Mammography (Mammogram) - RadiologyInfo.org

Mammography is specialized medical imaging that uses a low-dose x-ray system to see inside the breasts. A mammography exam, called a mammogram, aids in the ... Togglenavigation Test/Treatment PediatricCare Screening/Wellness Disease/Condition Safety EnEspañol MoreInfo AboutUs PhysicianResources Professions SiteIndexAtoZ Mammography Screeningmammographyisaspecifictypeofbreastimagingthatuseslow-dosex-raystodetectcancerearly–beforewomenexperiencesymptoms–whenitismosttreatable. Tellyourdoctoraboutanybreastsymptomsorproblems,priorsurgeries,hormoneuse,whetheryouhaveafamilyorpersonalhistoryofbreastcancer,andifthere'sapossibilityyouarepregnant.Ifpossible,obtaincopiesofyourpriormammogramsandmakethemavailabletoyourradiologistonthedayofyourexam.Leavejewelryathomeandwearloose,comfortableclothing.Youmaybeaskedtowearagown.Don'tweardeodorant,talcumpowderorlotionunderyourarmsoronyourbreastsasthesemayappearonthemammogramandinterferewithcorrectdiagnosis. × Forinformationoncoronavirus(COVID-19)orhowCOVID-19vaccinesideeffectscouldaffectyourimagingresults,seetheMedicalImagingandCoronavirusSafetypage. WhatisMammography? Whataresomecommonusesoftheprocedure? HowshouldIprepareforthemammogram? Whatdoesthemammographyequipmentlooklike? Howdoestheprocedurework? Howistheprocedureperformed? WhatwillIexperienceduringandaftertheprocedure? WhointerpretstheresultsandhowdoIgetthem? Whatarethebenefitsvs.risks? WhatarethelimitationsofMammography? Whichtest,procedureortreatmentisbestforme? WhatisMammography? Mammographyisspecializedmedicalimagingthatusesalow-dosex-raysystemtoseeinsidethebreasts.Amammographyexam,calledamammogram,aidsintheearlydetectionanddiagnosisofbreastdiseasesinwomen. Anx-rayexamhelpsdoctorsdiagnoseandtreatmedicalconditions.Itexposesyoutoasmalldoseofionizingradiationtoproducepicturesoftheinsideofthebody.X-raysaretheoldestandmostoftenusedformofmedicalimaging. Threerecentadvancesinmammographyincludedigitalmammography,computer-aideddetectionandbreasttomosynthesis. Digitalmammography,alsocalledfull-fielddigitalmammography(FFDM),isamammographysysteminwhichthex-rayfilmisreplacedbyelectronicsthatconvertx-raysintomammographicpicturesofthebreast.Thesesystemsaresimilartothosefoundindigitalcamerasandtheirefficiencyenablesbetterpictureswithalowerradiationdose.Theseimagesofthebreastaretransferredtoacomputerforreviewbytheradiologistandforlongtermstorage.Thepatient'sexperienceduringadigitalmammogramissimilartohavingaconventionalfilmmammogram. Computer-aideddetection(CAD)systemssearchdigitizedmammographicimagesforabnormalareasofdensity,mass,orcalcificationthatmayindicatethepresenceofcancer.TheCADsystemhighlightstheseareasontheimages,alertingtheradiologisttocarefullyassessthisarea. Breasttomosynthesis,alsocalledthree-dimensional(3-D)mammographyanddigitalbreasttomosynthesis(DBT),isanadvancedformofbreastimagingwheremultipleimagesofthebreastfromdifferentanglesarecapturedandreconstructed("synthesized")intoathree-dimensionalimageset.Inthisway,3-Dbreastimagingissimilartocomputedtomography(CT)imaginginwhichaseriesofthin"slices"areassembledtogethertocreatea3-Dreconstructionofthebody. Althoughtheradiationdoseforsomebreasttomosynthesissystemsisslightlyhigherthanthedosageusedinstandardmammography,itremainswithintheFDA-approvedsafelevelsforradiationfrommammograms.Somesystemshavedosesverysimilartoconventionalmammography. Largepopulationstudieshaveshownthatscreeningwithbreasttomosynthesisresultsinimprovedbreastcancerdetectionratesandfewer"call-backs,"instanceswherewomenarecalledbackfromscreeningforadditionaltestingbecauseofapotentiallyabnormalfinding. Breasttomosynthesismayalsoresultin: earlierdetectionofsmallbreastcancersthatmaybehiddenonaconventionalmammogram fewerunnecessarybiopsiesoradditionaltests greaterlikelihoodofdetectingmultiplebreasttumors clearerimagesofabnormalitieswithindensebreasttissue greateraccuracyinpinpointingthesize,shapeandlocationofbreastabnormalities topofpage Whataresomecommonusesoftheprocedure? Mammogramsareusedasascreeningtooltodetectearlybreastcancerinwomenexperiencingnosymptoms.Theycanalsobeusedtodetectanddiagnosebreastdiseaseinwomenexperiencingsymptomssuchasalump,pain,skindimplingornippledischarge. ScreeningMammography Mammographyplaysacentralpartinearlydetectionofbreastcancersbecauseitcanshowchangesinthebreastyearsbeforeapatientorphysiciancanfeelthem.CurrentguidelinesfromtheAmericanCollegeofRadiology(ACR)andtheNationalComprehensiveCancerNetwork(NCCN)recommendscreeningmammographyeveryyearforwomen,beginningatage40.Researchhasshownthatannualmammogramsleadtoearlydetectionofbreastcancers,whentheyaremostcurableandbreast-conservationtherapiesareavailable. TheACRandtheNationalCancerInstitute(NCI)alsosuggestthatwomenwhohavehadbreastcancer,andthosewhoareatincreasedriskduetoafamilyhistoryofbreastorovariancancer,shouldseekexpertmedicaladviceaboutwhethertheyshouldbeginscreeningbeforeage40andtheneedforothertypesofscreening.Ifyouareathighriskforbreastcancer,youmayneedtoobtainabreastMRIinadditiontoyourannualmammogram. SeetheBreastCancerTreatment pageforinformationaboutbreastcancertherapy. DiagnosticMammography Diagnosticmammographyisusedtoevaluateapatientwithabnormalclinicalfindings—suchasabreastlumpornippledischarge—thathavebeenfoundbythewomanorherdoctor.Diagnosticmammographymayalsobedoneafteranabnormalscreeningmammograminordertoevaluatetheareaofconcernonthescreeningexam. topofpage HowshouldIprepareforthemammogram? Beforeschedulingamammogram,theAmericanCancerSociety(ACS)andotherspecialtyorganizationsrecommendthatyoudiscussanynewfindingsorproblemsinyourbreastswithyourdoctor.Inaddition,informyourdoctorofanypriorsurgeries,hormone use,andfamilyorpersonalhistoryofbreastcancer. Donotscheduleyourmammogramfortheweekbeforeyourmenstrualperiodifyourbreastsareusuallytenderduringthistime.Thebesttimeforamammogramisoneweekfollowingyourperiod.Alwaysinformyourdoctororx-raytechnologist ifthereisanypossibilitythatyouarepregnant. TheACSalsorecommendsyou: Donotweardeodorant,talcumpowderorlotionunderyourarmsoronyourbreastsonthedayoftheexam.Thesecanappearonthemammogramascalciumspots. Describeanybreastsymptomsorproblemstothetechnologistperformingtheexam. Obtainyourpriormammogramsandmakethemavailabletotheradiologistiftheyweredoneatadifferentlocation.ThisisneededforcomparisonwithyourcurrentexamandcanoftenbeobtainedonaCD. Askwhenyourresultswillbeavailable;donotassumetheresultsarenormalifyoudonothearfromyourdoctororthemammographyfacility. topofpage Whatdoesthemammographyequipmentlooklike? Amammographyunitisaboxwithatubethatproducesx-rays.Theunitisusedexclusivelyforbreastx-rayexamsandfeaturesspecialaccessoriestolimitx-rayexposuretoonlythebreast.Theunitfeaturesadevicetoholdandcompressthebreastandpositionitsothetechnologistcancaptureimagesatdifferentangles. Breasttomosynthesisisperformedusingdigitalmammographyunits,butnotalldigitalmammographymachinesareequippedtoperformtomosynthesisimaging. topofpage Howdoestheprocedurework? X-raysareaformofradiationlikelightorradiowaves.X-rayspassthroughmostobjects,includingthebody.Thetechnologistcarefullyaimsthex-raybeamattheareaofinterest.Themachineproducesasmallburstofradiationthatpassesthroughyourbody.Theradiationrecordsanimageonphotographicfilmoraspecialdetector. Differentpartsofthebodyabsorbthex-raysinvaryingdegrees.Denseboneabsorbsmuchoftheradiationwhilesofttissue(muscle,fat,andorgans)allowmoreofthex-raystopassthroughthem.Asaresult,bonesappearwhiteonthex-ray,softtissueshowsupinshadesofgray,andairappearsblack.Mostx-rayimagesareelectronicallystoreddigitalfiles.Yourdoctorcaneasilyaccessthesestoredimagestodiagnoseandmanageyourcondition. Inconventionalfilmanddigitalmammography,astationeryx-raytubecapturesanimagefromthesideandanimagefromabovethecompressedbreast.Inbreasttomosynthesis,thex-raytubemovesinanarcoverthebreast,capturingmultipleimagesfromdifferentangles. topofpage Howistheprocedureperformed? Mammographyisperformedonanoutpatientbasis. Duringmammography,aspeciallyqualifiedradiologictechnologistwillpositionyourbreastinthemammographyunit.Yourbreastwillbeplacedonaspecialplatformandcompressedwithaclearplasticpaddle.Thetechnologistwillgraduallycompressyourbreast. Breastcompressionisnecessaryinorderto: Evenoutthebreastthicknesssothatallofthetissuecanbevisualized. Spreadoutthetissuesothatsmallabnormalitiesarelesslikelytobehiddenbyoverlyingbreasttissue. Allowtheuseofalowerx-raydosesinceathinneramountofbreasttissueisbeingimaged. Holdthebreaststillinordertominimizeblurringoftheimagecausedbymotion. Reducex-rayscattertoincreasesharpnessofpicture. Youwillbeaskedtochangepositionsbetweenimages.Theroutineviewsareatop-to-bottomviewandanangledsideview.Theprocesswillberepeatedfortheotherbreast.Compressionisstillnecessaryfortomosynthesisimaginginordertominimizemotion,whichdegradestheimages.Duringscreeningbreasttomosynthesis,two-dimensionalimagesarealsoobtainedorcreatedfromthesynthesized3-Dimages. Youmustholdverystillandmayneedtoholdyourbreathforafewsecondswhilethetechnologisttakesthex-ray.Thishelpsreducethepossibilityofablurredimage.Thetechnologistwillwalkbehindawallorintothenextroomtoactivatethex-raymachine.Whentheexaminationiscomplete,thetechnologistmayaskyoutowaituntiltheradiologistconfirmstheyhaveallthenecessaryimages. Theexaminationprocessshouldtakeabout30minutes. topofpage WhatwillIexperienceduringandaftertheprocedure? Youwillfeelpressureonyourbreastasitissqueezedbythecompressionpaddle.Somewomenwithsensitivebreastsmayexperiencediscomfort.Ifthisisthecase,scheduletheprocedurewhenyourbreastsareleasttender.Besuretoinformthetechnologistifpainoccursascompressionisincreased.Ifdiscomfortissignificant,lesscompressionwillbeused.Alwaysremembercompressionallowsbetterqualitymammograms. topofpage WhointerpretstheresultsandhowdoIgetthem? Aradiologist,adoctortrainedtosuperviseandinterpretradiologyexaminations,willanalyzetheimages.Theradiologistwillsendasignedreporttoyourprimarycareorreferringphysicianwhowilldiscusstheresults withyou. Youwillalsobenotifiedoftheresultsbythemammographyfacility. Youmayneedafollow-upexam.Ifso,yourdoctorwillexplainwhy.Sometimesafollow-upexamfurtherevaluatesapotentialissuewithmoreviewsoraspecialimagingtechnique.Itmayalsoseeiftherehasbeenanychangeinanissueovertime.Follow-upexamsareoftenthebestwaytoseeiftreatmentisworkingorifaproblemneedsattention. topofpage Whatarethebenefitsvs.risks? Benefits Screeningmammographyreducestheriskofdeathduetobreastcancer.Itisusefulfordetectingalltypesofbreastcancer,includinginvasiveductalandinvasivelobularcancer. Screeningmammographyimprovesaphysician'sabilitytodetectsmalltumors.Whencancersaresmall,thewomanhasmoretreatmentoptions. Theuseofscreeningmammographyincreasesthedetectionofsmallabnormaltissuegrowthsconfinedtothemilkductsinthebreast,calledductalcarcinomainsitu(DCIS). Noradiationstaysinyourbodyafteranx-rayexam. X-raysusuallyhavenosideeffectsinthetypicaldiagnosticrangeforthisexam. Risks Thereisalwaysaslightchanceofcancerfromexcessiveexposuretoradiation.However,giventhesmallamountofradiationusedinmedicalimaging,thebenefitofanaccuratediagnosisfaroutweighstheassociatedrisk.Theradiationdoseforthisprocedurevaries.SeetheRadiationDoseinX-RayandCTExams pageformoreinformationaboutradiationdose. FalsePositiveMammograms.Fivepercentto15percentofscreeningmammogramsrequiremoretestingsuchasadditionalmammogramsorultrasound.Mostoftheseteststurnouttobenormal.Ifthereisanabnormalfinding,afollow-uporbiopsymayhavetobeperformed.Mostofthebiopsiesconfirmthatnocancerwaspresent.Itisestimatedthatawomanwhohasyearlymammogramsbetweenages40and49hasabouta30percentchanceofhavingafalse-positivemammogramatsomepointinthatdecadeandabouta7percentto8percentchanceofhavingabreastbiopsywithinthe10-yearperiod. Womenshouldalwaystelltheirdoctorandx-raytechnologistiftheyarepregnant.SeetheSafetyinX-ray,InterventionalRadiologyandNuclearMedicineProcedures pageformoreinformationaboutpregnancyandx-rays. AWordAboutMinimizingRadiationExposure Doctorstakespecialcareduringx-rayexamstousethelowestradiationdosepossiblewhileproducingthebestimagesforevaluation.Nationalandinternationalradiologyprotectionorganizationscontinuallyreviewandupdatethetechniquestandardsradiologyprofessionalsuse. Modernx-raysystemsminimizestray(scatter)radiationbyusingcontrolledx-raybeamsanddosecontrolmethods.Thisensuresthattheareasofyourbodynotbeingimagedreceiveminimalradiationexposure. topofpage WhatarethelimitationsofMammography? Whilemammographyisthebestscreeningtoolforbreastcanceravailabletoday,mammogramsdonotdetectallbreastcancers.Thisiscalledafalsenegativeresult.Ontheotherhand,whenamammogramlooksabnormalandnocancerispresent,thisiscalledafalse-positiveresult. Screeningmammographicimagesthemselvesareoftennotenoughtodeterminetheexistenceofabenign ormalignant diseasewithcertainty.Ifthereareabnormalities,yourradiologistmayrecommendfurtherdiagnosticstudies. Itisveryimportanttorealizethatnotallbreastcancerscanbeseenonmammography.Interpretationsofmammogramscanbedifficultbecauseanormalbreastlooksdifferentforeachwoman.Also,theappearanceofanimagemaybecompromisedifthereispowderorsalveonthebreastsorifyouhaveundergonebreastsurgery.Becausesomebreastcancersarehardtovisualize,aradiologistmaywanttocomparetheimagetoviewsfrompreviousexaminations. Increasedbreastdensity hasattractedattentionfromanumberofstatelegislaturesandmorerecentlythefederalgovernmentformultiplereasons,including: Increasedbreastdensitymakesitdifficulttoseeacanceronmammography. Increasedbreastdensitymayincreasetheriskofgettingbreastcancer. Theradiologistreadingyourmammogramdeterminesyourbreastdensityandreportsittoyourdoctor.Somestatesalsorequirethefacilitytonotifyyouifyouhavedensebreasts. Breastimplantscanalsoimpedeaccuratemammogramreadingsbecausebothsiliconeandsalineimplantsarenottransparentonx-raysandcanblockaclearviewofthetissuesaroundthem,especiallyiftheimplanthasbeenplacedinfrontof,ratherthanbeneath,thechestmuscles.Experiencedtechnologistsandradiologistsknowhowtocarefullycompressthebreaststoimprovetheviewwithoutrupturingtheimplant. Researchisbeingdoneonavarietyofbreastimagingtechniquesthatcancontributetotheearlydetectionofbreastcancerandimprovetheaccuracyindistinguishingnon-cancerousbreastconditionsfrombreastcancers. topofpage Whichtest,procedureortreatmentisbestforme? BreastCancerScreening BreastImagingofPregnantandLactatingWomen BreastImplantEvaluation topofpage AdditionalInformationandResources MammographySavesLives:BreastImaging ACR:BreastDensityandBreastCancerScreeningBrochure RTAnswers.org:RadiationTherapyforBreastCancer MedLinePlus:Mammography topofpage ThispagewasreviewedonMarch,23,2021 Sendusyourfeedback Didyoufindtheinformationyouwerelookingfor? Yes No Pleasetypeyourcommentorsuggestionintothetextboxbelow.Note:weareunabletoanswerspecificquestionsorofferindividualmedicaladviceoropinions. Comments: E-Mail: AreaCode: Phoneno: Images × ImageGallery Mammographyprocedure Viewfullsizewithcaption RelatedArticlesandMedia BreastCancer BreastCancerTreatment StereotacticBreastBiopsy SafetyinX-ray,InterventionalRadiologyandNuclearMedicineProcedures RadiationDoseinX-RayandCTExams BreastCancerScreening BreastTomosynthesis ImagesrelatedtoMammography SponsoredBy Pleasenote RadiologyInfo.orgisnotamedicalfacility.Pleasecontactyourphysicianwithspecificmedicalquestionsorforareferraltoaradiologistorotherphysician.Tolocateamedicalimagingorradiationoncologyproviderinyourcommunity,youcansearchtheACR-accreditedfacilitiesdatabase. 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