(Image Credits: shutterstock.com)
Mammogram test is a specialised breast imaging technique which utilizes a low dose of ionizing radiation known as x-rays to enable the inner breast tissue to be view.
A mammogram exam is use for early detection and diagnosis of breast diseases, in particular, breast cancer in women.
What is the procedure of Mammogram test ?
- The mammogram exam is an outpatient procedure, which means you will check into the facility near the appointment schedule time and once the procedure is done, you are free to leave.
- The Mammogram Technologist will come and escort you from the waiting area, after you have completed your paperwork, to the changing unit.
- She will provide you with an gown and ask you to take off your top clothes and bra and to wear the gown in a changing room.
- She will then escort you to the mammogram room and ask you to stand in front of the mammogram machine, like the equipment shown on your right side below:
- You will then be ask you to untie your top gown. Then she will put stickers with tiny silver balls on your nipples and other places around your breasts to mark the nipple and specific positions on the mammogram images.
- She will position one of your breasts on the breast support platform of the mammogram machine.
- Your breast will be compress with the clear plastic compression paddle.
- For screening purposes, a small dose of x-rays is pass through the breast from two different directions to obtain two sets of images, so you will be ask to change positions.
- You may be ask to hold your breath for the imaging to make the pictures clear.
- The mammogram imaging is repeat for the other breast.
- When the mammogram exam is complete, the Technologist will check to make sure all the images are clear so you would have to wait for a little while.
- She will send you back to the changing room to put your clothes back on and then you are ready to go.
Some technical Inputs
- The conventional 2D mammogram exam will only have the mammogram machine unit.
- 3D mammogram exam or breast tomosynthesis involves the acquisition of multiple images of the breast from different angles and using them to reconstruct 3D images, so there is tomosynthesis unit connect to the mammogram machine. 3D imaging is more sensitive.
What are the differences between 2D film screens, digital and 3D mammograms?
All of the three techniques utilize low doses of x-rays to create images of the breast tissue. The differences between the mammograms are as follows:
Conventional 2D mammogram
The camera of the mammogram equipment takes the breast tissue pictures as the x-rays pass through and store on a film which is develope in order to make the images visible.
(Image Credits: shutterstock.com)
On the other hand, in a digital mammogram, an electronic image of the breast tissue is created and stored on a computer as a file. This digital information can be intensify and magnify for further evaluation and has enable the use of lower doses of x-rays in mammography. It also saves time with callbacks to repeat the exam. In certain instances, the digital system has computerized aided detection (CAD) component which detects abnormal breast tissue areas that are dense, lumpy or has calcifications, all of these are indications of cancer.
Three-dimensional (3D) mammography
This is also referred to as breast tomosynthesis. It is a type of digital mammogram technique in which x-ray machines detect and take multiple pictures of thin slices of the breast from different angles as the x-rays pass through the breast tissue. 3D computer software is use to reconstruct the images. The technique is similar to computed tomography (CT) scan which also detects and generate slices of images at several angles and used in the 3D reconstruction of organs and tissues inside of the body. 3D mammography is perform alongside with the conventional two-dimensional (2D) digital mammography, so there is a slightly higher radiation dosage requirement than standard mammography alone exam.
Among the three types of mammogram exams, the 3D technique is most sensitive and it is a more helpful tool for women with non-cancerous dense breast tissue, which in part, results from aging and has been shown to obscure cancerous growths or cause false positives to arise in conventional 2D mammogram images. 3D mammogram exam has been shown to detect the most invasive type of breast cancer by about 41% because of its sensitivity and accuracy and a reduction in call backs to repeat the mammogram exams.
How should I prepare for a mammogram test?
Mammogram exam does not require any special preparation such as fasting overnight or postponing taking your medication on the scheduled date. However, low doses of x-rays are used and so it requires necessary precautions. It is also important to follow instructions during the exam to ensure that clear images are obtained.
The day your doctor ordered your mammogram test
- Let your doctor know if you are having any breast symptoms.
- Tell your doctor if you are using any hormone medications or whether you have had any breast surgeries.
- Let your doctor know if you are pregnant; even very low doses of x-ray is likely to affect a fetus.
- Let your doctor know if you have implants, as special techniques are require for mammogram exam to cater for this.
- Be prepare to spend 1 hour at the facility on the schedule appointment date.
The day of your mammogram exam
- Arrive at the facility 30 minutes earlier than the scheduled appointment time to do paperwork.
- Don’t wear jewelry on the day of your mammogram exam. You will be ask to take it off prior to imaging.
- Wear comfortable clothing, as you will be asked to change into a hospital
- Don’t wear deodorant, talcum powder or lotion under your arm or around your breasts, as this will interfere with imaging
What are the side effects of mammogram test?
- The mammogram exam takes only about 20 minutes and produces very little discomfort.
- However, breasts get tender during the menstrual period and so breast compression might enhance discomfort. For this reason, you might want to have your mammogram exam outside of your menstruation period.
- Very low doses of x-rays are use in mammogram exam and have no known side effects.
What are the risks of mammogram test?
- There is the likelihood to have false negative results; mammograms are not perfect. A dense breast tissue can obscure cancer such that it does not appear on the mammogram. If these happens, cancer may advance before it is found out.
- There is also a chance of obtaining the false positive result of your breast mammogram when a normal breast tissue cluster to look like a lump is developing. This will subject you to worries, more tests, more radiation exposures and follow-up visits that are unnecessary.
What are the limitations of mammogram test?
If your mammogram results show any indication of tumor growth, it is still not enough information to you have cancer. Further tests need to be perform to confirm the results.
Mammograms can produce false positive results by the interference of imaging with powder, lotion, and deodorant in the armpit area.
Not all breast cancers can be seen on the mammogram. Radiologists like to compare current mammogram with previous years to see if there have been any changes in breast tissue.
Increased breast density makes mammogram interpretation difficult. Unfortunately, this occurs with age and so 3D mammogram exam is recommended in this regard.
Who interprets the mammogram results and what shall I expect?
We all wonder who will interpret our imaging results and whether it will be done accurately. A Radiologist doctor who has a special training for understanding radiology images interprets and sends a report to your doctor . You will be notify by your doctor of the results once they are receive. If an abnormality on your mammogram is found, you will need follow-up appointment for further tests for clarification of the findings and to confirm whether you have cancer or not. Don’t panic; not all abnormalities or masses are cancerous and a lot of cancers, if identify at very early stage can be treated. Furthermore, there are instances when ultimate tests, such as lab tests with biopsies, taken from lump suspicious sites have been non-cancerous.
Why do I need annual mammogram screen if my breast exam was negative the first time?
Under normal circumstances, it is advised that a woman at the age of 40 years will start an annual mammogram screen until 50 years, after which she undergoes screening exam every 2 years. The reason is because women tend to be at higher risk for breast cancer ranging from ages of 40-50 years. An individual evaluate to be at high risk is ask to start screening at an age earlier than 40 years. Image 1 below shows a 3D mammogram of patient who was at high risk for breast cancer so start screening at the age of 36 years. Her right breast seems normal between the ages of 36 and 40 years. However, by the age 43 years, a suspicious site was discover, which at higher magnification, reveal a cancerous mass.
Now biopsy will be consider for further tests. If the mass is cancerous, it will be easier to treat. Without annual mammogram, the mass will advance into tumor and possibly other organs, making treatment and chance of survival harder.
Image 2 shows a 60-year-old woman with dense breast tissue. The 2D mammogram shows a suspicious hidden spot which was reveal as cancerous with the 3D tomosynthesis imaging.
For mammogram exam and other cancer screening tests click here