Mammography is a low dose x-ray of your breasts. It is used for screening and diagnosis of certain conditions that affect breast tissue. It is commonly used for the early detection of breast cancer.
Mammography to detect breast cancer can be done by screening mammography or diagnostic mammography. A screening mammogram every two years is recommended for women aged 50 to 74 years.
Screening mammography is provided as a free service through the BreastScreen Australia program. It is used to detect breast cancer early, when there are no obvious breast symptoms.
Screening mammograms can detect breast cancers that are too small to be felt by you or your doctor. Mammograms taken at different times can later be compared to show changes in breast tissue over time.
Screening mammograms can find most cancers present at the time of screening but, like other medical tests, they are not 100 per cent accurate. A visit to BreastScreen once every two years is still the best way to detect breast cancer early, before there are any signs of the disease.
Diagnostic mammography mostly takes place at a breast clinic or diagnostic imaging service. It is a test to investigate breast symptoms that you or your doctor may be concerned about, such as breast pain, a lump or discharge from the nipple.
Medical issues to consider when having a mammogram
Your doctor, nurse or other health professional will explain the test. Make sure you understand why you are having a mammogram, and try not to jump to the conclusion that you have breast cancer. Talk to your doctor about any concerns you may have. If you suspect you may be pregnant, tell your doctor.
Inform the clinic if you have breast implants, because the radiographer may use special techniques to take clear x-rays of your breasts. Implants can hide some of the breast tissue so breast x-rays may be less effective for women with implants.
The tissue of younger women’s breasts is usually denser than that of older women and can show up as white areas on the x-ray. Breast cancers also show up as white areas on x-rays. This makes breast cancer more difficult to detect in screening mammograms for women in their 40s compared to women aged 50 to 74 years.
The mammogram procedure
Mammogram x-rays use very low doses of radiation, similar to that of many common x-rays. In preparing for a mammogram, wear a skirt or pants and a top, rather than a dress, as you need to undress from the waist up.
The procedure will involve the following steps:
- You are asked to remove all clothing above your waist. If you wish, you can request a gown that opens in the front.
- When you are ready and comfortable, you are positioned at the mammography machine – usually while standing. The radiographer positions one of your breasts on the x-ray machine.
- While the mammogram is being taken, your breast is gently compressed between two flat plates on the x-ray machine to smooth out the breast tissue and to prevent any movement. Compressing the breast only lasts for a few seconds but some women may experience discomfort. If you feel any pain during the mammogram, let the radiographer know. They can release the compression and discuss whether you wish to continue. You can ask for the procedure to stop at any time.
- X-rays are taken from different angles to make sure that the relevant part of your breast, or your whole breast, is x-rayed. (Usually two pictures are taken of each breast, one from the side and one from the top.)
- The procedure is repeated for your other breast.
- The test itself may take only ten to 15 minutes to perform, but you may be asked to wait a short time while the images are processed to check that the images are of the quality needed.
After a mammogram
After your visit to BreastScreen Victoria for a screening mammogram, the images are sent to be looked at independently by two different doctors. They decide the result.
Your results will be sent to you within 2 to 4 weeks. Your doctor will also receive a copy of your results, if you have provided BreastScreen with their contact details.
BreastScreen keeps hold of all images taken so that they can be compared when you next return to the service, to look at changes in your breasts.
After having a diagnostic mammography, you may need to make an appointment with your doctor to get the results.
Sometimes, after a diagnostic mammography, the radiologist may recommend that you have an ultrasound examination. This doesn’t mean they have detected anything serious – sometimes ultrasound can be a more accurate way to examine breast tissue.
After a breast ultrasound, most women will be reassured that they do not have breast cancer. Some women may be asked to have further tests.
Further tests for breast cancer
Abnormal findings do not automatically mean that you have cancer. Sometimes further tests are needed because the mammography results are unclear. Some things that can cause difficulty with reading the film include:
- glandular (lumpy) breasts, which are common in women under 30 years of age
- dense (muscular) breasts, common in pre-menopausal women
- previous breast surgery or radiation therapy
- breast implants
- movement of the breast during the procedure.
Further tests are more commonly needed for women having a mammogram for the first time. This is usually because there are no other mammograms to compare with.
Remember, most women who are called back for further tests do not have breast cancer.
Possible complications of mammography
Mammography is a safe procedure that uses very low doses of radiation, similar to that of many common x-rays. Current research shows that the benefits of regular screening mammograms outweigh any possible risks from radiation.
Radiographers take special care to use minimal compression on the breast during the screening procedure to ensure they will obtain a satisfactory image. It is highly unlikely, but possible, that this compression could cause or worsen the leaking of silicone or change the shape or texture of the breast in women with breast implants.
Taking care of yourself at home after a mammogram
Be advised by your doctor but, generally, there are no special instructions for aftercare following a mammogram.
Other forms of breast cancer detection and diagnosis
Other methods used to help detect or diagnose breast conditions may include:
- breast awareness – it is important for all women to know the normal look and feel of their breasts. If you notice any breast changes, nipple discharge or a lump, it is important that you visit your doctor as soon as possible
- clinical examination – the doctor physically examines the breast tissue to feel for lumps or thickenings
- ultrasound scan – a device that uses sound waves to form a picture of the inside of the breast
- magnetic resonance imaging (MRI) scan [https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/mri-scan] – a process that produces three-dimensional pictures of the breast using radio waves and a magnetic field
- fine needle aspiration – fluid or cells are drawn off using a fine needle, then examined in a laboratory
- core biopsy – using a needle, a tissue sample is taken for examination in a laboratory. This is done while you are under local anaesthetic.
Where to get help
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