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Mammography

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Definition:

A mammogram is an x-ray picture of the breasts. It is used to find tumors and to help tell the difference between non-cancerous ( benign ) and cancerous (malignant) disease.

Alternative Names:

Mammogram

How the test is performed:

You will be asked to undress from the waist up and will be given a gown to wear. Depending on the type of equipment used, you will sit or stand.

One breast at a time is rested on a flat surface that contains the x-ray plate. A device called a compressor will be pressed firmly against the breast to help flatten out the breast tissue.

The x-ray pictures are taken from several angles. You may be asked to hold your breath as each picture is taken.

How to prepare for the test:

Do not wear deodorant, perfume, powders, or ointments under the arms or on the breasts on the day of the mammogram. These substances may obscure the images. Remove all jewelry from your neck.

Notify your health care provider and the radiologist if you are pregnant or breast-feeding .

How the test will feel:

When the breast is compressed, there may be some discomfort.

Why the test is performed:

Mammography is performed to screen healthy women for signs of breast cancer . It is also used to evaluate a woman who has symptoms of a breast disease, such as a lump, nipple discharge , breast pain , dimpling of the skin on the breast, or retraction of the nipple.

Screening mammograms are important for early breast cancer detection. The American Cancer Society recommends mammogram screening every year for all women age 40 and older. The National Cancer Institute recommends mammogram screening every 1 to 2 years for women age 40 and older. Experts recommend that certain women at high risk of breast cancer should also have a breast MRI along with their yearly mammogram. Ask your doctor if you need an MRI.

Guidelines from the American College of Physicians, however, debate whether women with a low risk for breast cancer should begin mammogram screening at age 40. The 2007 guidelines, instead, recommend that women in their 40s ask their doctor when they should begin having the test.

In addition to mammography, clinical breast exams (where the clinician palpates with the fingers) and breast self-examinations are important for breast cancer screening. Women age 20 and older should receive clinical breast exams every 3 years; women age 40 and older should receive clinical breast exams every year. The American Cancer Society recommends that all women age 20 and older perform monthly breast self-examination .

These are general recommendations for mammography, clinical breast exams, and breast self-exam. Women should discuss with their personal physician how often to receive breast cancer screening, including mammography and clinical breast exam. Recommendations vary depending on personal risk factors such a strong family history of breast cancer.

References:

Smith RA, Salsow D, Sawyer KA, et al. American Cancer Society guidelines for breast cancer screening: Update 2003. CA Cancer J Clin . 2003;53(3):141-169.

Saslow D, Boetes C, Burke W, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin . 2007 Mar-Apr;57(2):75-89.

Lehman CD, Gatsonis C, Kuhl CK, et al. MRI evaluation of the contralateral breast in women with recently iagnosed breast cancer. N Engl J Med . 2007 Mar 29;356(13):1295-303. Epub 2007 Mar 28.

Qaseem A, Snow V, Sherif K, et al. Screening mammography for women 40 to 49 years of age: A clinical practice guideline from the American College of Physicians. Ann Intern Med . 2007;146(7):511-515.

• Review Date: 4/3/2007
• Reviewed By: A.D.A.M. Editorial Team: Greg Juhn, M.T.P.W., David R. Eltz, Kelli A. Stacy. Previously reviewed by Jonathan Gross, M.D., Department of Radiology, Columbia University Medical Center, New York, NY. Review provided by VeriMed Healthcare Network (8/22/2006).

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