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Mammography

A mammography is an X-ray examination of the breast.  It is a type of imaging that uses low dose X-Rays to detect changes in the breast that are cancerous as well as non-cancerous.

Images can be viewed on film on a view box or as soft copy on a digital mammography work station.

Did you know that a mammogram can show changes in the breast up to two years before a patient or physician can feel them during a physical examination? No wonder the mammogram has become a critical tool in the early diagnosis of breast cancer.

All women above the age of 40 are therefore advised to undergo a mammography once a year for screening purposes. In fact, the National Cancer Institute in the United States advises women who have had breast cancer and those who are at increased risk due to a genetic history to seek medical advice on whether they should begin screening before the age of 40.

How To Prepare
Before scheduling a mammogram, discuss any new findings or problems in your breasts with your consulting physician. In addition, inform your doctor of any prior surgeries, hormone use and family or personal history of breast cancer.

Do not schedule your mammogram a week before your period if your breasts are usually tender during this time. The best time is one week following your period. Always inform your doctor or X-ray technologist if there is any possibility that you are pregnant.

  1. Do not wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These can appear on the X-ray film as calcium spots.
  2. Describe any breast symptoms or problems to the technologist performing the exam.
  3. If possible, obtain prior mammograms and make them available to the radiologist.

In addition, before the examination, you will be asked to remove all jewelry and clothing above the waist and you will be given a gown or loose-fitting material that opens in the front.

How It’s Done
During a mammography, a qualified radiologic technologist will position you to image your breast. The breast is first placed on a special platform and compressed with a paddle.
Breast compression is necessary in order to:

  1. even out the breast thickness so that all of the tissue can be visualised
  2. spread out the tissue so that small abnormalities won't be obscured by overlying breast tissue
  3. allow the use of a lower X-ray dose since a thinner amount of breast tissue is being imaged
  4. hold the breast still to eliminate blurring of the image
  5. reduce X-ray scatter to increase sharpness of the image

The technologist will step behind a glass shield while making the X-ray exposure. A beam of X-rays is aimed through the breast to the film behind the plate, thus exposing the film. You will be asked to change position slightly between images. The process is repeated for the other breast. The examination process should take about half an hour.

What You Experience
You will feel pressure on the breast as it is squeezed by the compressor. Some women with sensitive breasts may experience discomfort. If this is the case, schedule the procedure when your breasts are least tender. The technologist will apply compression in gradations. Let the technologist know if you experience pain as compression is increased.

Caution
Cancer : Interpretations can be difficult because a normal breast can appear different for each woman. Also, the image may be compromised if there is powder or salve on the breasts or if you have undergone breast surgery. Because some breast cancers are hard to visualise, a radiologist may want to compare the image with those of previous examinations. Not all cancers of the breast can be seen on a mammogram.

Implants : Breast implants can impede accurate mammogram readings because both silicone and saline implants are not transparent on X-rays and can block a clear view of the tissues behind them. But experienced technologists and radiologists know how to carefully compress the breasts to improve the view without rupturing the implant. Before the mammogram is taken, it is a good idea to ask whether the technologist is experienced in performing a mammography on patients with breast implants.

What Next?
A mammogram must be interpreted by a qualified radiologist who is a physician experienced in mammography and other X-ray examinations. He / she will analyse the images, detect abnormalities if any and offer a likely diagnosis. The report will be prepared by the radiologist and then sent to your referring physician. You will also be notified of the results by the mammography facility.

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