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An annual screening mammogram is recommended for women age 40 and older. Th e
American Cancer Society, American College of Radiology, and American College of Obstetricians and Gynecologists each support this recommendation. Annual screening mammography detects breast cancer at its earlier stages. This makes treating the cancer easier and has been proven eff ective in decreasing the number of deaths associated with breast cancer.
A typical mammogram consists of two X-rays of each breast. In all four X-rays, the breast is compressed firmly between two plates. The breast compression and positioning that occurs during the procedure or exam is necessary in order to acquire the best possible visualization of breast tissue.
Screening Mammography is used to detect breast changes in women who have no signs, symptoms or observable breast abnormalities. The goal is to detect cancer before any clinical signs are noticeable. This usually requires at least two scans from different angles of each breast.
Diagnostic Mammography is used to investigate suspicious breast changes, such as a breast lump, an unusual skin appearance, nipple thickening or nipple discharge. It is also used to evaluate abnormal findings on a screening mammogram. Additional images can be made from other angles or focus on areas of concern at higher magnification. A diagnostic mammogram takes longer than a screening mammogram because it requires additional scans in order to obtain more comprehensive images. Ultrasound may also be used in conjunction with mammography to investigate any areas of concern.
Family History and Breast Cancer
Some women have an increased risk of developing breast cancer and should start annual screening mammography at an earlier age. This group includes women with a strong family history of breast cancer, especially a mother or sister with breast cancer before menopause. Some women have a genetic mutation (BRCA) which increases the risk of breast cancer.
The American College of Radiology and the Society of Breast Imaging recommend these women should begin screening mammograms by age 30 and as early as age 25. Talk to your health care provider if you think you may be at an increased risk for breast cancer.
Frequently Asked Questions
If you have had previous mammograms taken at another facility, please obtain the films and bring them with you when you have your mammogram. When you schedule your appointment with us, please let us know if you have breast implants. On the day of your test, do not wear deodorant, powder, lotion, or jewelry around your neck. Wear a two-piece outfit, as you will be asked to remove all of your clothing from the waist up and wear a gown.
- Having a mammogram may be uncomfortable because of the compression applied during the exam. Compression is necessary to prevent motion, spread the tissues to allow better visualization, and actually decreases the amount of radiation.
- The amount of radiation a woman receives during a mammogram is very small. The amount of background radiation the average person in the United States receives per year (from naturally occurring sources) is 7.5 times greater than from a mammogram.
- All of the clinical technologists who perform the mammograms are women, and every effort is made to maintain modesty, privacy and comfort during the exam.
If there is something abnormal discovered on the mammogram, you may need to return for additional tests, which usually include another mammogram and/or ultrasound (up to 10-12 percent of women fall into this category). Of these women, a small number will need a breast biopsy or need to return in six months for closer follow up. Breast cancer is daignosed in approximately four women per 1,000 screening mammograms.
An ultrasound is a valuable tool for breast imaging, but cannot replace a screening mammogram. An ultrasound is particularly helpful to differentiate cysts (fluid-filled structures) from solid masses. However, an ultrasound may miss some signs of cancer that may only be seen in a mammogram.
MRI is a more recent tool that is also helpful in breast cancer diagnosis. It is the most sensitive test available to detect breast cancer and is usually used to screen high-risk women. However, it is more time consuming, expensive and invasive. Like ultrasound, an MRI may miss some signs of cancer. It is also used to identify other areas of cancer in women who have recently been diagnosed with breast cancer. The American Cancer Society recommends an annual MRI screening in women with an increased risk of breast cancer and women with a breast cancer gene (BRCA) mutation.