A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. The results are recorded on x-ray film or directly into a computer for a doctor called a radiologist to examine.
A mammogram allows the doctor to have a closer look for changes in breast tissue that cannot be felt during a breast exam. It is used for women who have no breast complaints and for women who have breast symptoms, such as a change in the shape or size of a breast, a lump, nipple discharge, or pain. Breast changes occur in almost all women. In fact, most of these changes are not cancer and are called “benign,” but only a doctor can know for sure. Breast changes can also happen monthly, due to your menstrual period.
A high-quality mammogram plus a clinical breast exam, an exam done by your doctor, is the most effective way to detect breast cancer early. Finding breast cancer early greatly improves a woman’s chances for successful treatment.
Like any test, mammograms have both benefits and limitations. For example, some cancers can’t be found by a mammogram, but they may be found in a clinical breast exam.
Checking your own breasts for lumps or other changes is called a breast self-exam (BSE). Studies so far have not shown that BSE alone helps reduce the number of deaths from breast cancer. BSE should not take the place of routine clinical breast exams and mammograms.
If you choose to do BSE, remember that breast changes can occur because of pregnancy, aging, menopause, menstrual cycles, or from taking birth control pills or other hormones. It is normal for breasts to feel a little lumpy and uneven. Also, it is common for breasts to be swollen and tender right before or during a menstrual period. If you notice any unusual changes in your breasts, contact your doctor.
You stand in front of a special x-ray machine. The person who takes the x-rays, called a radiologic technician, places your breasts, one at a time, between an x-ray plate and a plastic plate. These plates are attached to the x-ray machine and compress the breasts to flatten them. This spreads the breast tissue out to obtain a clearer picture. You will feel pressure on your breast for a few seconds. It may cause you some discomfort; you might feel squeezed or pinched. This feeling only lasts for a few seconds, and 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 20 minutes from start to finish.
The National Cancer Institute recommends:
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.
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 with your most recent one to check for changes. The doctor will also look for lumps and calcifications.
There are two types:
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. Calcium in the diet does not create calcium deposits, or calcifications, in the breast.
If you have a screening test result that suggests cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor may ask about your personal and family medical history. You may have a physical exam. Your doctor also may order some of these tests:
Women with breast implants should also have mammograms. A woman who had an implant after breast cancer surgery in which the entire breast was removed (mastectomy) should ask her doctor whether she needs a mammogram of the reconstructed breast.
If you have breast implants, be sure to tell your mammography facility that you have them when you make your appointment. 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.
Although they are not perfect, mammograms are the best method to find breast changes that cannot be felt. If your mammogram shows a breast change, sometimes other tests are needed to better understand it. Even if the doctor sees something on the mammogram, it does not mean it is cancer.
As with any medical test, mammograms have limits. These limits include:
When breast cancer is detected early treatment is easier and more successful. For that reason, some experts recommend that women over 20 perform a monthly breast self exam to look for new lumps and other changes. The self exam does have limitations, however,and is not a substitute for regular breast examinations from your doctor and screening mammograms. If you do perform monthly exams, it’s best to do them 3-5 days after your period ends, when your breasts are the least tender and lumpy.
How to perform a self breast exam: First, lie on your back. Place your right hand behind your head. With the middle fingers of your left hand, gently yet firmly press down using small motions to examine the entire right breast. Then, while sitting or standing, examine your armpit, an important area that is commonly overlooked. Breast tissue extends to this area, so it is important that it be included in every breast exam. Gently squeeze the nipple, checking for discharge. Repeat the process on the left breast.
Although some women find it easiest to do the exam in the shower when the skin is soft and wet, you are more likely to examine all of the breast tissue if you are lying down. Next, stand in front of a mirror with your arms by your side. Look at your breasts directly, as well as in the mirror. Search for changes in skin texture, such as dimpling, puckering, indentations, and skin with an “orange peel-like texture”. Look for changes in shape, contour, and inversion of the nipples. Finally, perform the exam again, this time with your arms raised above your head.
Immediately discuss any changes you find with your doctor. Most women have some naturally occurring lumps in their breasts, but it’s important that you become familiar with the way your breasts normally feel, so you can be aware of any new changes. Though the American Cancer Society considers self examinations to be optional, it’s a good idea to talk to your health care provider about what is right for you.
While it’s true that the risk of breast cancer increases as you grow older, breast cancer can occur at any age. From birth to age 39, one woman in 231 will get breast cancer (<0.5% risk); from age 40-59, the risk is one in 25 (4% risk) and from age 60-79, the risk is one in 15 (nearly 7%). If a woman were to live to age 90, her risk of getting breast cancer over the course of her entire lifetime is one in 7, with an overall lifetime risk of 14.3%.
Getting breast cancer is never a certainty even if you have one of the stronger risk factors, like a breast cancer gene abnormality. Of women with a BRCA1 or BRCA2 inherited genetic abnormality, 40-80% will develop breast cancer over their lifetime and 20-60% won’t. All other risk factors are associated with a much lower probability of being diagnosed with breast cancer.
Every woman has some risk of breast cancer, in fact increasing age is the biggest single risk factor for getting the disease. About 80% of women who get breast cancer have no known family history of the disease. If you do have a family history of breast cancer and are concerned, discuss it with your physician or a genetic counselor. You may be worrying needlessly.
A history of breast cancer in both your mother’s and your father’s family will influence your risk equally. That’s because half of your genes come from your mother, half from your father. However, a man with a breast cancer gene abnormality is less likely to develop breast cancer than a woman with a similar gene. So, if you want to learn more about your father’s family history, you have to look mainly at the women on your father’s side.
There is no evidence that the active ingredient in antiperspirants influences breast cancer risk. The supposed link between breast cancer and antiperspirants is based on misinformation about anatomy and a misunderstanding of breast cancer.
Modern day birth control pills contain a low dose of the hormones estrogen and progesterone. Many research studies show no association between birth control pills and an increased risk of breast cancer. However, one study that combined the results of many different studies did show an association between birth control pills and a very small increase in risk. The study also showed that this slight increase in risk decreased over time. So after 10 years, birth control pills were not associated with an increase in risk. Birth control pills also have benefits, such as decreasing ovarian and endometrial cancer risk; relieving menstrual disorders, pelvic inflammatory disease, and ovarian cysts; and improving bone mineral density As with any medicine, you have to weigh the risks and benefits and decide what is best for you.
Women with breast implants should also have mammograms. A woman who had an implant after breast cancer surgery in which the entire breast was removed (mastectomy) should ask her doctor whether she needs a mammogram of the reconstructed breast.
If you have breast implants, be sure to tell your mammography facility that you have them when you make your appointment. 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.
Thus far, studies have not been able to demonstrate a clear connection between eating high-fat foods and a higher risk of breast cancer, though the issue is still being investigated. Regardless, avoidance of high-fat foods is a healthy choice for a multitude of reasons: to lower “bad” cholesterol (low-density lipoproteins), increase “good” cholesterol (high-density lipoproteins), to make more room in your diet for healthier foods, and to help you control your weight. And excess body weight is a risk factor for breast cancer because the extra fat increases the production of estrogen outside the ovaries and adds to the overall level of estrogen in the body. If you are already overweight, or have a tendency to gain weight easily, avoiding high-fat foods is strongly advised.
Digital mammography or high quality film-screen mammography is the most reliable way to find breast cancer as early as possible, when it is most curable. By the time a breast cancer can be felt, it is usually larger than the average size of a cancer first found on mammography. However, breast examinations by you and your health care provider are still very important. About 25% of breast cancers are found only on breast examination (not on the mammogram), about 35% are found on mammography alone, and 40% are found by both physical exam and mammography. It makes good breast health sense to keep all your bases covered.
Every woman has some risk of breast cancer, in fact increasing age is the biggest single risk factor for getting the disease. About 80% of women who get breast cancer have no known family history of the disease. If you do have a family history of breast cancer and are concerned, discuss it with your physician or a genetic counselor. You may be worrying needlessly.
While it’s true that the risk of breast cancer increases as you grow older, breast cancer can occur at any age. From birth to age 39, one woman in 231 will get breast cancer (<0.5% risk); from age 40-59, the risk is one in 25 (4% risk) and from age 60-79, the risk is one in 15 (nearly 7%). If a woman were to live to age 90, her risk of getting breast cancer over the course of her entire lifetime is one in 7, with an overall lifetime risk of 14.3%.
Getting breast cancer is never a certainty even if you have one of the stronger risk factors, like a breast cancer gene abnormality. Of women with a BRCA1 or BRCA2 inherited genetic abnormality, 40-80% will develop breast cancer over their lifetime and 20-60% won’t. All other risk factors are associated with a much lower probability of being diagnosed with breast cancer.
Every woman has some risk of breast cancer, in fact increasing age is the biggest single risk factor for getting the disease. About 80% of women who get breast cancer have no known family history of the disease. If you do have a family history of breast cancer and are concerned, discuss it with your physician or a genetic counselor. You may be worrying needlessly.
A history of breast cancer in both your mother’s and your father’s family will influence your risk equally. That’s because half of your genes come from your mother, half from your father. However, a man with a breast cancer gene abnormality is less likely to develop breast cancer than a woman with a similar gene. So, if you want to learn more about your father’s family history, you have to look mainly at the women on your father’s side.
There is no evidence that the active ingredient in antiperspirants influences breast cancer risk. The supposed link between breast cancer and antiperspirants is based on misinformation about anatomy and a misunderstanding of breast cancer.
Modern day birth control pills contain a low dose of the hormones estrogen and progesterone. Many research studies show no association between birth control pills and an increased risk of breast cancer. However, one study that combined the results of many different studies did show an association between birth control pills and a very small increase in risk. The study also showed that this slight increase in risk decreased over time. So after 10 years, birth control pills were not associated with an increase in risk. Birth control pills also have benefits, such as decreasing ovarian and endometrial cancer risk; relieving menstrual disorders, pelvic inflammatory disease, and ovarian cysts; and improving bone mineral density As with any medicine, you have to weigh the risks and benefits and decide what is best for you.
Women with breast implants should also have mammograms. A woman who had an implant after breast cancer surgery in which the entire breast was removed (mastectomy) should ask her doctor whether she needs a mammogram of the reconstructed breast.
If you have breast implants, be sure to tell your mammography facility that you have them when you make your appointment. 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.
Thus far, studies have not been able to demonstrate a clear connection between eating high-fat foods and a higher risk of breast cancer, though the issue is still being investigated. Regardless, avoidance of high-fat foods is a healthy choice for a multitude of reasons: to lower “bad” cholesterol (low-density lipoproteins), increase “good” cholesterol (high-density lipoproteins), to make more room in your diet for healthier foods, and to help you control your weight. And excess body weight is a risk factor for breast cancer because the extra fat increases the production of estrogen outside the ovaries and adds to the overall level of estrogen in the body. If you are already overweight, or have a tendency to gain weight easily, avoiding high-fat foods is strongly advised.
Digital mammography or high quality film-screen mammography is the most reliable way to find breast cancer as early as possible, when it is most curable. By the time a breast cancer can be felt, it is usually larger than the average size of a cancer first found on mammography. However, breast examinations by you and your health care provider are still very important. About 25% of breast cancers are found only on breast examination (not on the mammogram), about 35% are found on mammography alone, and 40% are found by both physical exam and mammography. It makes good breast health sense to keep all your bases covered.
Every woman has some risk of breast cancer, in fact increasing age is the biggest single risk factor for getting the disease. About 80% of women who get breast cancer have no known family history of the disease. If you do have a family history of breast cancer and are concerned, discuss it with your physician or a genetic counselor. You may be worrying needlessly.
