Mammography (Breast Imaging)


Best Way to Detect Breast Cancer

Mammography is a process of photographing (imaging) the breast tissue. It does this by use of a special type of film and low-dose x-ray. This process is used to screen for or help diagnose breast diseases, especially breast cancer. A screening mammogram should be done every one or two years in women over age 40 who have no symptoms of breast disease. As a woman ages, her chances of being diagnosed with breast cancer increase. At age 30, only one out of every 2,000 women is diagnosed with the disease, but by age 50, the incidence rises to one out of every 53 women. A diagnostic mammogram (with more x-rays) is performed in women with symptoms of breast disease, which include a lump, which is usually firm, discharge from the nipple, or a change in the size or shape of the breast. Mammography, combined with a breast exam by a health professional, is the best way to detect breast cancer early. New developments, such as the digital mammogram systems, will continue to help medical professionals detect and treat breast cancer in its early stages, which greatly increases the likelihood of a cure.

Mammography is recommended to detect changes in breast tissue. Mammography is done with a special x-ray machine that compresses and holds the breast in various positions. This permits breast tissue to be seen clearly on the x-ray.

A Key Screening Procedure

Routine mammograms every one or two years are recommended for women over age 40. Women with increased risk of breast cancer may need to start annual mammograms before age 40. Conditions known to increase breast cancer risk include a family history of breast cancer, certain genetic abnormalities, or precancerous cell changes in the breast. Women with dense breast tissue, those who had their first pregnancy after age 30, started their periods before age 12, began menopause after age 55, or never had children are also at a somewhat increased risk. There may be a relationship between the use of hormone replacement therapy for longer than 5 years and the risk of breast cancer. It is not clear if birth control pills increase the risk of breast cancer. Breast implant patients should also have regular mammograms. They should check at their mammogram facility to make sure the technologists and radiologists have experience in x-raying women with implants. Breast implants can hide some breast tissue and make it difficult to see cancerous changes on the x-ray.

Importance of Regular Mammography: Mammography can show changes in breast tissue much earlier than they can be felt, and early detection means early treatment and a better chance for a cure. The combination of regular mammograms and an annual breast exam by a healthcare professional is the most effective way to detect early breast cancer. Although routine breast self-exams are important, they should not replace regular mammograms and breast exams. The mammogram itself is done by a special x-ray machine with accessories that allow the breast to be compressed and held in various positions to take the best image possible. The breast is compressed briefly with a plastic paddle so the tissue is more even and the entire breast tissue can be seen clearly on the x-ray. For most women, the compression feels more like pressure than pain, but some women with sensitive breasts may feel discomfort and should say so. For a screening mammogram, a top-to-bottom view and a side view of the breast are taken. If an abnormality is seen, the radiologist may request a diagnostic mammogram, which involves more x-rays than a screening mammogram. The best time to schedule a mammogram is one week following your period, since this is a time when there is the least amount of breast tenderness. If possible, previous mammograms should be sent to the facility so the radiologist can compare them with your current mammogram. Most facilities recommend avoiding deodorant, talcum powder, or lotion under the arms prior to a mammogram since they may appear as calcium deposits on an x-ray. All mammography facilities must be accredited by the Food and Drug Administration and undergo an annual inspection. Be sure to look for a certificate in the facility that documents this accreditation.

New Developments: There are new developments to improve breast imaging. Magnetic resonance imaging (MRI) and positron emission tomography (PET) scans are being tested, as are ways to detect breast cancer early using blood, urine, or nipple aspirates. Recently approved digital mammography is now available in some facilities. This form of mammography records the x-ray images on a computer, which allows them to be electronically stored or transferred to other facilities. It also allows the radiologist to correct for under- or over-exposure of the x-ray and look at all areas of the breast, even those with dense tissue.

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