Mammograms - diagnostic tests for breast cancer.

What is a mammogram?  A mammogram is a safe test that is used to look for any problems in a woman's breast, not just breast cancer.  It involves a special, low-dose x-ray that takes diagnostic images of the breast.  These images are recorded on x-ray film or recorded digitally.  A radiologist interprets the images to determine whether or not breast cancer is present.  Mammograms are the best way that doctors have for finding breast cancer.

Mammograms can show small lumps or tissue growths that a doctor a woman may not be able to feel during a breast self-exam or during a clinical breast exam.  Mammograms allow the doctor to have a closer look at the tissue of a breast for lumps and for changes that may indicate the development of breast cancer.

Should a woman find a lump during a mammogram, a breast self-exam or if one be discovered during a clinical breast exam, your doctor may order other diagnostic tests such as an ultrasound or a biopsy to aid in determining if the lump is malignant (cancer) or benign (not cancer).

There are different types of mammograms.  Screening mammograms are done for women who have no symptoms of breast cancer but may be at a higher risk of breast cancer because a close blood relative has had the disease.  These types of mammograms may also be scheduled on a regular basis when a person reaches 40 because of the increased risk of developing breast cancer associated with aging.  Diagnostic mammograms are generally done when a woman has symptoms of breast cancer or a lump has been discovered.  This mammogram generally takes a much longer time to perform because more pictures of the breast are taken.  A typical screening mammogram will last approximately 15 minutes with a diagnostic mammogram lasting anywhere from 30 - 45 minutes.

All mammograms are performed in the same manner.  The patient will stand in front of a special x-ray machine.  The technician will place your breast between two plastic plates and these plates press your breast to make it flat.  There will be some pressure and discomfort during this procedure but it will only last for a few seconds.  The latter your breast, the better the picture.  The technician will take two pictures of each breast, one from the side and one from above.

Women generally wonder about how often they should have a mammogram.  While there is no "preset" number, a good rule of thumb to follow for women who are over 40 years of age is to have a mammogram every 1 to 2 years.  Doctors may recommend that women who have had breast cancer or who are at a higher risk of breast cancer to start taking mammograms before the age of 40 or to have them more often.

There are also several things that patients should consider when scheduling a mammogram.  If you have breast implants, be sure to communicate this when making your appointment.  Implants can hide some breast tissue and make it difficult to see breast cancer on your mammograms.  Make sure that you make your appointment for one week after your period.  This lessens the discomfort associated with having a mammogram .  Do not wear deodorant, lotion or powder under your arms or on your breasts the day of your mammogram.  These tend to leave shadows on the image and could be misinterpreted by the radiologist.

As with any diagnostic test, mammograms do have limitations.  These include:

• False negatives can occur.  This means that everything may appear normal but breast cancer may be present.  Younger women are more likely to have false negatives than older women because the breast tissue is typically more dense, making it difficult to identify the cancer;
  
• False positives can occur.  This is when the mammogram results look like cancer even though there is no cancer present.  This is more common in younger women than older women.  A biopsy will most likely be used to determine if there is indeed cancer;

Remember, it is important that you consult your physician and determine the proper schedule for your mammogram.  Do not rely on breast self-exams as your only mechanism for determining if you have breast cancer.  Early detection of breast cancer is important to successful treatment.