Mammogram

A screening mammogram is generally used to detect breast cancer or other changes in the breast tissue in women who do not have symptoms.

A diagnostic mammogram may be ordered when a screening mammogram shows something abnormal in the breast.

It may also be ordered if the woman has symptoms, such as:

• a discharge from the nipple other than breast milk
• a lump or swelling in the breast or underarm area
• nipple pain
• redness or scaliness of the nipple or breast skin
• retraction, or turning inward, of the nipple
• skin irritation or dimpling

Breast cancer screening with mammograms has reduced deaths from breast cancer in women 40 to 69 years of age.

For a screening mammography, the woman undresses to the waist and puts on a gown that opens from the front. The technologist places one breast on an X-ray film cassette, which resembles a metal shelf. The woman rests her breast on the film cassette. Usually the woman stands during this procedure.

A plastic paddle briefly squeezes the breast from above to flatten it out. This allows a clearer X-ray to be taken. Two views are usually taken of each breast for a screening mammogram. A diagnostic mammogram requires more views and more detail than the screening exam.

With modern mammography equipment used specifically for breast X-rays, very low levels of radiation are used. Some mammography units offer a stereotactic (x-ray guided) biopsy of any suspicious areas at the time of the examination. A woman is counseled and prepared for this by her healthcare professionals.

Examples of these newer techniques employed to gain a better diagnosis of breast abnormalities include:

• digital mammography, which records images in computer code instead of on X-ray film
• MRI imaging, which uses a large magnet and radio frequencies to produce pictures of the breast tissue
• positron emission tomography, or PET, which uses radioactive materials to create computer images
• radionuclides, which uses contrast agents
• ultrasound, which uses high-frequency sound waves instead of X-rays

It is recommended that a mammogram be scheduled one week after a woman's last period. Women should not wear powder, deodorant, lotion, or perfume under the arms or on the breasts. Wearing a two-piece outfit is suggested. Prior to the exam, all jewelry and metal objects need to be removed.

A mammogram can detect breast cancer, often before a lump can be felt. A mammogram may also show the following conditions:

• calcifications, or mineral deposits
• cysts, or fluid-filled masses
• leaking breast implants
• noncancerous tumors or growths