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Mammogram Overview

What is a mammogram?

Mammogram Equipment

Mammography Exam Room
Mammograms are X-ray pictures of the breast that are effective for finding breast cancer. A mammogram allows the doctor to have a closer look at changes in breast tissue that cannot be felt during a breast exam.

There are two types of mammograms: screening and diagnostic.

Screening:
Mammograms can be used to check for breast cancer in women who have no signs or symptoms of the disease. This type of mammogram is called a screening mammogram.

Diagnostic:
Diagnostic mammograms require an order from a physician. They are used to check for breast cancer after a lump or other sign or symptom of the disease has been found. This type of mammogram is called a diagnostic mammogram. A diagnostic mammogram also can be used to view breast tissue because of special circumstances, such as the presence of breast implants.

A diagnostic mammogram takes longer than a screening mammogram because it involves more X-rays to obtain views of the breast from several angles. The technician can magnify a problem area to make a more detailed picture, which helps the doctor make a correct diagnosis.

What can a mammogram tell my doctor?

The radiologist will look at your X-rays for breast changes that do not look normal and for differences in each breast. He or she will compare your past mammograms. The doctor will also look for lumps and calcifications.

Image of mammogram
Lump or mass. The size, shape, and edges of a lump sometimes can give doctors information about whether or not it may be cancer. On a mammogram, a growth that is benign often looks smooth and round with a clear, defined edge. Breast cancer often has a jagged outline and an irregular shape.

Calcification. A calcification is a deposit of the mineral calcium in the breast tissue. Calcifications appear as small white spots on a mammogram. If calcifications are grouped together in a certain way, it may be a sign of cancer. Depending on how many calcium specks you have, how big they are, and what they look like, your doctor may suggest that you have other tests.

A mammogram can also identify dense breast tissue.

Mammograms can also identify dense breast tissue.
What does that mean?

Following your mammogram, the breast center may notify you that you have dense breasts. Breast tissue is made of fatty and connective tissue. Dense breasts have less fat and more connective tissue. When a woman has dense breasts, small cancers are harder to find on a mammogram.

If you have dense breasts:
Get a mammogram every year.
Know your family history of breast cancer.
Do monthly breast exams.
Follow recommendations for having a clinical breast exam every three years from age 20 to 40 and yearly after age 40.
Confirm your mammogram is done using digital mammography, which is the case at Sentara. Data suggests digital mammography is more effective for women with dense breasts.
Discuss lifestyle changes with your physician to decrease your risk for developing breast cancer.

How do I prepare for my exam?

Do not schedule your mammogram for the week before your period if your breasts are usually tender during this time because of breast compression during the exam. The best time for a mammogram is one week following your period. Always inform your doctor or X-ray technologist if there is any possibility that you are pregnant.

The American Cancer Society also recommends you:

Do not wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These can appear on the mammogram as calcium spots.

Describe any breast symptoms or problems to the technologist performing the exam.

If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam.

What if I have a breast implant?

If you have breast implants, be sure to tell your mammography facility when you schedule your exam. The technician and radiologist must be experienced in X-raying patients with breast implants. Implants can hide some breast tissue, making it harder for the radiologist to see a problem when looking at your mammogram. To see as much breast tissue as possible, the X-ray technician will gently lift the breast tissue slightly away from the implant and take extra pictures of the breasts.

How is the test performed?

During your mammography appointment, a specially qualified radiologic tech will position your breast in the mammography unit. Your breast will be placed on a special platform and compressed with a paddle (often made of clear Plexiglas or other plastic). The tech will gradually compress your breast.

Some women with sensitive breasts may experience discomfort. If this is the case, schedule the procedure when your breasts are least tender. Be sure to inform the technologist if pain occurs as compression is increased. If discomfort is significant, less compression will be used.

Breast compression is necessary to:

Even out the breast thickness so that all of the tissue can be visualize.
Spread out the tissue so small abnormalities are less likely to be obscured by overlying breast tissue.
Allow the use of a lower X-ray dose since a thinner amount of breast tissue is being imaged.
Hold the breast still in order to minimize blurring of the image caused by motion.
Reduce X-ray scatter to increase sharpness of picture.

You will be asked to change positions between images. The routine views are a top-to-bottom view and an angled side view. The process will be repeated for the other breast.

You must hold very still and may be asked to keep from breathing for a few seconds while the X-ray picture is taken to reduce the possibility of a blurred image.

The examination process should take about 30 minutes.

Are there risks?

Mammograms expose the breast to radiation. The risk of harm from this radiation exposure is slight, but repeated X-rays have the potential to cause cancer. The benefits, however, nearly always outweigh the risk. Women should talk with their health care providers about the need for each X-ray.

How will I find out the results?

While at your mammogram, ask when your results will be available. Do not assume the results are normal if you do not hear from your doctor or the mammography facility.

A radiologist will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with you.

If your results were normal, your breast tissue shows no signs of a mass or calcification. Visit your health care provider if you notice a breast change before your next appointment.

If your results were abnormal, a breast change was found. It may be benign (not cancer), premalignant (may become cancer), or cancer. Keep in mind that most breast changes are not cancer. But all changes need to be checked, and more tests may be needed.

Additional resources:

Sentara Breast Centers
Sentara Cancer Network
American Cancer Society
Breast Cancer Care at Sentara