A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. The results are recorded on x-ray film or directly into a computer for a doctor called a radiologist to examine.
A mammogram allows the doctor to have a closer look for changes in breast tissue that cannot be felt during a breast exam. It is used for patients who have no breast complaints and for patients who have breast symptoms, such as a change in the shape or size of a breast, a lump, nipple discharge, or pain. Breast changes occur in almost all patients. In fact, most of these changes are not cancer and are called "benign," but only a doctor can know for sure. Breast changes can also happen monthly, due to your menstrual period.
A full field digital mammogram plus a clinical breast exam, an exam done by your patient's doctor, is the most effective way to detect breast cancer early. Finding breast cancer early greatly improves a patient's chances for successful treatment.
Like any test, mammograms have both benefits and limitations. For example, some cancers can't be found by a mammogram, but they may be found in a clinical breast exam.
your patients should check their own breasts for lumps or other changes via a breast self-exam (BSE). Studies so far have not shown that BSE alone helps reduce the number of deaths from breast cancer. BSE should not take the place of routine clinical breast exams and mammograms.
If your patients choose to do BSE, remember that breast changes can occur because of pregnancy, aging, menopause, menstrual cycles, or from taking birth control pills or other hormones. It is normal for breasts to feel a little lumpy and uneven. Also, it is common for breasts to be swollen and tender right before or during a menstrual period. If your patients notice any unusual changes in their breasts they should contact their doctor.
Your patient stands in front of a special x-ray machine. The person who takes the x-rays, called a radiologic technician, places your patient's breasts, one at a time, between an x-ray plate and a plastic plate. These plates are attached to the x-ray machine and compress the breasts to flatten them. This spreads the breast tissue out to obtain a clearer picture. Your patient will feel pressure on the breast for a few seconds. It may cause your patient some discomfort; she might feel squeezed or pinched. This feeling only lasts for a few seconds, and the flatter your patient's breast, the better the picture. Most often, two pictures are taken of each breast - one from the side and one from above. A screening mammogram takes about 15-30 minutes from start to finish.
A digital mammogram also uses x-rays to produce an image of the breast, but instead of storing the image directly on film, the image is stored directly on a computer. This allows the recorded image to be magnified for the doctor to take a closer look. Patients with dense breasts who are pre- or perimenopausal, or who are younger than age 50, may benefit from having a digital rather than a film mammogram. Digital mammography may offer these benefits:
The National Cancer Institute recommends:
The radiologist will look at your patient's x-rays for breast changes that do not look normal and for differences in each breast. He or she will compare your patient's past mammograms (when necessary) with their most recent one to check for changes. The doctor will also look for lumps and calcifications.
If calcifications are grouped together in a certain way, it may be a sign of cancer. Depending on how many calcium specks your patient has, how big they are, and what they look like, your patient's doctor may suggest they have other tests. Calcium in the diet does not create calcium deposits, or calcifications in the breast.
If your patient has a screening test result that suggests cancer, your patient's doctor must find out whether it is due to cancer or to some other cause. Your patient's doctor may ask about your patient's personal and family medical history. Your patient may have a physical exam. Your patient's doctor also may order some of these tests:
Women with breast implants should also have mammograms. A woman who had an implant after breast cancer surgery in which the entire breast was removed (mastectomy) should ask her doctor whether she needs a mammogram of the reconstructed breast.
If your patient has breast implants, be sure to tell your patient's mammography provider that she has them if you make her appointment for her. The technician and radiologist must be experienced in x-raying patients with breast implants. Implants can hide some breast tissue, making it harder for the radiologist to see a problem when looking at your mammogram. To see as much breast tissue as possible, the x-ray technician will gently lift the breast tissue slightly away from the implant and take extra pictures of the breasts.
First, check with the place your patient is having the mammogram done for any special instructions your patient may need to follow up on before an appointment. Here are some general guidelines to follow: