Definition and Overview
A mammography is a screening test that is highly recommended to all women particularly those who have a history of breast cancer and those who are on or beyond the menopausal age.
A mammography is a breast cancer screening procedure that detects the presence of the disease at an early stage. It can thus help women seek the care that they need as early as possible, which can significantly increase their chances of recovery.
Who Should Undergo And Expected Results
A mammography can benefit all women, including those with no breast cancer history as this is not the only factor that puts a person at risk of developing the disease.
Other established and probable risk factors include:
- Older age
- Advanced age at first childbirth
- Young age at first menstruation
- Menopausal age
- Alcohol consumption
- Gender (women are typically more susceptible, although men are not completely exempted)
- Jewish heritage
- Use of contraceptives
- High blood androgen or estrogen levels after menopause
- Existing benign breast conditions
- High IGF-1 hormone levels prior to menopause
- Hormone therapy
- History of other cancers
- High prolactin hormone levels
- Frequent exposure to radiation
- Previous radiation treatment
- High breast density
- High bone density
The test will show whether the breast tissue has some abnormalities, which may or may not indicate cancer but may precede cancer. If such abnormalities are found, the doctor may conduct further investigations (such as a biopsy) and may provide some advice on how the patient’s risks may be controlled or minimised.
For patients who are considered at risk of breast cancer, regular screening scans will be recommended as this can detect the disease early if it does develop. The earlier treatment is begun, the greater the patient’s chances of recovery.
Generally, a mammography for women with no breast cancer history should be done at least once every two years when they reach menopause or the age of 50, whichever comes first. On the other hand, those who meet several of the major risk factors should undergo the screening once a year from age 40.
How the Procedure Works
A mammography is conducted in the same way for both women with and without breast cancer history. The test is performed in a special lab that is equipped with a mammogram machine designed so that the breasts can be placed flat on a plastic plate and compressed with another plate from the top. While being compressed, images of the breast tissue will be taken and recorded.
During the actual procedure, it is normal for patients to feel some pain or discomfort when the breast is compressed, but this only lasts for a minute or so. Despite the discomfort, patients are advised to keep still, as any movement may cause the images to become blurry, rendering the test inaccurate or unsuccessful.
The entire test usually takes about 20 to 30 minutes, but patients would have to wait a few weeks before the results are released. At this point, their doctor will discuss the findings with them.
If the results are normal, the patient will be advised as to when to come back for the next scan. If there are any abnormalities in the findings, the doctor will order more tests to determine whether they are indicative of cancer or other breast conditions. From then on, the patient will be guided by her doctor as to what her next options and steps should be.
Possible Risks and Complications
Despite the established accuracy and the prevalent use of mammography in scanning for breast cancer, there is still a small risk that the test will yield inaccurate results. This risk is mainly due to the following factors:
- The use of talcum powder, creams, lotions, perfumes and deodorants on or near the breasts
- Breast implants, which may prevent the doctor from scanning all breast tissue
- Hormonal breast changes, which may or may not be normal and may thus lead to false positive or false negative results
- Previous breast surgery
To avoid such risks, mammography should be scheduled one or two weeks after the start of the menstrual period as breasts tend to be tender and more susceptible to hormonal changes in the week before and during menstruation. Also, patients are advised not to apply any cosmetic products on their breasts or near their breasts on the day of the screening.
If the patient has breast implants or has had a previous breast surgery that may cause some parts of breast tissue to become obscured, special preparations and techniques may be used to get a clear and complete view of the breast tissues.
American Cancer Society. American Cancer Society Recommendations for Early Breast Cancer Detection in Women Without Breast Symptoms. Last revised October 24, 2013. Available at: www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs. Accessed January 29, 2015.
American College of Obstetricians and Gynecologists (ACOG). ACOG practice bulletin no.122. Breast cancer screening. Obstet Gynecol. 2011;118:372-82. PMID 21778569 www.ncbi.nlm.nih.gov/pubmed/21775869.