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Mammography

Definition

A mammogram is an x-ray picture of the breasts. It is used to find breast tumors and cancer.

Alternative Names

Mammogram

How the test is performed

You will be asked to undress from the waist up. You 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. This helps flatten 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.

You may be asked to come back at a later date for more mammogram images. This does not always mean you have breast cancer. The doctor may simply need to recheck an area that could not be clearly seen on the first test.

Digital mammography is a newer technique. It allows the x-ray image of the breast to be viewed and manipulated on a computer screen. It improves accuracy, but it is not yet available everywhere.

How to prepare for the test

Do not use deodorant, perfume, powders, or ointments under your arms or on your breasts on the day of the mammogram. These substances may hide the images. Remove all jewelry from your neck and chest area.

Tell your health care provider and the radiologist if you are pregnant or breastfeeding.

How the test will feel

The metal may feel cold. When the breast is pressed down, you may have some pain. This needs to be done to get good images.

Why the test is performed

Mammography is performed to screen women to detect early breast cancer when it is more likely to be cured. Mammography is recommended for:

  • Women starting at age 40, repeated every 1 - 2 years. (This is not recommended by all expert organizations.)
  • All women starting at age 50, repeated every 1 - 2 years.
  • Women with a mother or sister who had breast cancer at a younger age should consider yearly mammograms. They should begin earlier than the age at which their youngest family member was diagnosed.

Mammography is also used to:

  • Follow a woman who has had an abnormal mammogram.
  • Evaluate a woman who has symptoms of a breast disease. These symptoms may include as a lump, nipple discharge, breast pain, dimpling of the skin on the breast, changes of the nipple, or other findings.

Discuss with your health care provider how often you need to have screening mammograms.

Normal Values

Breast tissue that shows no signs of a mass or calcification is considered normal.

What abnormal results mean

Most abnormal findings on a screening mammogram turn out to be benign or nothing to worry about. New findings or changes must be further evaluated.

A radiology doctor (radiologist) may see the following types of findings on a mammogram:

  • A well-outlined, regular, clear spot (this is more likely to be a noncancerous condition such as a cyst)
  • Masses or lumps
  • Dense areas in the breast that can be breast cancer or hide breast cancer
  • Calcifications, which are caused by tiny deposits of calcium in your breast tissue. Most calcifications are not a sign of cancer.

The American College of Radiology has developed a grading system for radiologists to use when they report the results of a mammogram. Terms you may hear your doctor use include:

  • Negative
  • Benign (noncancerous) finding
  • Probably benign
  • Suspicious abnormality
  • Highly suggestive of malignancy or cancer

Often, the following tests are also needed:

  • Additional mammogram views -- called magnification or compression views
  • Breast MRI exam
  • Breast ultrasound

Comparing your current mammogram to your past mammograms helps the radiologist tell whether you had an abnormal finding in the past, and whether it has changed.

When mammogram or ultrasound results look suspicious, a biopsy is done to test the tissue and see if it is cancerous. Types of biopsies include:

What the risks are

The level of radiation is low, and any risk from mammography is very low. If you are pregnant and need to have an abnormality checked, your belly area will be covered and protected by a lead apron.

Routine screening mammography is not done during pregnancy or while breastfeeding.

References

American Cancer Society. American Cancer Society Recommendations for Early Breast Cancer Detection in Women Without Breast Symptoms. August 2012. Available at: http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs. Accessed November 16, 2012.

American College of Obstetricians and Gynecologists (ACOG). ACOG practice bulletin no.122. Breast cancer screening. Obstet Gynecol. 2011;118:372–82.

Davidson N. Breast cancer and benign breast disorders. In: Goldman L, Schafer AI, eds. Cecil Medicine . 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 204.

U.S. Preventive Services Task Force. Screening for Breast Cancer. July 2010. U.S. Preventive Services Task Force. Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm. Accessed November 16, 2012.


Review Date: 11/17/2012
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
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