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Using mammography to detect breast cancer

The key to finding breast cancer is early detection, and the key to early detection is screening. Screening mammography looks for breast cancer in women without symptoms. The best available tool is a regular screening mammogram coupled with a clinical breast exam performed by a doctor or nurse.

  • Schedule a regular mammogram

    Early detection of breast cancer is crucial for successful treatment. Regular screening mammograms currently are the best tool for early detection.

    The sooner you begin to have regular mammograms, the better. Being able to compare earlier mammograms with recent ones helps your doctor evaluate areas that appear suspicious.

    If you move, ask for your films and hand-carry them to your new physician, so the films can be kept with your file. Always make sure that the radiologist who reads your mammogram has the previous films to use for comparison.

    Contact your physician’s office to find a radiology center near you.

    To learn more about breast cancer, see the National Cancer Institute’s website at www.cancer.gov.

  • What is a mammogram?
    A mammogram is an x-ray picture of the breast that can detect breast cancer in its earliest, most treatable stage. Cancers found on mammograms that cannot be felt (nonpalpable cancers) usually are smaller than cancers that can be felt, and are less likely to have spread.

    Mammography is not foolproof. Some breast changes including lumps that can be felt, do not show up on a mammogram. Changes can be especially difficult to spot in the dense, glandular breasts of younger women. This is why women of all ages should have their breasts examined every year by a physician or trained health care professional.

  • Diagnostic mammography

    If a woman visits her doctor because of unusual breast changes such as a lump, pain, nipple thickening or discharge, changes in the breast size or shape, or has a suspicious screening mammogram, the doctor often will order a diagnostic mammogram: an x-ray of the breast to help assess her symptoms. A diagnostic mammogram is a basic medical tool, and is appropriate for women of any age.

  • Screening mammography

    High-quality mammography is the most effective tool available to detect breast cancer early, before symptoms appear — often before a breast lump can even be felt. Undergoing annual mammograms can decrease a woman's chance of dying from breast cancer. For some women, early detection may prevent the need to remove the entire breast and/or receive chemotherapy.

  • Reporting the results

    The radiologist will report your mammogram findings directly to you, or to your doctor who will contact you with the results. If you need further tests or exams, your doctor will notify you. If you don't receive your results, you should call your doctor’s office and ask for these results.

    Mammography reports are standardized to assure consistent recommendations for follow up.  Reports are classified from Category 0 to Category 5.  Based on these classifications, your provider will discuss your results and a plan of care based on your mammography findings.

    • Category 0 - Requires additional testing/imaging for evaluation
    • Category 1 - Negative findings
    • Category 2 - Benign finding
    • Category 3 - Probably a benign finding, recommend short term follow up
    • Category 4 - Suspicious abnormality, biopsy should be considered
    • Category 5 - Highly suggestive of malignancy
    Dense breasts

    Density is a term used to describe breast tissue with many glands close together. Though fairly common (especially in younger women), dense breasts may make breast masses difficult to detect on a mammogram film. If a radiologist identifies that you have dense breasts, s/he may recommend ultrasound or MRI to further evaluate your breasts.

    False negative mammograms

    Breasts of younger women contain many glands and ligaments. Because their breasts appear dense on mammography, more often it is difficult to see tumors or to distinguish between normal and abnormal breast conditions. These results are called false negatives. A normal mammogram in a woman with symptoms does not rule out breast cancer. Sometimes a clinical breast exam by a doctor or nurse can reveal a breast lump that is missed by a mammogram.

    False positive mammograms

    Between 5 and 10% of mammogram results are abnormal and require additional testing (more x-rays, fine needle aspiration, ultrasound, MRI or biopsy), and most of the follow-up tests confirm that no cancer is present.

  • Having a mammogram

    Mammography is a simple procedure to undergo. It utilizes a "dedicated" x-ray machine specifically designed for x-raying the breast and is used only for that purpose (in contrast to machines used to take x-rays of the bones or other parts of the body).

    The standard diagnostic service includes two views of each breast, one from above and one angled from the side. A registered technologist places the breast between two flat plastic plates which are pressed together. The idea is to flatten the breast as much as possible; spreading out the tissue makes any abnormal details easier to spot with a minimum of radiation. The technologist will take the x-ray, then repeat the procedure for the next view.

    Pressure from the plates may be uncomfortable, or even somewhat painful. It helps to remember that each x-ray takes less than one minute and it could save your life. It also helps to schedule mammography just after your period, when your breasts are least likely to be tender, or at the same time each year if you no longer have your period.

    Although some women are concerned about radiation exposure, risk of any harm is extremely small since the doses of radiation used for mammography are very low and considered safe. The amount of radiation needed for a mammogram will depend on several factors. For instance, in order to secure clear images, breasts that are large or dense will require higher doses..

    The mammogram is first checked by the technologist before being read by a diagnostic radiologist (a doctor who specializes in interpreting x-rays). The radiologist looks for unusual shadows, masses, distortions, special patterns of tissue density, and differences between the two breasts.

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