Using a digital X-ray machine made especially for breast tissue, a technologist compresses the breast and takes pictures from at least two different angles, creating a set of images for each of your breasts. This set of images is called a mammogram. Breast tissue appears white and opaque and fatty tissue appears darker and translucent. Many centers also do 3-D mammography. This is similar to regular mammograms but many more pictures of the breast are taken at various angles to produce a 3-D picture for the radiologist to check.
The mammogram is used to look for lumps or other findings that are too small to be felt during a physical exam. A mammogram can also help your doctor determine the next step if a lump, growth, or change in your breast is found.
Why Do I Need a Mammogram?
The risk of breast cancer increases with age. That is why it is very important for all menopausal women to get regular mammograms.
Mammography is your best defense against breast cancer because it can detect the disease in its early stages, before it can be felt during a breast exam. Research has shown that mammography can increase breast cancer survival.
How Often Should a Menopausal Woman Get Mammograms?
There's disagreement among breast cancer experts about when you should have your first mammogram.
The American Cancer Society recommends yearly screening mammograms starting at age 45 and continuing for as long as you are in good health. However, the U.S. Preventive Services Task Force (USPSTF) recommends mammograms for women between the ages of 50 and 74 every two years. The task force does not recommend screening at all after age 74. They say that beginning screening before the age of 50 should be an individual decision based on your personal needs and risks.
Whether you need a mammogram is a personal decision between you and your doctor. If you're over 40, talk to your doctor about when you should begin mammogram screening. Some doctors recommend starting earlier than age 40. This decision depends on your individual risk factors.
How Should I Prepare for a Mammogram?
Before your mammogram, inform your doctor or the technologist performing the test if you are pregnant or think that you may be pregnant.
No dietary changes are necessary. Take your medicines as usual.
Do not wear body powder, cream, deodorant, or lotion under your arms or on your chest the day of the test. These substances may interfere with the X-rays.
You will be asked to remove all clothing above the waist and you will be given a hospital gown to wear. You may want to wear a two-piece outfit the day of the test.
You will be asked to remove all jewelry.
What Happens During a Mammogram?
Registered technologists who are certified in mammography will perform your mammogram.
You will be asked to stand in front of an X-ray machine. A technologist will place your breast on an X-ray plate. A clear plastic paddle will gently compress your breast until taut. Compression is necessary to obtain the clearest possible picture with the least amount of radiation. Your cooperation for these few seconds is important to get a clear picture. If you feel that the pressure on your breast is too great, tell the technologist.
If you feel some discomfort from this pressure, it will only last for a few seconds while the X-ray is being taken. To minimize discomfort during compression, you may want to consider scheduling your appointment seven to 10 days after the start of your period, when your breasts are least likely to be tender.
The breast will be imaged in several positions to enable the radiologist to visualize all breast tissue adequately. For a routine breast screening, two pictures are taken of each breast. The exam takes about 5-10 minutes.
Board-certified radiologists, or doctors who specialize in interpreting imaging studies, examine the X-rays. After examining the images, the radiologist may ask the technologist to obtain additional images or a breast ultrasound for a more precise diagnosis. This is often just a routine measure.
What Happens After a Mammogram?
The results of your mammogram will be given to your doctor, who will discuss with you what the test results could mean and what further tests might be recommended.
If you do not receive your results within two weeks, do not assume the results are normal. Contact your doctor and the mammogram facility to get confirmation of the results.
According to the American Cancer Society, only two to four mammograms out of every 1,000 lead to a diagnosis of cancer. Approximately 10% of women will require additional imaging, such as additional views or ultrasound. Don't be alarmed if this happens to you. Only 8% to 10% of those women will need a breast biopsy (a sample of breast tissue is taken to evaluate for irregularities), and 80% of those biopsies will not show evidence of cancer. Those odds may improve with more widespread use of three-dimensional mammography.
Are There Other Tests for Breast Cancer Besides Mammograms?
This is another area where the experts do not agree. The USPSTF recommends against self breast exams. The American Cancer Society (ACS), however, states women should be familiar with how their breasts normally look and feel and report changes to a doctor right away. The American Congress of Obstetricians and Gynecologists states that women in their 20s and 30s should get a clinical breast exam with their doctor at least every three years, and annually after the age of 45. The USPSTF does not feel that there is enough evidence to make a recommendation regarding clinical breast exam in women age 40 or older.