What Is a Mammogram?

A mammogram is a medical imaging technique used primarily for the early detection of breast cancer in women. It involves taking X-ray images of the breast tissue to identify abnormalities, such as tumours or suspicious masses. Mammograms are an essential tool in breast cancer screening. They can help detect cancer early when it is more treatable.

How is a mammogram done?

Here’s how a mammogram typically works:

Compression: During a mammogram, the breast is gently compressed between two flat plates. Compression is necessary to spread the breast tissue, which helps obtain clear and detailed X-ray images while minimizing the required radiation dose.
X-ray Imaging: X-rays are then passed through the compressed breast tissue, creating images of the breast on a special X-ray film or a digital detector. The X-ray machine used for mammograms is designed to produce low-dose radiation to reduce the potential risks of radiation exposure.
Image Evaluation: The obtained images are examined by radiologists, who are medical doctors specialized in interpreting medical images. They look for abnormalities, such as masses, calcifications, or distortions, which could indicate the presence of cancer or other breast conditions.

Why is a mammogram done?

Mammograms are typically performed as part of routine breast cancer screening for women, especially those over 40 or at higher risk for breast cancer due to factors like family history or genetic mutations. Read Signs of Breast Cancer: What to Look for?

Regular screening mammograms can help detect breast cancer in its early stages, often before any symptoms are noticeable, increasing the chances of successful treatment.

Women need to discuss the frequency and timing of mammograms with their healthcare providers, as recommendations may vary based on individual risk factors and guidelines from health organizations. Additionally, breast self-examinations and clinical breast exams by a healthcare provider are often recommended with mammography as part of a comprehensive approach to breast health.

What does having a mammogram feel like?

The entire procedure usually takes about 20-30 minutes. While the compression can be uncomfortable for some women, it is a necessary part of the mammogram to obtain clear and accurate images. The discomfort is generally brief, and many women find it manageable.

If you experience severe pain or discomfort during the mammogram, be sure to communicate this to the technologist, as they may be able to make adjustments to minimize your discomfort. It’s also important to remember that the benefits of early breast cancer detection through mammograms can far outweigh the temporary discomfort experienced during the procedure. Regular mammograms are recommended for breast cancer screening, particularly for women over a certain age or with certain risk factors.

What happens if my mammogram is abnormal?

If your mammogram results are abnormal, the images taken during the mammogram show an area of concern or an irregularity in your breast tissue. It’s important to note that an abnormal mammogram does not necessarily mean you have breast cancer, as there are various reasons for abnormal findings, including benign (non-cancerous) conditions. Here’s what typically happens next:

Additional Imaging: If an abnormality is detected on your mammogram, the radiologist may recommend further imaging tests to better view the area in question. This may involve more mammographic views or imaging techniques like breast ultrasound or breast MRI. These tests can help provide more information about the abnormality and determine whether it is benign or suspicious.
Clinical Evaluation: Depending on the additional imaging results, your healthcare provider may perform a clinical breast examination to assess the lump or abnormal area. They will ask about your medical history and any symptoms you may be experiencing.
Biopsy: If the abnormality still raises concerns after additional imaging and clinical evaluation, a biopsy may be recommended. A biopsy involves removing a small tissue sample from the abnormal area for laboratory analysis. Several breast biopsies include fine-needle aspiration, core needle biopsy, and surgical biopsy. The biopsy results will determine whether the abnormality is cancerous (malignant) or non-cancerous (benign).
Treatment Planning: If the biopsy results indicate the abnormality is cancerous, further diagnostic tests may be performed to determine the cancer stage and whether it has spread. Based on the diagnosis and stage, your healthcare team will work with you to develop a treatment plan, including surgery, radiation therapy, chemotherapy, hormone therapy, or targeted therapy.
Close Monitoring: If the biopsy results indicate the abnormality is benign, your healthcare provider may recommend periodic follow-up and monitoring to ensure no changes over time. Depending on their nature and symptoms, some benign conditions may require treatment or removal.

It’s essential to maintain open communication with your healthcare provider throughout the process, ask questions, and seek second opinions if necessary. Remember that early detection of breast cancer through mammograms and prompt follow-up is crucial for better treatment outcomes and prognosis. Not all abnormal mammograms result in a cancer diagnosis, but it’s essential to investigate any abnormalities to determine the appropriate course of action for your situation. Read Breast Cancer: What are the Symptoms and Treatment?

What is the side effect of a mammogram?

Mammograms help in screening and early detection, but like any medical procedure, they can have potential side effects and drawbacks. Some possible side effects and considerations of mammograms include:

Discomfort or Pain: Mammograms involve compressing the breast tissue between two plates to obtain clear images. This compression can cause temporary discomfort or mild pain for some women. However, the discomfort is usually brief and tolerable.
Radiation Exposure: Mammograms use a small amount of ionizing radiation to create images of the breast tissue. The radiation exposure is very low, and the risk of harm is considered minimal. The benefits of early breast cancer detection typically outweigh this small risk.
False Positives: Mammograms can sometimes produce false-positive results, suggesting the presence of cancer when there isn’t. False positives can lead to additional tests and anxiety until the situation is clarified.
False Negatives: Conversely, mammograms can also produce false-negative results, meaning they may not detect cancer that is present. This is more likely in women with dense breast tissue, underscoring the importance of regular screenings and clinical breast exams.
Overdiagnosis: Mammograms may detect some breast cancers that are slow-growing and may never cause harm during a person’s lifetime. Overdiagnosis can lead to unnecessary treatment, which can have side effects and emotional stress.
Compression-related Issues: Some women may experience minor bruising or tenderness after a mammogram due to breast compression. These symptoms usually resolve on their own.
Anxiety and Stress: Waiting for mammogram results or undergoing additional tests in case of suspicious findings can cause anxiety and stress for some individuals.

BI-RADS Classification

The Breast Imaging Reporting and Data System (BIRADS/BI-RADS) is a standardized system used by radiologists to categorize and report the findings of breast imaging studies, such as mammograms, ultrasound, and MRI scans. BIRADS classification helps healthcare professionals communicate breast imaging results clearly and consistently, facilitating patient management and follow-up. Read Signs of Breast Cancer: What to Look for?

BI-RADS scores range from 0 to 6, with higher numbers indicating a greater possibility of breast cancer:

BIRADS 0: Incomplete assessment or need for additional imaging. This category is used when the initial imaging study is incomplete or unclear, requiring further evaluation.
BIRADS 1: Negative. This category means that the imaging study shows no signs of breast abnormalities, and there is no suspicion of cancer.
BIRADS 2: Benign finding. This category indicates the presence of a non-cancerous (benign) breast condition. It may include findings like cysts or benign masses.
BIRADS 3: Probably benign. In this category, there is a low level of suspicion for cancer. The radiologist may recommend short-term follow-up imaging to monitor the condition.
BIRADS 4: Suspicious abnormality. This category suggests a moderate to high suspicion of breast cancer. Further diagnostic tests, such as a biopsy, are usually recommended.
BIRADS 5: Highly suggestive of malignancy. This category indicates a very high likelihood of breast cancer. A biopsy is typically recommended to confirm the diagnosis.
BIRADS 6: Known biopsy-proven malignancy. This category is used when breast cancer has already been diagnosed through a biopsy. It helps in reporting the extent of the known cancer.

Each BI-RADS category provides important guidance to clinicians, helping them decide on the appropriate next steps for patient care. It’s important to note that while the BIRADS system is a valuable tool, it doesn’t provide a definitive diagnosis of breast cancer. Further evaluation, often including a biopsy, is necessary to confirm or rule out breast cancer.

Patients receiving a BI-RADS score will work closely with their healthcare providers to determine the most appropriate course of action, including additional imaging, biopsy, or other diagnostic tests.

Consult a Cancer Specialist

References:

Photo by Christina Morillo: https://www.pexels.com/photo/woman-standing-near-whiteboard-1181519/
Ganesan, K., et al. “Computer-Aided Breast Cancer Detection Using Mammograms: A Review.” IEEE Reviews in Biomedical Engineering, 2013, https://doi.org/10.1109/rbme.2012.2232289.
BI-RADS Classification for Management of Abnormal Mammograms | American Board of Family Medicine. https://www.jabfm.org/content/19/2/161.long
Oza, P., Sharma, P., Patel, S., & Bruno, A. (2021). A bottom-up review of image analysis methods for suspicious region detection in mammograms. Journal of Imaging, 7(9), 190.