Mammogram Recommendations: Who To Listen To

Advances in detection and treatment method for breast cancer are welcome innovations. A lot of confusion still exists about what a mammogram is, what it is capable of doing, and what it does not do. This can add to the stress of the screening process.

What is a mammogram? And what is it not?

A mammogram is a type of X-ray that enables the radiologist and healthcare provider to look at the breast tissue and surrounding tissue. During the mammogram the breast is pressed between two plates located above and below the breast so that x-rays of all the tissue layers can be captured. The breast is then pressed again with two plates on either side so that the tissue layers can be looked at from the other direction. Looking at the breast from these two directions helps identify any overlapping structures and distinguish between what is abnormal and what is normal. After the images are captured they are reviewed by the provider. Once this has been done, the patient will be called with the results and any recommendations for followup.

There are two main types of mammography; screening and diagnostic. Screening mammography is for women who do not have any symptoms, while diagnostic mammography is for women with breast complaints or women who have had an abnormal screening mammogram.

The purpose of a screening mammogram is to decrease the mortality of breast cancer by detecting it early on. With a diagnostic mammogram a radiologist is always present, and the view-points obtained are designed to look at the specific abnormality or evaluate the specific symptoms. Abnormalities for both screening and diagnostic mammograms are typically followed up with ultrasound and/or biopsies in order to make a diagnosis.

Screening is not diagnosing

It is important that women who are going to get their screening mammogram understand that it is a screening tool. This means that it cannot be used to diagnose breast cancer. All that this does is identify and locate abnormalities in the tissue. Basically, it says “this is normal,” or “this is abnormal.” Depending on the results, your provider will decide what to do next. According to the provider reference Up To Date, there is no evidence that exposure to radiation after age 40 for the purpose of mammography is associated with heightened radiation risk.

If the results are normal and you and your provider have no other reason to believe that there may be an abnormality (i.e., neither of you has felt a lump or noticed breast changes, etc.), then you will likely not have further screening. It is important to note that there is a chance of getting false-negative results with mammography. This means that the results come back normal, when there is an abnormality present. The false-negative rate for mammography is 10-30 percent with higher rates being found in women with dense breast tissue. Additionally, up to 15 percent of breast cancers cannot be detected with mammography.

If the mammogram result is positive, or abnormal, your breast needs further evaluation. This usually means further imaging, whether in the form of repeat mammograms and/or ultrasounds, and biopsies to evaluate the abnormal tissue. Depending on the results, multiple biopsies may be necessary.

Read on to learn more about the current recommendations and confusion associated with mammograms.