What is a Mammogram?
A mammogram is a
safe, low-dose x-ray picture of the breast.
Mammograms are taken
during a mammography exam. There are two kinds of mammography: exams-screening
and diagnostic.
A screening mammogram
is a quick, easy way to detect breast cancer early, when treatment is
more effective and survival is high. Usually two x-ray pictures are
taken of each breast. A physician trained to read x-ray pictures-a radiologist-examines
them later.
It is generally
agreed that screening mammography decreases deaths from breast cancer
in women 50 and over. There is a range of opinion about the value of
screening mammography for women under 50.
Have a screening
mammogram as often as your doctor or other health care provider suggests.
A screening mammogram often can show breast changes like lumps long
before they can be felt.
A diagnostic mammogram
is used if there may be a problem. It is also used if it is hard to
get a good picture because of special circumstances (for instance, in
women with breast implants). Diagnostic mammography takes a little longer
than screening mammography because more x-ray pictures usually are taken.
A radiologist may check the x-ray pictures while you wait.
Purpose
of This Guide
This guide can
help you learn more about getting the best possible
mammogram. Being informed will help you work with members of your health
care team before, during, and after your mammogram to get quality,
reliable results.
Many types of health
care providers can help you with your breast care.
Doctors, nurses, nurse practitioners, and physician assistants can examine
your breasts, refer you for mammography when appropriate, and help you
get more exams if they are needed. In this guide, the word "doctor"
is used for easier reading, but any of these health care providers can
provide good care.
At the mammography
facility, the person who takes the x-ray pictures (the radiologic technologist),
the radiologist, and the people who keep the equipment in top working
order have all had special training in mammography. They work as a team
to make sure you get the best mammogram possible.
After your mammogram,
your doctor receives your mammography results.
Make sure you get your results from either your doctor or the mammography
facility.
Make sure you understand
the results and any recommendations for followup. And never be afraid
to ask questions.
Following the six
steps in this guide can help you maintain your breast health. Stay on
top of things every step of the way.
6 Steps to Breast Health
1. Get regular
exams.
This is the most
important way you can protect your breast health.
- Get a breast
exam from your doctor when you get your regular physical exam.
- Get a mammogram
as often as your doctor recommends. Ask your doctor when
to schedule your next mammogram.
- Check your breasts
each month. Your doctor can show you how.
These three exams
can help you and your doctor learn what is normal for
your breasts and what may be signs of problems.
Call your doctor
if you notice:
- A lump or thickening
of the breast.
- A discharge
from the nipple that stains your bra or bedclothes.
- Skin changes
in the breast.
These changes may
be normal, but you should always have them checked as
soon as possible.
2. Schedule
the mammogram for when your breasts will be least tender.
During mammography,
the breast is pressed between two clear plastic plates for a few seconds.
This gives a clear picture of the breast with the least amount of x-rays.
But it may be uncomfortable, and a few women complain of some pain.
If you have sensitive
breasts, try having your mammogram at a time of month when your breasts
will be least tender. Try to avoid the week right before your period.
This will help to lessen discomfort.
3. Give and get important information when you schedule the mammogram.
When you call for
an appointment, be ready to provide information the mammography facility
needs to know. The facility may wait until your appointment to ask some
questions, so it's a good idea also to take the
information with you when you have your mammogram. The information
requested may include:
- Your name, address,
and phone number.
- Your age.
- Name, address,
and phone number of any facility where you have had
a mammogram.
- Any breast disease
in your family.
- Any current
problems with your breasts, and how long you have had
the problems.
- Past problems
with your breasts, breast biopsies, or breast
surgeries.
- Whether you
have breast implants.
- Other personal
information:
-- Whether you are pregnant or nursing.
-- The timing of your menstrual cycle or when menopause began.
-- Anything that might make it harder to do a mammogram (unusually
large breasts or inability to stand, for example).
- Name, address,
and phone number of your doctor.
Here are some questions
for you to ask before your appointment:
- How and when
you will find out the results of the exam.
- What you need
to do to prepare for the exam.
If you have any
other questions before your mammogram, be sure to call
your doctor or the mammography facility.
4. Know what to expect.
Understanding what
happens during a mammogram will help reduce any
anxious feelings you might have. It is important to know that only a
small amount of radiation is used in mammography.
When you have a
mammogram, you stand in front of a special x-ray machine. The radiologic
technologist lifts each breast and places it on a platform that holds
the x-ray film. The platform can be raised or lowered to match your
height.
The breast is then
gradually pressed against the platform by a specially designed clear
plastic plate. Some pressure is needed for a few seconds to make sure
the x-rays show as much of the breast as possible.
This pressure is
not harmful to your breast. In fact, flattening the breast lowers the
x-ray dose needed.
Studies show that
most women do not find a mammogram painful for the short time needed
to take the picture. Try to relax. If the pressure becomes painful,
you can tell the radiologic technologist to stop.
If there is an area
of your breast that appears to have a problem, the
radiologist or radiologic technologist may examine the breast.
5. Come prepared.
- Wear a two-piece
outfit so you will have to remove only your top.
- Don't use deodorant,
talcum powder, or lotion under your arms or near the breasts that
day. These products can show up on the x-ray picture.
- Bring the name,
address, and phone number of your doctor or other
health care provider.
- Bring a list
of the places and dates of mammograms, biopsies, or other breast treatment
you have had before.
- Ask the facilities
where you had mammograms before to release them to you, and bring
them with you if possible. Your new mammogram can be compared with
the earlier ones to see if there have been any changes.
It also may be
helpful to:
- Bring a list
of any questions you may have about mammography and
your mammograms.
- If you think
you may have trouble hearing or understanding the
instructions, consider bringing a friend or family member to help
you.
- If you are worried
about discomfort, you may want to take a mild over-the-counter pain
reliever about an hour before your mammogram. This will not affect
the mammogram.
If there is something
you do not understand, ask. And keep asking until all your questions
are answered.
6. Follow up on your results.
Learning the results
of your mammogram is very important.
Chances are your
mammogram will be normal. But do not assume that your mammogram is normal
just because you have not received the results. If you have not received
your screening results within 10 days, ask your doctor or call the mammography
facility.
If your screening
mammogram shows anything unusual, talk to your doctor as soon as possible
about what you should do next. Your doctor may schedule a diagnostic
mammogram, or you can schedule it yourself-but have it done soon. Discuss
the results with your doctor.
When a diagnostic
mammogram shows something abnormal, the radiologist may recommend another
type of exam. A biopsy is a way to obtain a small piece of breast tissue
for study under a microscope. Sometimes a biopsy is needed because of
something your doctor found in checking your breast even though the
mammogram appears normal.
Whenever a mammogram
uncovers a problem or a need to check something further:
- Make sure you
understand what you need to do next.
- Always get results
of any test that you have.
- Ask questions
about your results if something is hard to understand.
If you do not have
a doctor or other health care provider, you will need to find one if
you have an abnormal mammogram. Ask the mammography facility to help
you find a doctor. Then make an appointment right away so you can discuss
your results and what should be done next.
Mammography is very
effective, but it does not detect all breast problems. If you find something
unusual in your breast, see your doctor.
You're in charge
of your breast health:
- Schedule screening
mammograms as often as your doctor recommends.
- Always find
out the results of your mammogram.
- Follow your
doctor's recommendations for follow-up and schedule diagnostic mammography,
if needed, as soon as possible.
- Have your doctor
check your breasts as part of your regular physical exam, and check
your breasts yourself each month.
- If you have
a breast lump or change at any time, even if your last mammogram was
normal, see a doctor as soon as possible.
How Can I Learn
More About Mammography?
Most mammography
facilities or Health Units have printed information and videotaped instructions
on breast care. You can read or watch them when you go for a mammogram.
For general information
on breast cancer and mammography, contact:
In
Canada:
The Canadian
Breast Cancer Society at 1-800-567-8767 or
The Canadian
Cancer Society Information
Service at
1-888-939-3333
In the United States:
The Cancer Information
Service (a service of the National Cancer Institute at 1-800-4-CANCER
or
The American Cancer Society at 1-.800-227-2345
Use something like this to keep a record of every time you go for a
mammogram: the date, the name and address of the facility, and its
telephone number.
Doctor or other
health care provider:
____________________________________
____________________________________
____________________________________
Date of mammogram:__________________
Facility:_____________________________
Address:____________________________
Phone:______________________________
Date of mammogram:__________________
Facility:_____________________________
Address:____________________________
Phone:______________________________
Date of mammogram:__________________
Facility:_____________________________
Address:____________________________
Phone:______________________________
The information
in this guide is based on the Clinical Practice Guideline, Quality Determinants
of Mammography. The Guideline was developed by a non-Federal panel of
experts sponsored by the Agency for Health Care Policy and Research.