October is Breast Cancer Awareness Month and a great time to talk about the importance of routine mammograms. I’m dedicating this blog to mammogram basics. What are mammograms and how do they help detect breast cancer? What can you expect during this procedure?
Early detection is the best chance to prevent cancer, and mammograms are considered one of the most beneficial tools for screening breast cancer. In fact, they’ve helped decrease breast cancer deaths (1). The procedure doesn’t take long, but it’s recommended sparingly and can help save your life.
What are mammograms?
Mammograms are basically X-rays of breast tissue taken from top and side views. The images appear in shades of white, black, and gray on a black background. The denser the anatomical structure, the lighter it will appear. That’s why bones appear white, and surrounding tissue, such as skin, fat, and muscle, appears black (5).
As you know, breast tissue isn’t as dense as bone, but mammograms are sensitive and reveal fine changes in density between the fatty tissue, which looks black, and glandular or connective tissue, which looks gray (5). Younger women generally have denser breast tissue, which may show up as white or light gray in a mammogram image. Of course, everyone is different, so getting mammograms on a regular basis is critical to establish what’s normal for you.
Routine mammograms enable your doctor to compare changes in breast tissue from year to year. Your doctor should be able to quickly detect any abnormal changes and screen for signs of breast cancer. If you take anything away from this read, let it be this: The earlier you detect breast cancer, the faster and more effectively it can be treated.
When to get a mammogram
You’ve probably heard some debate about when to get your first mammogram, but most health organizations agree that it’s safe for a woman who’s at average risk of breast cancer to start getting a mammogram every one or two years in her early 40s (1). If you’re younger than 40 and have a history of breast cancer in your family, or if you think you felt a lump, I encourage you to talk to your doctor about scheduling a mammogram sooner.
What to expect during the procedure
Whether you’re referred to a clinic, a certified imaging center, or a mobile mammography van, there are a few things you can expect. First, I suggest scheduling your appointment the week after your period because breasts are typically more sensitive when you’re menstruating (3). Second, if there’s a possibility you could be pregnant, talk to your doctor before taking any kind of X-rays. Finally, don’t use any lotions, powders, perfumes, or deodorants on the day of your procedure because these products have ingredients that may appear as false spots on the X-ray image (3).
Although the procedure is pretty straightforward, it’s common for women to feel anxiety before getting a mammogram. Take a deep breath and just remind yourself that it will be over quickly.
A technician will position your breast for the X-ray. Be prepared to feel some pressure as your breast is compressed between a pair of parallel plates that are adjusted to flatten your breast as much as possible. This might feel a tiny bit painful, but flattening the breast is necessary because it reduces tissue thickness to prevent overlap of tissue that can lead to false results. Eliminating tissue overlap also reduces the amount of X-ray exposure needed to obtain an accurate mammogram (5).
If radiation exposure is a concern, you should discuss it with your doctor. You’ll be exposed to a minimal amount of radiation during a mammogram, but experts agree that the preventative value outweighs any risk (2).
What are mammogram findings and what happens next?
About a week after your mammogram, you’ll get your results and the opportunity to review your images with the doctor. As I’ve mentioned, healthy breast tissue of a woman over 40 will generally appear black and gray. In a woman with denser breasts, healthy tissue can appear white or light gray. Abnormal findings typically appear as bright white spots or flecks (5).
In addition to early detection of breast cancer, mammogram results can reveal other conditions, including cysts, which are basically lumps of fibrous or glandular breast tissue, and tiny calcium deposits called microcalcifications (2). When reading mammogram results, the doctor inspects any unusual findings by looking at their size, borders (whether they’re clean or rough), location, and groupings. This helps the doctor characterize the condition as cancerous, non-cancerous (benign), or negative.
If something is found during your mammogram, a follow-up test will be ordered. A diagnostic mammogram may be used to focus on specific areas, or a whole breast ultrasound may be recommended for women who have dense breasts (2). An MRI or tissue biopsy may be required. If you’re called back for another test, there’s no need to panic. Recalls are normal and are often caused by false-positive results related to dense breast tissue (2).
Routine mammograms are a vital step toward taking control of your health. The best way to beat breast cancer is to catch it early and treat it before it spreads. Now that you know what to expect, I’m sure you’re eager to schedule your mammogram. Ask your doctor for a referral, and if you don’t have a doctor or access to a clinic, check the CDC’s website for information about where to find screening services, including those available for low-income or uninsured women (3).
Source List
http://www.mayoclinic.org/tests-procedures/mammogram/home/ovc-20230954
https://www.cancer.gov/types/breast/mammograms-fact-sheet
http://www.cdc.gov/cancer/breast/basic_info/mammograms.htm
http://www.breastcancer.org/symptoms/testing/types/mammograms/types
https://www.nibib.nih.gov/science-education/science-topics/mammography#1071
Source: Ask Dr. Nandi
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