Mammography

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An overview of mammography. 

A mammogram is an X-ray imaging of the breast to screen for breast cancer. Alongside consistent clinical exams and monthly breast self-examinations, mammograms are a vital tool in the early diagnosis of breast cancer.

Experts, generally, recommend women who are 40 years old and above to carry out mammography every one to two years. However, for those with personal or family history of breast cancer, their doctor may recommend starting screenings earlier, do them more often, or use additional diagnostic tools.

There are two types of mammogram – screening mammography and diagnostic mammography. Screening mammography is the type of mammogram carried out routinely to check for any cancer or changes. In this type of mammogram, several X-rays of each breast are taken.

Diagnostic mammography is the type of mammogram carried out when any of the symptoms of breast cancer has been displayed or a lump has been found in the breast. Also, for those with breast implants diagnostic mammography is the type of mammogram usually recommended, because they are more extensive than screening mammography. Unlike screening mammography, they require more X-rays so as to get the views of the breast from multiple positions. Certain areas of concern can also be magnified.

What’s the use of a mammography screening? 

A mammography is an X-ray imaging diagnostic technique carried out to find or detect breast cancer in its early stages, when it’s still very small and even before a lump can be felt. At this stage, it’s easiest to treat.

Mammography is used either for screening purposes or for diagnostic purposes in evaluating a breast lump.

Types of mammogram

As mentioned earlier, there are two types of a mammogram.

• Screening mammography: A screening mammography technique involves X-raying the breast to detect breast changes in women who show no signs or symptoms of breast cancer, or new breast abnormalities. It involves 2 X-rays of each breast. With the use of mammography, it is probable to detect a tumour that cannot yet be felt. The aim of carrying out screening mammography is to detect cancer before the manifestation of clinical signs.
• Diagnostic mammography: A diagnostic mammography involves X-raying the breast to diagnose unusual breast changes, for instance, a lump, a pain, an unusual skin appearance, nipple thickening or discharge, and a change in breast size or shape. Diagnostic mammography is also used to assess the abnormalities detected by screening mammography. Sometimes also, diagnostic mammography is used to screen women who were previously treated for breast cancer.

Preparation for a mammography

To prepare for mammography, ensure to take the following steps

• Choose a certified and standardised mammogram facility. 
• Plan the test for a period when your breasts are least likely to be tender.
• Go with previous mammogram images if you’re going to a new facility for your mammogram.
• Do not use things like deodorants, antiperspirants, powders, lotions, creams or perfumes under your arms or on the breasts before a mammogram, as metallic particles in them could appear on the mammogram and generate confusion.
• It is advisable to wear a two-piece outfit with no neck jewellery because you will have to undress above the waist.

Mammography procedure.

At the commencement of the mammography procedure, all clothing from the waist up and neck jewellery will have to be removed and a gown will be given to wear.

Next is positioning. The patient will be made to stand in front of an X-ray machine, specially designed for mammography. 

The expert in charge places the breasts (one after the other) on a platform and raises or lowers the platform to match the patient’s height. The expert also positions the head, arms and torso to allow an unobstructed view of the breast.

The breast is then gradually and gently pressed against the platform by a clear plastic plate. Pressure will be applied for few seconds to spread out the breast tissue. While the pressure isn’t harmful, it may be uncomfortable or even painful. 

The breast will have to be compressed to even out its thickness and permit the X-rays penetration to the breast tissue. The pressure also holds the breast static to decrease blurring, which can result from movement, and minimizes the dose of radiation required. During the short-term X-ray exposure, the patient must stand still and hold their breath.

Results interpretation of a mammography

The end result of a mammography is the production of a mammogram, a black and white images of the breast tissue. The images are examined and interpreted by a radiologist, after which a written report of the findings is sent to your doctor.

It should be known that what the radiologist looks out for is the evidence of cancer or noncancerous (benign) conditions that may require further testing, follow-up or treatment.

Possible findings include:

• Calcium deposits (known as calcifications) in ducts and other breast tissues.
• Masses or lumps.
• Distorted areas on the mammogram.
• Dense areas, which appears in only one breast or one particular area on the mammogram.
• New dense parts that has appeared since your last mammogram.

FAQs 

What’s the associated risk of a mammogram? 

Mammography exposes one to a very small amount of radiation. However, this exposure poses an extremely low risk.

What’s 3D mammography? 

One of the advancement made in mammography is the 3-dimensional (3D) breast imaging. Also known as breast tomosynthesis.

In tomosynthesis, the breast is positioned and flattened in the same way it is for the digital mammography. However, tomosynthesis takes fewer seconds longer than a digital mammography. Being that an x-ray tube moves in a curve and takes pictures of the breast from several angles. The information captured is processed by a computer, which generates images that show numerous thin sections of the breast. Studies have shown that 3D imaging results in fewer follow-ups.

What is a normal mammogram?

A normal mammogram means all is well, and nothing fishy was found.

What is an abnormal mammogram?

An abnormal mammogram, however, does not always interpret to the presence of cancer. For a comprehensive diagnosis, additional mammograms, tests, or exams may be conducted.

How long does it take to for a mammography result to come out?

Results should be out within a few weeks. However, if you don’t get your results within 30 days, you should reach out to the doctor in charge.

What are the benefits of mammography in breast cancer diagnosis?

• Screening mammography has helped to drastically reduce the risk of death due to breast cancer. 
• It can be used to detect all types of breast cancer, even invasive ductal and invasive lobular cancer.
• Screening mammography improves the chances of detecting small tumours. 
• No radiation leftover in the patient’s body after the examination.