Mammogram

How to Prepare for the Test

DO NOT use deodorant, perfume, powders, or ointments under your arms or on your breasts on the day of the mammogram. These substances may hide the images. Remove all jewelry from your neck and chest area.

Tell your provider and the x-ray technologist if you are pregnant or breastfeeding, or if you've had a breast biopsy.

How the Test will Feel

The compressor surfaces may feel cold. When the breast is pressed down, you may have some pain. This needs to be done to get good quality images.

Why the Test is Performed

When and how often to have a screening mammogram is a choice you must make. Different expert groups do not fully agree on the best timing for this test.

Before having a mammogram, talk to your provider about the pros and cons of having the test. Ask about:

• Your risk for breast cancer
• Whether screening decreases your chance of dying from breast cancer
• Whether there is any harm from breast cancer screening, such as side effects from testing or overtreatment of cancer when it's discovered

Mammography is performed to screen women to detect early breast cancer when it is more likely to be cured. Mammography is generally recommended for:

• Women starting at age 40, repeated every 1 to 2 years. (This is not recommended by all expert organizations.)
• All women starting at age 50, repeated every 1 to 2 years.
• Women with a mother or sister who had breast cancer at a younger age should consider yearly mammograms. They should begin earlier than the age at which their youngest family member was diagnosed.

Mammography is also used to:

• Follow a woman who has had an abnormal mammogram.
• Evaluate a woman who has symptoms of a breast disease. These symptoms may include a lump, nipple discharge, breast pain, dimpling of the skin on the breast, changes of the nipple, or other findings.

Normal Results

Breast tissue that shows no signs of a mass or calcifications is considered normal.

What Abnormal Results Mean

Most abnormal findings on a screening mammogram turn out to be benign (not cancer) or nothing to worry about. New findings or changes must be further evaluated.

A radiology doctor (radiologist) may see the following types of findings on a mammogram:

• A well-outlined, regular, clear spot (this is more likely to be a noncancerous condition, such as a cyst)
• Masses or lumps
• Dense areas in the breast that can be breast cancer or hide breast cancer
• Calcifications, which are caused by tiny deposits of calcium in the breast tissue (most calcifications are not a sign of cancer)

At times, the following tests are also needed to further examine mammogram findings:

• Additional mammogram views, called magnification or compression views
• Breast ultrasound
• Breast MRI exam (less commonly done)

Comparing your current mammogram to your past mammograms helps the radiologist tell whether you had an abnormal finding in the past and whether it has changed.

When mammogram or ultrasound results look suspicious, a biopsy is done to test the tissue and see if it is cancerous. Types of biopsies include:

• Stereotactic
• Ultrasound
• Open

Risks

The level of radiation is low and any risk from mammography is very low. If you are pregnant and need to have an abnormality checked, your belly area will be covered and protected by a lead apron.

Routine screening mammography is not done during pregnancy or while breastfeeding.

References

American Cancer Society. American Cancer Society Recommendations for Early Breast Cancer Detection in Women Without Breast Symptoms. Updated October 20, 2015. www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs. Accessed March 17, 2016.

American College of Obstetricians and Gynecologists (ACOG). ACOG statement on breast cancer screening guidelines. Updated 2016. www.acog.org/About-ACOG/News-Room/Statements/2016/ACOG-Statement-on-Breast-Cancer-Screening-Guidelines. Accessed March 17, 2016.

National Cancer Institute: PDQ Breast Cancer Screening. Bethesda, MD: National Cancer Institute. Updated March 4, 2016. www.cancer.gov/cancertopics/pdq/screening/breast/healthprofessional. Accessed March 9, 2016.

U.S. Preventive Services Task Force. Final Update Summary: Breast Cancer: Screening. Updated February 2016. www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening1. Accessed March 17, 2016.