by Krisha McCoy, MS
Anatomy and Physiology
A woman's breasts are composed of glandular tissue and ducts, fat, connective tissue, and blood vessels. Occasionally, lymph nodes are also seen in the breast. The glands produce and secrete milk for breastfeeding an infant.
Changes in the breast are common. A woman's breast tissue changes over the course of her lifetime. It also changes during her menstrual cycle or if she is taking hormones.
Reasons for Procedure
One type of breast change is the development of a lump or mass. Breast lumps are often found upon self-examination or by a mammogram. Most breast masses are benign, but some are cancerous. A breast biopsy is required to determine if a lump is cancerous.
A mammogram is a procedure that uses x-rays to detect changes in breast tissue. Mammograms can detect masses, tiny deposits of calcium referred to as microcalcifications, and other subtle changes that may indicate cancer. The major advantage of mammography is that it can detect changes that you or your physician may not be able to feel on examination. Most abnormalities found on a mammogram turn out to be benign on further evaluation.
A mammogram cannot prevent breast cancer, but it may allow for earlier detection and thereby increase the chance of curing the breast cancer. Depending on a woman's age, mammography has been shown to reduce a woman's risk of dying from breast cancer by 25% to 35%.
Common methods of detecting breast cancer include: breast self-examination, clinical breast exams by health professionals, mammograms.
Screening mammograms are used to look for breast cancer in women with no symptoms. Typically, two films are taken of each breast. Women with the following characteristics can expect to benefit the most from regular mammograms: 50 years and older, history of abnormal breast biopsy, strong family history of breast cancer, carrier of gene predisposing to breast cancer, some authorities recommend regular mammograms beginning at age 40 for all women.
Diagnostic mammograms are used to further evaluate an abnormal screening mammogram or physical exam finding, such as nipple discharge or a breast mass. Typically, additional films are taken of the affected breast, often with extra compression in order to clarify the area of concern. Diagnostic mammograms cannot, however, determine whether a mass is cancerous or not. A breast biopsy is necessary to diagnose breast cancer.
Before your mammogram, take the following steps: If you experience breast tenderness before or during your period, schedule your mammogram approximately one week after your period. On the day of your examination, make sure that your breasts and underarms are clean, and do not wear deodorant, since it may appear on mammogram x-rays as calcium spots. At the time of your mammogram, be prepared to discuss any breast symptoms you are having, prior surgeries, hormone use, and family or personal history of breast cancer with your doctor or nurse.
A mammogram usually takes about 20 minutes. A technician will begin by placing one of your breasts between two specialized plates. The plates will compress to flatten your breast so that the camera can get clear pictures of your breast tissue. You may feel some discomfort during the compression, but it will only last a few seconds. This procedure will then be repeated on your other breast.
Risks and Benefits
Mammograms are very safe procedures. Even though small doses of radiation are involved, the risk posed to women who have mammograms once per year is felt to be negligible. And, while there is some discomfort during the test itself, breast compression does not lead to permanent damage to breast tissue.
Like any screening test, mammograms pose a risk of both false negative and false positive results: a false negative result occurs when a mammogram fails to show a breast cancer that really exists. Approximately 10% of breast cancers are not seen on mammography, although this number is somewhat higher in women under the age of 50. A false positive result occurs when a mammogram shows an abnormality that turns out to be nothing serious. False negative results lead to many unnecessary breast biopsies.
Benefits of a mammogram include: Identifying cancer that is too small to be felt Finding breast cancer early, when more treatment options are available and are more likely to be successful.
When deciding to have a mammogram, or any procedure, you and your doctor must carefully weigh the risks and benefits to determine whether it is the most appropriate choice for you.
After the Procedure
After your procedure, you may be asked to wait until a radiologist reviews your x-rays, so that more pictures may be taken from different angles, if necessary. Since a mammogram is a simple outpatient procedure, you will be able to go home immediately following the test.
You will most likely get the official results of your mammogram over the phone or by mail. If your results are abnormal, your doctor may recommend a repeat mammogram, a different imaging test, such as an ultrasound, or a breast biopsy. It is important to keep in mind that approximately 80% of mammograms that require a biopsy do not turn out to be cancer.
- Get a mammogram: do it for yourself, do it for your family. National Cancer Institute website. Available at: http://cancer.gov/images/Mammogram/Documents/68432989-7c99-4e56-8352-c813d5ef3422/english.pdf. Accessed August 11, 2004.
- Mammograms. Breastcancer.org website. Available at: http://www.breastcancer.org/testing_mammogram.html. Accessed August 11, 2004.
- Mammograms and other breast imaging procedures. American Cancer Society website. Available at: http://www.cancer.org/docroot/cri/content/cri_2_6x_mammography_and_other_breast_imaging_procedures_5.asp?sitearea=cri. Accessed August 11, 2004.
- Mammography: reference summary. National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus/tutorials/mammography/rd139101.pdf. Accessed August 12, 2004.
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