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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Women's Health Mammography

Mammography

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A mammogram is an X-Ray of breasts to look for any abnormalities like breast lump or to find out the consistency if any such lump is present. Using mammography it is possible to diagnose a breast cancer in its early stages compared to self examination of breasts in which there is always a late diagnosis of the condition.

 

Early diagnosis is helpful as the treatment can be started before the disease spreads locally to lymph nodes. Mammographic is a highly sensitive method and if a tumor is present in a woman over the age of 50, it is very uncommon for that tumor not to be detected by mammography. Modern screening equipment emits an extremely low dose of radiation and the chances that a mammogram will cause a cancer to develop are therefore extremely small. The benefits in terms of the number of cancers detected far outweigh the small risks of mammography. Mammography is a good way of identifying abnormalities in the breast but they don't always show whether those abnormalities are benign /non-cancerous or malignant /cancerous. Further tests are sometimes necessary.

Indications

  • As part of screening programme when woman reaches the age of 50
  • Once in every three years above age of 65 years
  • Mammography is not indicated in women below 50 years of age as there are less chances of Breast cancer in young females and so is cost ineffective.
  • Mammography is less likely to detect breast cancer in young women because the breast tissue is denser, which can make breast cancer much more difficult to detect.
  • Only young women with family history of breast cancer are offered mammography

Benefits

  • Imaging of the breast improves a physician's ability to detect small tumors. When cancers are small, the woman has more treatment options and a cure is more likely.
  • The use of screening mammography increases the detection of small abnormal tissue growths confined to the milk ducts in the breast, called ductal carcinoma in situ. These early tumors cannot harm patients if they are removed at this stage and mammography is the only proven method to reliably detect these tumors.
  • It is also useful for detecting all types of breast cancer, including invasive ductal and invasive lobular cancer.
  • No radiation remains in a patient's body after an x-ray examination.
  • X-rays usually have no side effects.

Risks

  • There is always a slight chance of cancer from radiation. However, the benefit of an accurate diagnosis far outweighs the risk.
  • The effective radiation dose from a mammogram is about 0.7 mSv, which is about the same as the average person receives from background radiation in three months.
  • False Positive Mammograms
  • Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant

Limitations

  • Initial mammographic images themselves are not always enough to determine the existence of a benign or malignant disease with certainty.
  • Interpretations of mammograms can be difficult because a normal breast can appear differently for each woman. Also, the appearance of an image may be compromised if there is powder or salve on the breasts or if you have undergone breast surgery. Because some breast cancers are hard to visualize, a radiologist may want to compare the image to views from previous examinations.
  • Not all cancers of the breast can be seen on mammography.
  • Breast implants can also impede accurate mammogram readings because both silicone and saline implants are not transparent on x-rays and can block a clear view of the tissues behind them, especially if the implant has been placed in front of, rather than beneath, the chest muscles. But the NCI says that experienced technologists and radiologists know how to carefully compress the breasts to improve the view without rupturing the implant.
  • False positive cases