Mammography
Mammography is a screening tool for breast cancer...
What is Mammography

Mammography is a special type of X-ray imaging designed specifically to image the abnormalities in the breast and plays a major role in early detection of breast cancers. Mammography can show changes in breast well before a woman or her physician can feel them. Mammography can help detect these changes two years or more before you would feel them. Successful treatment of breast cancer depends on early diagnosis.

The development of digital mammography provides electronic images of the breasts; usually recommended in the patient having dense breast tissue. These images can be enhanced by computer technology, stored on computers, and even transmitted electronically in situations where remote access to the mammogram is required.

What are the different types of mammograms?

According to the National Cancer Institute, the different types of mammograms are:

Screening mammogram A screening mammogram is an X-ray of the breast used to detect breast changes in women who have no signs of breast cancer. It usually involves two X-rays of each breast. Using a mammogram, it is possible to detect a tumor that cannot be felt.
Diagnostic mammogram A diagnostic mammogram is an X-ray of the breast used to diagnose unusual breast changes, such as a lump, pain, nipple thickening or discharge, or a change in breast size or shape. More pictures are taken than during a screening mammogram.

A diagnostic mammogram is also used to evaluate abnormalities detected on a screening mammogram.

Why the test is to be performed?
For screening of the women who are above 40 years, pre menopausal women, who are having strong family history and genetically susceptible to cancer, having h/o breast cancer, undertaking hormone replacement therapy, Unmarried women and those without children are also at risk.
To diagnose unusual breast changes like lump, mass, pain, change of the skin condition over breast, discharge from nipple, change in shape & size of the breast.
Pre preparations

There is no special preparations required to undergo mammography. If pt has acute pain / inflammation, Mammogrphy is postponded as mild compression is required during the test. Pt may not able to tolerate this compression in presence of acute pain & inflammation. If you have any previous Mammogram report, you should bring your old film.

How is mammography performed?

X-rays of the breast are different from those used for other parts of the body. The breast X-ray does not penetrate tissue as easily as the X-ray used for routine X-rays of other parts of the body. The breast is compressed by the mammogram equipment to spread the tissue apart. This allows for a lower dose of radiation. Compression of the breast may cause temporary discomfort, but the compression is necessary to produce a good mammogram. The compression only lasts for a few seconds for each image of the breast. A breast health nurse or X-ray technologist usually takes the X-rays, but the resulting films are read and interpreted by a radiologist, who reports the results to your doctor. Mammography is usually a fast procedure which takes about 20 minutes and discomfort was minimal.

Risk

Modern day Mammography only involves a tiny amount of radiation – even less than a standard chest X-Ray.

Who should get a screening?

The following screening guidelines are for early detection of cancer in women who have no symptoms:

Age Recommendations for Mammography for Women at Average Risk for Developing Breast Cancer

Over 50 years : All women over the age of 50 years should have annual mammography examinations.
40-50 years : The Indian Cancer Society recommends annual mammograms for women in this age group. The National Cancer Institute recommends that these women get a mammogram every 1-2 years. Your physician should offer appropriate guidance on this issue according to your personal medical history.
Under 40 years : Most women under the age of 40 years do not need annual mammograms. However a baseline mammogram may be done at 35 years.
Result

Finding breast cancer early reduces risk of dying from the disease by 25-30% or more. Mammogram can miss 20% breast cancer that simply not visible using this technique which is called false negative. Mammography can also create “False alarm” or “False positive” result in which Mammography can identify lump which looks like cancer but it is not. In that situation, you need another form of further Ix like breast MRI / Ultrasound.