US Pharm. 2017;42(9):9-10.
Detects Early Breast Cancer
The earlier cancer is found, the better the chance of a cure. Breast cancer is no exception because small breast cancers are less likely to spread to lymph nodes and vital organs such as the lungs and the brain. Mammography is an early screening test that can detect very small changes in breast tissue before a lump is felt. The low-dose x-ray of the mammogram shows abnormalities in breast tissue, such as masses or calcium deposits. Because an abnormality detected by a mammogram may not be cancerous, some follow-up testing is often required by a physician for a final diagnosis.
Capturing Clear Tissue Images
A mammogram is a simple test that uses a machine designed specifically to observe breast tissue. During the x-ray, the breast is positioned on the machine’s flat surface while it is compressed by another flat surface. Flattening the breast tissue allows the radiologist to see a clearer image of the tissue. The compression of the breast between the plates is done twice—once vertically and once horizontally.
Tutorial on Mammography Types
There are three basic types of x-ray mammography: standard, digital, and three-dimensional (3D). The standard mammogram takes an x-ray, and the image is printed on a large sheet of film for review by a radiologist using a light box. A digital mammogram (called full-field digital mammography, or FFDM) takes a low-dose x-ray image that is stored digitally on a computer and reviewed on a digital screen. Because the x-ray images are easier to store and retrieve with digital mammograms, they are becoming more common. The newest type of mammogram is 3D mammography (or breast tomosynthesis). For this x-ray, the breast is compressed between the two flat plates only once, and the machine takes many low-dose x-rays as it moves around the breast. A computer then arranges the images into a 3D picture. Three-dimensional mammography is not covered under all health insurance policies, but it may allow doctors to see the breast tissues more clearly.
Screening Recommendation Depends on Risk Factors
Approximately one in every eight women in the United States will develop breast cancer during her lifetime, and the risk of breast cancer increases dramatically with age. Regular screening mammograms in women over age 40 years have been proven to lower the number of deaths due to breast cancer.
Your doctor will recommend a breast cancer–screening schedule after taking into account your age and specific risk factors. The general recommendation for women with an average risk of breast cancer is for mammograms to begin at age 45 years, or as early as age 40 years if the patient chooses. For these women, follow-up mammograms should occur every 1 to 2 years. Women with a higher risk of breast cancer, such as those with a family history of breast cancer or with certain genetic markers for breast cancer, may need to start screening earlier and receive screening more often. Unfortunately, mammography is not a perfect testing procedure. X-rays of breast tissue may not show all cancers, or they may falsely show an abnormality that is not present. This imperfection is why repeated screening on an agreed-upon schedule is important.
Preparing for a Successful Mammogram
If you are going to a mammography facility for the first time, bring a list of the places and dates of mammograms, biopsies, or other breast treatments you have had before. On the day of the mammogram, refrain from using creams, deodorants, powders, and perfumes under the arms or near the breasts. In some women, the pressure used to flatten the breast causes some temporary discomfort, but most women do not consider mammograms painful. To minimize the discomfort of a mammogram, schedule your appointment when your breasts are not tender or swollen and try to avoid the week just before your period.
If you have any questions about mammograms for breast-cancer screenings or community resources that provide affordable low or no-cost screenings for women, speak with your trusted local pharmacist or another healthcare provider.
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