Mammography, or what is also known as a mammogram, is an x-ray of the breasts. Mammograms are very important procedure to get done as they help diagnose any breast abnormalities. With mammography, a physician can further detect abnormalities in the breast tissue, such as lumps, discharge or any pain felt by the patient. Early detection, even when a woman doesn’t feel pain or discomfort can be lifesaving. Mammography also takes a greater look at certain health concerns such as cysts, forms of cancer or even breast tumors.
Since mammography can further detect certain health concerns, it makes searching for breast cancer much easier. If a physician suspects a patient has abnormal tissue, they will extract that tissue from the breast and send it in for a biopsy. This tissue is removed very easily by a needle and/or through a surgical biopsy.
Advancements in mammography also allow for women under 50 and for premenopausal or perimenopausal women to get better imaging than ever before.
Mammography allows digital images to be enhanced by a computer, saved to computers and hardware and for the images to be transmitted electronically. Digital mammography is very similar to a basic mammogram in the way that it is performed.
Computer-aided detection systems, also known as CAD systems, create a digital mammographic image from a conventional film. These films are used to find breast masses, cancer potential areas or calcifications that may have an abnormal density. After the images have been processed, they will be analyzed by a radiologist.
The anatomy of a breast is very similar to that of a flower. Like the petals of a flower, the breast has lobes that divide into 15-20 sections. Each one of the lobes further divides into lobules, which divides into several little bulbs that are required for milk production.
All of lobes, lobules and the bulbs are connected through ducts. All of the breast’s ducts are connected to the nipple, which is located in the center of the areola. Fat is what fills the gaps between the ducts and the lobules.
In the breast, there are no muscles, although, there are muscles under each breast which connect to the ribs and provide protection.
Breasts also contain several blood vessels. These blood vessels play a very important role when it comes to the lymph nodes of the body. The lymph vessels connect to small organs called the lymph nodes. Lymph nodes are found all over the body. For instance, a person can find lymph nodes in the collarbone area, under his or her arm, as well as other parts of their body.
What Types of Mammograms are Offered?
Since breast abnormalities and tumors can’t always be felt early on, a screening mammogram is done. This type of mammogram takes about two images of each breast using an x-ray machine. This mammogram is done in order to detect any changes of the breasts over time.
If a patient is experiencing any changes in their breasts, a diagnostic mammogram is done. This mammogram is an x-ray used in order to detect any changes. For example, this mammogram will be given if a patient is experiencing any discharge, pain in their breasts or they are experiencing lumps and/or differences in the size of their breasts. This mammogram may also be given if there were any abnormalities on the screening mammogram.
Mammograms have been given for about 30 years now and continue to improve over time. Mammograms are also given for prevention and diagnostic purposes. Fortunately, technology advancements have made it possible for breast x-rays to be low in levels of radiation but higher in quality.
If ever a woman is experiencing any breast concerns, such as pain, lumps, discharge or swelling, they should undergo a mammogram. Mammograms are also recommended to patients who have a family history of breast cancer or who are at a higher risk.
Mammograms can further diagnose breast pain and the history of a patient. Although mammography offers a great opportunity to detect breast abnormalities, mammograms can be harder to perform on a woman with breasts that are lumpy, large in size and/or dense.
Who Should Get Screened for a Mammogram?
Though some women may have no symptoms of breast cancer, the American Cancer Society does recommend that women follow these guidelines as far as early detections go:
- The starting age for a mammogram should be 40.
- Women should provide themselves with a routine breast exam done by their physician about every three years when they’re in their twenties and thirties.
- Women 40 and older should get a breast exam yearly.
- Women in their twenties should be self-examining their breasts regularly.
- For women with an increased risk of breast cancer due to things like breast cancer history, family history and genetic increases, it is recommended that they talk with their physician about their concerns, as well as their benefits of screening and getting additional tests done.
- Women should familiarize themselves with their breasts and look for any changes regularly.
- The age that mammograms should be stopped is something a patient will want to discuss with their physician.
The American Cancer Society recommends that women undergo a screening mammogram every year if they are in their forties or older.
The National Cancer Institute recommends that women get a mammogram yearly or every two years if the woman is in her forties.
What Important Information Can a Mammogram Reveal?
Mammograms can help identify and detect:
- Mass: may or may not include calcifications due to many different causes, such as the following:
- Benign breast conditions: masses that may require an immediate or scheduled biopsy. These masses can be under the watch of periodic mammography, but fortunately, around 80 percent of the changes found result in non-cancerous changes.
- Breast cancer
- Cyst: fluid filled, non-cancerous sacks that lie in the breast tissue. These can be diagnosed by touch alone or by a mammography. A needle is often used in order to drain the fluid from the breast. If the mass doesn’t turn out to be a cyst, more imaging must be done.
- Calcifications: Small deposits of minerals that are found in breast tissue.
- Micro-calcifications: Microscopic pieces of calcium found in the breast tissue. When several pieces are found in one spot of the breast, they are known as clusters.
- Macro-calcifications: Larger and coarser deposits of calcium found in the breast. These are usually a sign of degenerative changes including:
- Breast inflammation
- Previous injuries
- Aged breast arteries
How are Mammograms Performed?
Though mammograms are usually done through outpatient care, they can also be done as inpatient care. For a mammogram to be performed, there are no requirements as far as preparation. All that is asked is that women avoid wearing lotion underneath their arms, power and/or deodorant, as these things can make the imaging process more difficult.
It is also very important for women with implants to let the facility know, as well as the x-ray technologist beforehand. There are certain x-ray technologists that are skilled to work with patients who have implants. Since breast implants can make it hard for technologists to see, as well as can hide certain tissues, it’s extra important to give them a friendly reminder.
Each facility may have the certain guidelines as far as mammography takes place, but the general process is as follows:
- Patients are asked to remove the clothing from their waist up and are given a gown.
- The exam takes 20-30 minutes on average.
- Patients are encouraged to share with the technologist any problems or concerns with their breasts.
- Patients are positioned either lying flat, standing or seated in an upright position.
- Each breast will be examined by the unit and will be compressed with pressure. This pressure is needed in order to get the highest quality image at the lowest radiation possible.
- The patient will need to hold their breath for a few seconds as the x-ray is being taken.
- The patient’s breasts may be x-rayed more than once and in different positions if necessary.
- Once the x-rays are taken, the patient will meet with the radiologist to discuss if further imaging needs to be done.