recommends.

What Happens If Your Mammogram Is Not Normal?

If your mammogram is not normal, then it means that there is some abnormality seen in your breasts. But it is not certain that the abnormality is cancer. You have to undergo additional tests, such as a biopsy, to confirm it.

What Are the Advantages of a Mammogram?

The advantages of a mammogram are as follows:

• It can detect breast cancer early.

• Early diagnosis and treatment improve the survival rates.

• It is a minimally invasive and less aggressive treatment approach.

• It identifies the specific tissue changes in the breasts.

What Are the Risks of a Mammogram?

The risks of a mammogram are as follows:

• A mammogram can yield a false-positive result. It can also detect abnormalities that appear to be cancer but are not.

• It also yields a false-negative result. Sometimes, you may have breast cancer, but a mammogram is unable to detect it.

• Next is overdiagnosis, in which a mammogram detects even small abnormal cells and cancer, which never grows and spreads; you may take unusual treatments like surgery or radiation.

• The procedure requires breast compression, which can be painful and uncomfortable.

• Anxiety arises from the uncertainty of whether you have cancer or not. Because, in most cases, the women being screened are healthy.

Conclusion:

Mammograms help catch breast cancer early, which gives you a much better shot at beating it. If you're over 40, it's time to talk with your cancer specialist about getting them regularly.

If you are pregnant, breastfeeding, having periods, or have breast implants, just tell your doctor before a mammogram.

If you got diagnosed, don't go through this alone; lean on family or friends or join a support group. Your doctor will figure out the best treatment plan for you. Meanwhile, eat well, stay active, and get your rest.

If you're worried about any breast changes or it's time for your screening, consult a women's specialist today.

Key Takeaways:

• A mammogram is an X-ray used to diagnose breast disease. It uses low doses of radiation to take pictures that help doctors spot problems early.

• If you've got dense breast tissue, it’s difficult to spot on regular mammograms. 3D mammography takes multiple pictures from different angles, making it way easier to catch things that might be hiding.

• Most doctors recommend yearly mammograms starting at 40. When breast cancer is caught early through regular screening, survival rates jump to almost 90%.