MAMMOGRAM

A mammogram is an x-ray of the breast that is designed to detect breast cancer. What is the best method of detecting breast cancer?

A mammogram along with a clinical breast exam (an exam done by your doctor) is the most effective way to detect breast cancer early. Mammograms have both benefits and limitations. For example, some cancers can't be detected by a mammogram, but may be detectable by breast exam.

Checking your own breasts for lumps or other changes is called a breast self-exam. Studies so far have not shown that breast self-exam alone reduces the numbers of deaths from breast cancer. Breast self-exam should not take the place of clinical breast exam and a mammogram.

A mammogram is a safe test used to look for any problems with a woman's breasts. The test uses a special, low-dose x-ray machine to take pictures of both breasts. The results are recorded on x-ray film or directly onto a computer for a radiologist to examine.

Mammograms allow the doctor to have a closer look for breast lumps and changes in breast tissue. They can show small lumps or growths that a doctor or woman may not be able to feel when doing a clinical breast exam. "Mammography" is the best screening tool that doctors have for finding breast cancer.

If a lump is found, your doctor may order other tests, such as ultrasound or a biopsy--a test where a small amount of tissue is taken from the lump and area around the lump. The tissue is sent to a lab to look for cancer or changes that may mean cancer is likely to develop. Breast lumps or growths can be benign (not cancer) or malignant (cancer). Finding breast cancer early means that a woman has a better chance of surviving the disease. There are also more choices for treatment when breast cancer is found early.

• Screening mammograms are done for women who have no symptoms of breast cancer. When you reach age 40, you should have a mammogram every one to two years.
• Diagnostic mammograms are done when a woman has symptoms of breast cancer or a breast lump. This mammogram takes longer than screening mammograms because more pictures of the breast are taken.
• Digital mammograms take an electronic image of the breast and store it directly in a computer. Current research has not shown that digital images are better at finding cancer than x-ray film images.

You stand in front of a special x-ray machine. The person who takes the x-rays, called a radiologic technologist, places your breasts (one at a time) between two plastic plates. The plates press your breast to make it flat. You will feel pressure on your breast for a few seconds. It may cause you some discomfort; you might feel squeezed or pinched. But, the flatter your breast, the better the picture. Most often, two pictures are taken of each breast--one from the side and one from above. A screening mammogram takes about 15 minutes from start to finish.

If you have breast implants, be sure to tell your mammography facility that you have them when you make your appointment. You will need an x-ray radiologic technologist who is trained in x-raying patients with implants. This is important because breast implants can hide some breast tissue, which could make if difficult for the radiologist to see breast cancer when looking at your mammograms. For this reason, to take a mammogram of a breast with an implant, the x-ray technician might gently lift the breast tissue slightly away from the implant.

• Women 40 years and older should get a mammogram every 1 to 2 years.
• Women who have had breast cancer or other breast problems or who have a family history of breast cancer, might need to start getting mammograms before age 40 or they might need to get them more often. Talk to your doctor about when to start and how often you should have a mammogram.

First, check with the place you are having the mammogram for any special instructions you may need to follow before you go. Here are some general guidelines to follow:

• Make your mammogram appointment for one week after your period. Your breasts hurt less after your period.
• If you have breast implants, be sure to tell your mammography facility that you have them when you make your appointment.
• Wear a shirt with shorts, pants, or a skirt. This way, you can undress from the waist up and leave your shorts, pants, or skirt on when you get your mammogram.
• Don't wear any deodorant, perfume, lotion, or powder under your arms or on your breasts on the day of your mammogram appointment. These things can make shadows show up on your mammogram.

As with any medical test, mammograms have limits. These limits include:

• They are only part of a complete breast exam. Your doctor also should do a clinical breast exam. If your mammogram finds something abnormal, your doctor will order other tests.
• "False negatives" can happen. This means everything may look normal, but cancer is actually present. False negatives don't happen often. Younger women are more likely to have a false negative mammogram than are older women. This is because the breast tissue is denser, making cancer harder to spot.
• "False positives" can happen. This is when the mammogram results look like cancer is present, even though it is not. False positives are more common in younger women than older women.