When to get tested?
For preventive purposes, women between the ages of 40 – 49 should get a base-line mammogram at age 40 and discuss with their doctor how often they need mammogram screening.
Women between the ages of 50 – 74 should get a mammogram every one to two years as they are at a greater risk.
It is extremely important for women to get mammogram screening regularly because early detection of breast cancer can save a life.
What happens if your mammogram is abnormal?
Abnormal mammogram does not mean you have breast cancer. Radiologists interpret mammograms with extreme caution and for any questionable finding additional imaging is usually requested. Most of the time, these findings turn out to be benign or non-cancerous. These can include cysts or calcium deposits or just more dense gland tissue.
What are additional useful tests?
- Mammogram and Breast Ultrasound: Breast ultrasound often accompanies mammogram to increase the accuracy (without more radiation) in women under age 50 who might have more dense breast tissue.
- BRCA1 and BRCA2: a blood test which detects genetic mutation related to increased risk for breast and ovarian cancer in someone with a family history of the disease.
- Breast MRI: a breast scan used to screen women at a high risk for breast cancer
- PET/CT Scan: a breast scan used to help in diagnosis of abnormalities of the breast
- Breast biopsy: a tiny needle is inserted in a suspicious area of the breast to gather cells that are analyzed in the laboratory to make sure they are not cancerous. This is usually booked directly with the test center.
When to test
There are two types of mammograms which are done for different reasons:
- Screening Mammogram: Serves as an early preventative measure for patients that do not show signs or symptoms of breast cancer. Healthcare insurances usually cover one (1) screening mammogram per year. Please check your health insurance policy.
- Diagnostic Mammogram: done for patients who do show abnormal breast signs and symptoms such as a breast lump, breast pain, an unusual skin appearance, nipple thickening, or nipple discharge to help in diagnosis and proper treatment. While mammogram can help detect breast cancer, it can also detect other abnormalities that are not cancer. These can include cysts or calcium deposits or just more dense gland tissue. It should be noted that not all cancers detected by mammograms can be cured. Some tumors can be aggressive despite the best attempts to treat them.
What are the risks of a Mammogram?
Mammograms pose a risk of low-dose radiation. The radiation, however, is very low compared to normal background radiation from everyday living and has been known to be safe. Misreading of the mammogram can be another risk, such as in women with dense breasts which can mask abnormalities making it more difficult to interpret. It takes a highly skilled radiologist to interpret these types of results and therefore it is recommended to get your mammogram at an accredited facility by the Accredited College of Radiology. Anxiety is another risk, such as awaiting results or getting abnormal results leading to more testing. While the risks and benefits need to be considered on a case-to-case basis for each individual, overall the benefit of getting a mammogram far outweighs the risk.
How do you prepare for a Mammogram?
Making an appointment with an accredited radiology facility - ACR has established a reputation for strict guidelines regarding machine quality and inspections. Avoid using deodorant, antiperspirant and other cosmetics products that may have aluminum prior to the test. Aluminum can be seen on a mammogram and can obstruct the view leading to possible misinterpretations by the radiologist. Do not wear jewelry during the examination. If your breasts are sensitive, take an OTC pain medication such as Tylenol or Ibuprofen one hour before the exam which helps to alleviate some discomfort.
What do the results mean?
Radiologists use a particular system to classify mammography results, which is called a BI-RADS score. The scores range from 0 to 5 meaning: 0 - More information is needed and may need another mammogram before a score can be given. -1- Nothing abnormal is seen and should continue routine screening. -2- Benign conditions, such as cysts, are seen and routine screening should be continued. -3- Something is seen that probably is not cancer and must repeat a mammogram within 6 months. -4- Something is seen that is suspicious for cancer and may need to have a biopsy. -5- Something is seen that is highly suggestive of cancer and will require a biopsy. Any suspicious findings are communicated immediately to your doctor. Routine mammograms that are normal may take few weeks until final report is generated.
Radiology facilities usually have a mammography suite strictly designed for this procedure. Patient must be able to stand upright for approx 10 minutes. If breast ultrasound is also ordered, technician will do the procedure right after the mammogram where patient will be asked to lay flat on the US table for another 10-15minutes.