Mammogram

What is a mammogram?

A mammogram is a low-dose X-ray exam of the breasts.

When is it used?

A mammogram helps detect breast cancer at an early stage. Mammograms can detect some types of cancer before you or your healthcare provider can feel a lump. They detect most cancerous growths in the breasts.

Mammograms are also used to check lumps you or your healthcare provider have found in a physical exam. They can help determine which lumps are cancerous and which are benign. Fortunately, most of these lumps are not cancerous.

Mammograms can also check for any additional lumps that cannot be felt yet. All suspicious lumps should also be biopsied or removed, even when the lump appears noncancerous (benign) on a mammogram.

The smaller and the more localized a cancer is at the time of diagnosis and treatment, the greater the chance of a cure. The mammogram allows the detection of some types of breast cancer 1 to 2 years before you or your healthcare provider would be able to feel it. There is a better chance of curing the cancer if it is found at an early stage.

Mammograms can also show a more exact location of a growth before you have surgery or a biopsy to remove it.

In addition to the mammogram, other exams may include:

• monthly self exams of your breasts that you do at home
• yearly exams of your breasts by your healthcare provider
• magnetic resonance imaging (MRI) of your breasts for women at high risk of breast cancer

You may choose not to have this exam. Ask your healthcare provider about the benefits and the risks.

How do I prepare for this exam?

Be sure your underarms and chest are clean. Don't put any deodorants, powders, lotions, or perfumes on your underarms or chest on the day your mammogram is to be done. These products can make it difficult to interpret the test results correctly.

What happens during the procedure?

The exam is done in your healthcare provider's office, an X-ray clinic, or a mobile van with a mammography machine inside. You will be asked to take off your shirt, bra, and jewelry. It takes just a few minutes for the technologist to take X-rays of each breast. The machine has a platform for your breasts. The technologist will put one of your breasts on the platform and put a plate on the breast to press it gently. This may be uncomfortable for a few seconds, but it allows the X-ray to show more of the tissue deep within your breast. Two or three different views of each breast will be taken to check the whole breast. Each X-ray position requires just a few seconds.

What happens after the procedure?

You may need to wait a few minutes while the technician makes sure the mammograms are good quality for reading. The X-rays will be read by a radiologist and the results reported to your healthcare provider. You will also get a letter from the radiologist. Ask your healthcare provider how and when you will hear test results.

What are the risks or concerns associated with this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

• Mammograms often find small growths that are not cancerous. However, once detected, they must be checked to make sure that they are not cancer. You may be called back for another mammogram or another procedure to see if you have breast cancer and then find out that you don’t have cancer. This can be expensive and causes a lot of anxiety as you wait for results. Other procedures, such as a needle biopsy, can be painful, even though local anesthesia is used to numb the area.
• Mammograms also sometimes find very small cancers that are harmless. These cancers are groups of abnormal cells that will never cause any symptoms or problems. They may stop growing, shrink, or even go away on their own. But because it’s not possible to know if a cancer is going to be fast-growing and very malignant or if it will be harmless and go away on its own, cancers that are found need to be treated.
• Mammograms expose you to very low levels of radiation, but the more mammograms you have, the greater your lifetime exposure to chest radiation.
• Mammograms do not find all breast cancers. About 1 out of every 4 or 5 breast cancers are missed by a mammogram and found only when they are felt with the fingers. If you feel a lump in your breast, report it right away to your provider even if you have had a recent mammogram that did not find any cancer.

There is risk with every treatment or procedure. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.

How often should I have a mammogram?

Breast cancer screening guidelines released by the US Preventive Services Task Force (USPSTF) in 2009 recommend a mammogram every 2 years for women 50 to 74 years old. This recommendation is for women of average risk. Not every medical organization agrees with this recommendation and it is being reviewed. The American Cancer Society recommends that women with an average risk should start getting a mammogram at age 40 and then have one every year.

Depending on your personal and family history your provider may recommend a different screening schedule. Some women with a high risk of breast cancer may need to start screening earlier than age 40 and may need to be screened more often.

If you have a risk for breast cancer that is much higher than average and you are 25 years old or older, ask your healthcare provider when you should start having mammograms and how often you should have them. If you have a very high risk, you may want to see a breast specialist. Women who have the highest risk for breast cancer are women who:

• have a gene mutation making them more likely to get breast cancer (a change in the gene called BRCA1 or BRCA2)
• have an immediate family member with the BRCA mutation
• have had radiation to the chest for a medical problem
• have a history of breast cancer

If you have any questions about when you should start having mammograms and how often to have them, ask your healthcare provider.